Eye cancer tests

A doctor who specialises in diseases of the eye (an ophthalmologist) will examine your eyes to start with. If your ophthalmologist suspects you have an eye melanoma, they will refer you to a specialist centre for eye cancer. These are called ocular oncology centres. There are 4 in the UK, based in London, Sheffield, Glasgow and Liverpool. To diagnose melanoma of the eye you may have

• An eye examination
• Ultrasound
• Angiogram
• Testing genetic information in the cells
• Other tests

Eye examination

The ophthalmologist will examine your eyes with a number of different instruments. They will look at the different structures of your eye to check for abnormalities. They may put drops in your eyes which will temporarily affect your vision, so you shouldn't drive yourself home.

Ultrasound scan

You will usually have an ultrasound of your eye. First, you’ll have a local anaesthetic put on to the surface of your eye. Then the doctor will move a small probe over your eye’s surface to help find out more about the tumour, including its size. This might be a little uncomfortable, but should not be painful.

Angiogram

Your doctor may take pictures of a suspected cancer with a special camera. This test is called a fluorescein angiogram. This means looking at blood vessels using a type of dye. You have an injection of the dye (called fluorescein) into your arm. The dye travels through your bloodstream to the blood vessels of the eye. The camera shows up the dye on photographs, which helps the doctor to find out more about the nature of any tumour.

Testing genetic information in the cells

If you have an ocular melanoma your surgeon may ask a pathologist to examine the biopsy sample or tumour for abnormalities of the chromosomes in the tumour cells. This is known as cytogenetic testing and it may help to show the stage of the melanoma.

Other tests

You may have blood tests to check your general health and see how well your liver and kidneys are working. Melanoma of the eye can spread to the liver. So you are likely to have an ultrasound scan of their liver to check for any cancer spread.

To diagnose lymphoma of the eye you may have

• An eye examination
• Ultrasound or MRI scan
• A biopsy of the eye (vitreous biopsy)
• Lumbar puncture
• Bone marrow test

An eye examination

A doctor who specialises in diseases of the eye (an ophthalmologist) will examine your eyes to start with. An eye examination means your doctor will look at the jelly like substance (vitreous fluid) that fills most of the inside of your eye to see if it is cloudy. Unlike melanoma of the eye, an eye examination will not give your doctor enough information to make a diagnosis of lymphoma of the eye.

Scans

Your specialist may want you to have an ultrasound scan or an MRI scan. These scans can help to show the size of a tumour and whether there are any enlarged lymph nodes around the eye that may contain cancer cells.

A biopsy of the eye

This sounds quite frightening. But this is a quick and simple test for an experienced eye specialist. Your eye specialist will use a fine needle to remove a sample of the vitreous fluid from inside your eye. They send the sample to the lab, where a pathologist examines it to see if there are any lymphoma cells. You can have this test under a local or general anaesthetic.

Lumbar puncture

Your doctor may suggest that you have a lumbar puncture. In this test, the doctor puts a thin needle into your back and removes a sample of the fluid that circulates around your brain and spinal cord (the cerebrospinal fluid or CSF). Your doctor may suggest this test to check whether any cancer cells have spread to the brain.

If the cancer has spread to the brain, there will be cancer cells in this fluid. There is information about having a lumbar puncture in CancerHelp UK’s section about cancer tests.

Bone marrow examination

Your doctor might want you to have a bone marrow test to check for any lymphoma spread to your bone marrow. There is detailed information about what a bone marrow test involves in the cancer tests section of CancerHelp UK.

After your tests for eye cancer you may need to wait for a time to get the test results. Understandably, this is a very anxious time for most people.

While you are waiting for results it may help to talk to a close friend or relative about how you are feeling. Or you may want to contact a cancer support group to talk to someone who has been through the same experiences.

Look at the eye cancer organisations page for organisations that can put you in touch with a support group. There are also details of organisations who can tell you more about counselling and help you to find sources of emotional support and counselling in your area.