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Eye Cancer – Ocular Melanoma

St. Erik Eye Hospital specializes in diagnosing and treating retinoblastoma (eye cancer in children) and ocular melanoma. We are responsible for Sweden's national ophthalmic oncology and ophthalmic pathology service and provide the only ophthalmic pathology laboratory in Sweden.

Eye cancer is a tumor of the eye that can occur both on the eye's surface and in the eyelids. The most common form of cancer in adults is called ocular melanoma, which is more likely to affect older people around 50 years old. But it can also occur in younger people. In most cases, patients with eye cancer have a good prognosis where neither the disease nor the treatment affects vision.

The causes of eye melanoma are not well-known, but some probably start from birthmarks on the bottom of the eye. Hereditary ocular melanoma has been described in a few isolated families, but most cases occur sporadically with no known heredity. 

St. Erik Eye Hospital specializes in diagnosing and treating retinoblastoma (eye cancer in children) and ocular melanoma.  

Ocular melanoma can cause symptoms such as flashes of light or a reduction in the field of vision. In many cases, the patient has no signs of symptoms, and the tumor is discovered during a routine examination.

In the case of suspected ocular melanoma, the ophthalmologist thoroughly examines the eye and fundus to make a diagnosis. We check:

  • Different parts of the eye (enlarged)
  • The inside of the eye, including the retina and optic nerve. 
     

To establish the diagnosis, the examination is supplemented with an ultrasound. During the examination, the following are checked:

  • The size of the tumor
  • The tissue structure of the tumor 
  • If the cancer has spread 

All treatment for ocular melanoma aims to slow down the course of the disease. The treatment can be radiation therapy or surgical treatment. The preferred treatment depends on the size of the tumor; if it is large or located in a place where it cannot be treated with radiation, surgical intervention is recommended.

Radiation therapy with radiation plaque 

The most common procedure is radiation, which is sometimes supplemented with laser treatment. The aim of radiation therapy is to shrink the tumor.  

To be able to radiate, we attach a plaque to the eye. The attachment is performed during surgery while the patient is sedated. The plaque contains a radioactive substance (ruthenium 106 or iodine 125), and is in place on the eye for a few days or weeks. The time can vary depending on the tumor's thickness and the plaque's activity in order for a determined dose of radiation to reach the entire tumor. The removal of the plaque is carried out during a new surgery, which is also performed while the patient is under anesthesia.  

Evisceration – removing an eye 

Sometimes an eye may need to be surgically removed. The operation, called evisceration, is performed while the patient is under anesthesia.  

To fill in the patient’s eye socket after the eye has been removed, we insert an implant. The implant cannot be seen, and it cannot be felt either. Immediately after the surgery, the patient receives a bandage over the eyelid that needs to remain on for about 24 hours. After that, the eyelid is closed, and it looks like the patient has a closed eye.

A visionary eye hospital offering highly advanced ophthalmology care.