Ocular Surface Tumors
Tumors that occur on the surface of the eye fall into several categories. Two of the most important types of ocular surface tumors are squamous cell tumors and conjunctival melanomas.
Squamous cell tumors are much more common than conjunctival melanomas. They usually arise in the area of the eye surface that is not covered by the eyelids and result from sun damage.
Conjunctival melanomas are usually brown in color, although occasionally they have no color to them. They are uncommon tumors, with only about 50 new cases in the USA each year. We do not know what causes conjunctival melanomas. About three-quarters of newly discovered melanomas come from areas of flat pigment on the surface of the eye (primary acquired melanosis). The remainder comes from a pre-existing “freckle” (conjunctival nevus).
An experienced tumor surgeon can often tell the difference between a squamous cell tumor and a conjunctival melanoma by the way the tumor looks, but to be completely sure of the diagnosis, the lesion must be removed and examined by a pathologist. A consultation visit with a tumor specialist will involve an examination of the entire surface of the eye (as well as an examination of the rest of the eye). Photographs are usually taken to document the extent of the tumor. Special studies, such as an ultrasound (pictures generated using sound waves), may also be performed. A diagnosis of eye surface cancer can be frightening, but specialists at Massachusetts Eye and Ear have years of experience in successfully treating these tumors and guiding patients through the process.
Treatment for ocular surface tumors consists of surgical removal of the lesion (in an operating room) with freezing treatment (cryotherapy) to the surrounding tissues. This procedure is usually done under local anesthesia (an injection of numbing medicine around the eye) and usually takes less than one hour. After the surgery, the eye surface will be red and the eye may be a bit sore. Medicated drops or ointments are given after the surgery to encourage healing. Once the eye has healed from surgery, chemotherapy drops may be given to reduce the risk of recurrence of the tumor. Regular follow-up visits with your tumor surgeon are important to determine if the tumor has recurred.
If you have been diagnosed with an ocular surface tumor, your ophthalmologist may wish to refer you to Dr. Han-Ying Peggy Chan, who is the Mass. Eye and Ear specialist in this area. Dr. Chang's office can be reached at 617-573-6915.