Eye Cancer

Diagnosis

Diagnosis of eye cancer can be made through the following tests:

• Eye examination: Ocular examinations are the first step in diagnosing eye cancer. The patients experiencing ocular symptoms visit the clinic for evaluation. The ophthalmologist performs comprehensive ocular examinations by using certain specialized instruments. Some of the methods for eye examinations are:
  Direct ophthalmoscope: Ophthalmoscope is an instrument that uses multiple lenses and a source of light. It assists ophthalmologists in visualizing the ocular structures present at the back of the eye, such as the retina.
  Indirect ophthalmoscope: If the ophthalmologist has no clear view of the internal eye structures with the direct ophthalmoscope or if there is a need for a detailed and clearer view, a slit lamp or indirect ophthalmoscope may be used. These techniques use strong magnifying glasses along with a source of light. While the slit lamp sits on the platform in front of the patients, an indirect ophthalmoscope requires the patients to recline a bit during the examination.
  Gonioscopy: This test is generally used for the diagnosis of glaucoma. However, it also has an application in diagnosing eye tumor growth. Gonioscopy uses gonioscopy lenses that are placed on the cornea. The procedure is performed after instilling the eye drops that numb the eyes to avoid discomfort.
• Ultrasound: Ultrasound is one of the most common methods for diagnosing ocular melanomas. During this test, an instrument is placed against the eyeball or eyelid. The sound waves that echo from the eyes are then transformed into images on the screen. In some cases, ultrasound may be the only test performed to confirm the presence of eye melanomas. This technique detects the size and location of the tumor. If the patient is already diagnosed with eye melanoma, the oncologist recommends an abdominal ultrasound to check the spread of cancer in the liver, as the liver is a common organ for eye cancer metastasis. The patients may also undergo ultrasound biomicroscopy involving high-energy sound waves to develop detailed eye images.
• Optical coherence tomography: This technique is used to obtain retina and uveal tract images. The involved technology is similar to ultrasound, with the difference that optical coherence tomography uses a light source instead of sound waves for creating images.
• Fluorescein angiography: This test involves using dye to look for the health of blood vessels in the eye. The oncologists inject an orange fluorescent dye into the arm vein during this test. A special light that glows the dye is then used to take images of the back of the eye. Although this test may not directly diagnose melanoma, it rules out the presence of ocular conditions.
• CT scan: CT scan is performed to determine if the eye cancer has spread to the other nearby structures outside the eyes. It also provides information about the spread of cancer to distant organs, such as the liver.
• MRI: MRI uses strong magnets and radio waves to create detailed images of eye tumors. It also provides images of the organs suspected of having cancer metastasis.
• Blood tests: Blood tests do not diagnose eye cancer but provide detailed information about the overall health of the patients. Further, blood tests provide functional liver health that may help rule out the spread of cancer to the liver. Patients may undergo blood tests before and during the cancer treatment.
• Chest x-ray: Chest x-ray is performed in patients diagnosed with eye cancer to rule out cancer metastasis in chest organs, including lungs.
• Biopsy: Biopsy is not usually needed for diagnosing ocular melanoma as imaging tests, and ocular examinations are enough in most cases to diagnose eye cancer. In some cases, patients may undergo a biopsy to determine the type of mutation that may assist in selecting targeted therapy for treatment. Several types of biopsies, such as fine needle biopsy or incisional biopsy, are available, and the choice depends upon the location of abnormal tissues.