Ocular Oncology

The management of ocular tumours in the UK is a nationally funded specialist service with four centres providing treatment for intraocular and conjunctival melanoma (London, Liverpool, Sheffield and Glasgow) and two centres providing treatment for retinoblastoma (London and Birmingham).

Until the 1970’s the options for treatment other than removal of the eye were very limited, but research has yielded a great deal of information about the behaviour of these tumours which has allowed the development of protocols for treatment which reflect the size, location and histological type as well as the needs and wishes of the patient.

A number of therapeutic modalities which conserve the eye and vision are now available, including various forms of radiotherapy, photo therapy, surgical resection and chemotherapy. Many eyes that would have been removed in the past are now preserved. With advances in clinical staging, histogical grading of malignancy and genetic typing it is now possible to counsel patients and their relatives about prognosis much more accurately than in the past.

As ocular oncology is a highly specialised field of ophthalmology, there is active international collaboration between ocular oncologists.   Ocular oncology is a multidisciplinary service which includes general oncologists, paediatric oncologists, specialist nurses, clinical scientists and many others.

The most common malignancies include uveal and conjunctival melanoma, uveal metastasis, intraocular and conjunctival lymphoma and conjunctival carcinoma. As well as the management of confirmed malignant tumours, ocular oncologists receive a large number of referrals of patients with suspected malignant tumours. Diagnosisis based on biomicroscopy, ultrasonography, angiography, optical coherence tomography, autofluorescence imaging and biopsy. The most common benign tumors include naevi, chorodal haemangiomas. vasoproliferative tumours, and retinal haemangioblastomas. Many of these lesions require treatment and/or long-term surveillance.

Eyelid and orbital tumours are more likely to be managed within oculoplastic or orbital specialist services.