Although relatively rare, ocular neoplasms pose a significant threat to visual acuity and overall mortality. Because its early features may resemble those of more common ocular disorders, distinguishing malignant disease from benign eye conditions is critical. Timely recognition and referral significantly influence outcomes.
Clinical features suggestive of eye cancer
Eye cancers may present with subtle or obvious signs depending on the site and type of tumour. Patients may notice an unusual growth or pigmented lesion on the eye, visible changes in the iris or pupil, or distortion of the normal eye structure.
Certain tumours, such as retinoblastoma in children, may cause a white reflex in the pupil, known as leucocoria, which is a serious and vision-threatening sign.
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Optical side effects can include blurred vision, progressive peripheral field defects, and floaters and photopsia. In some cases, the unilateral protrusion or protrusion of an eye can indicate the occurrence of an orbital neoplasm. Repeat eyelid edema, non-resolving ulceration, and excavated lesions with erythema or bleeding should be of concern due to malignancy of epidermal or sebaceous glands of the eyelid. Although not mandatory, pain and erythema can occur, especially with the progression of the disease.
Features of common non-malignant eye conditions
Most eye complaints encountered in clinical practice are benign. Conjunctivitis is typically presented as ocular redness, irritation, and discharge and normally responds well to the correct use of topical ocular lubricants, without any structural changes or general loss of visual acuity.
Cataracts lead to gradual clouding of vision, glare, and difficulty with night vision; importantly, vision loss from cataracts is reversible with surgery.
Glaucoma is a disease that normally causes a slow progressive loss in the peripheral visual fields with increased intraocular pressure, but does not result in any ocular lesions.
Dry eye disease is marked by eye discomfort, which is expressed in the cases of burning, reddishness, and gritty feeling, and these symptoms are often relieved by the use of lubricating eye preparations.
Key points of differentiation
A defining feature of eye cancer is the presence of visible growths or structural changes, which are not characteristic of common eye conditions. Sudden or severe visual deterioration is more concerning for malignant or serious pathology, whereas gradual changes are more typical of cataracts or glaucoma. Another important distinction is that symptoms of eye cancer do not improve with routine over-the-counter treatments.
Any chronic or unaccounted eye symptom requires official assessment by an ophthalmologist. The red flags include a rapidly worsening vision, proptosis, the growth of pigmented lesions, and non-healing adnexal masses; even minor changes are to be taken into consideration.
Diagnostic work-up can include a complete ophthalmic examination, and imaging like ultrasonography, and, in a clinically appropriate situation, a tissue biopsy.
Early diagnosis helps to administer timely treatment therapy, maximize the visual performance, and may be life-saving.
(Dr Aditi Singh is a Sr. Consultant Ophthalmologist, Dr Agarwals Eye Hospital, Mangalore)
The opinions expressed in this article are those of the author and do not purport to reflect the opinions or views of THE WEEK.
