When you think of cancer, most of us do not think about the eye or vision. Though rare, cancer can start inside or outside of the eye. If cancer starts inside the eyeball it’s called intraocular and if it starts outside the eye (eyelid or in the eye socket) then it’s called extraocular tumor. It can occur in both children and adults. Most major eye centers have specialists who are trained in the diagnosis and treatment of eye cancers.
Here are a few types of cancer in eye:
- Eye Cancer in Children: The most common cancer seen in the eye of children is retinoblastoma. This occurs in children at very early age so these are the youngest cancer patients. This cancer starts inside the eye and affects the retinal cells. This is a cancer that presents very quietly, the child has no pain, no complaints and plays happily without any problem until one day parents notice that the pupil of the eye has some abnormal ‘White Glow’ (leukocoria) rather than the usual ‘red-eye’ reflection seen in a photo—that can be the first sign of retinoblastoma. So, it requires prompt evaluation by an ophthalmologist. Retinoblastoma is a curable cancer but if it is not treated on time, it can grow quickly and fill the eyeball. It can lead to loss of vision and life-threatening problems.
At the later stage of this cancer, the only one way to survive is to remove the eyeball (enucleation). Like many of other types of cancer, retinoblastoma has a genetic component so genetic testing needs to be done. The tumor begins with the RB1 gene mutation that stimulates retinal cells to develop into a tumor called a retinoblastoma. The RB1 mutation can be inherited from the parents, but in some cases it is sporadic and not inherited. There are various treatments such as surgery, chemotherapy, radiotherapy etc. to cure retinoblastoma cancer. Rarely it can spread beyond the eye.
- Eye Cancer in Adults: The development of a tumor in the back of the eye in adults can be from a metastatic cancer from elsewhere in the body or can arise in the eye itself. The most common primary eye cancer is called uveal melanoma and is a cluster of rapidly growing cells underneath the retina, which can lead to vision loss. The tumor can also appear as a dark black spot on the iris. Ideally the uveal melanoma can be treated when the tumor is still only in the eye.However, unfortunately, in approximately 50% of patients the uveal melanoma spreads (metastasis) to other part of the body, making it the most dangerous eye cancer in adults. Depending upon its location the uveal melanoma may not cause early symptoms but the patient may experience blurred vision or large numbers of floaters. The uveal melanoma can be diagnosed only when an ophthalmologist or eye care specialist examines your eye.
What is the main cause of uveal melanoma? How it starts, grow and spread? These questions are still unanswered. The risk of this cancer increases in persons having fair skin (white), light eye color and inability to tan. There are certain changes in the genes linked to uveal melanoma. Currently the most common are GNAQ and BAP-1 gene mutations that are associated with greater risk of metastasis, where it spreads to other parts of the body. The standard treatment of this tumor is fine-needle aspiration biopsy (FNAB), brachytherapy (radioactive material inside a small capsule placed next to the tumor), radiation therapy and possibly enucleation.
- Metastasis to Eye: Finally, the other types of cancers found in the eyes are because of the spreading of a primary cancer (from a distant site such as the breast, lung or liver) to the eye. Sometimes an eye exam can identify a metastatic tumor before the primary tumor is recognized elsewhere in the body. Examples of cancers that spread to the eye are breast cancer in women and lung cancer in men. Less commonly, the prostate, kidney, gastrointestinal and blood cancers (leukemia and lymphomas) can spread to the eye. Treatment depends on the type of cancer involved.
- Eye Damage from Chemotherapy: Eye problems can also develop through the side effects of chemotherapy or hormone therapies given for tumors outside the eye. When a person has any type of cancer, they often must undergo treatments with chemotherapeutic drugs. A commonly used cancer drug is called cisplatin. When treated with cisplatin, there can be damage to the retinal pigment epithelial cells in the inner part of the retina. Hemorrhages or bleeding can occur within the retina itself and vision can decrease temporarily. If a person is undergoing cancer treatments, it is a good idea to have their eyes checked, especially if they are having any vision problems. The chemotherapy does not actually cause cancers but only side effects.
Therefore, if you are having any decreased vision, it is always makes sense to have a good eye examination to identify any problems at early stage.
Good nutrition is important to keep your eyes healthy. Researchers have linked two very important eye nutrients that play a key role in healthy vision. Lutein (LOO-teen) and Zeaxanthin (zee-ah-ZAN-thin), both are potent antioxidants and are best known for protecting your eyes and may reduce your risk for 
Diets rich in these two nutrients may help hold off age-related eye diseases. The best natural food sources of lutein and zeaxanthin are green leafy vegetables and other green or yellow vegetables. Among these, cooked kale and cooked spinach top the list.
Tom Sullivan
The other day my daughter Blythe asked me which Christmas I consider to be my favorite. I had to think a minute, because as a family, the Sullivan’s have had some great ones. I was about to say the first time you and your brother Tom were old enough to really get into Santa, being absolutely sure that the fat man brought your presents right down the chimney. I was about to say that, and then I remembered. 
Colorado, when our children were teenagers and our friend, the marvelous Betty White, joined us for a Christmas Eve sleigh ride none of us will ever forget. The night was perfect. It had snowed earlier that day, and the air had a feeling of Christmas that you could almost taste. Oh, sure, it was cold, but we were bundled up under tons of blankets as two beautiful Clydesdale horses with bells jingling took us through the woods to a magical barn where dinner would be served and carols sung. 
Tom Sullivan
Today, people are living longer than ever before so it’s important to be proactive and take responsibility for your health as you age. 
Maintain a healthy weight. Being overweight increases your risk for diabetes. By exercising regularly, you can help keep your body healthy and prevent vision loss. 
Don’t smoke. Smoking increases your risk for age-related macular degeneration, cataract, and other eye diseases and conditions that can damage the optic nerve.
Wear protective eyewear when outdoors. Protecting your eyes from the sun’s ultraviolet rays when you are outdoors is vital for your eye health. Wearing sunglasses that block 99 to 100 percent of both UV-A and UV-B radiation.
Know your family history. Talk to your family members about their eye health history. It’s important to know if anyone has been diagnosed with a disease or condition since many are hereditary, such as glaucoma, macular degeneration, and diabetes . This will help determine if you are at higher risk for developing an eye disease or condition.
Consider a multivitamin. Vitamins C, E and the mineral zinc have been shown to promote eye health. Vitamins with Lutein and Zeaxanthin have been known to help patients with moderate to severe age-related macular degeneration.
Give your eyes a rest. If you spend a lot of time at the computer or focusing at any one distance, you sometimes forget to blink, resulting in dryness and eye fatigue. Every 20 minutes, look away about 20 feet in front of you for 20 seconds. This can help reduce eyestrain. Consider using a lubricant eye drop during long periods of intense eye use and rest your eyes for 5 minutes.
Be sure to start your holiday meal with a salad, it’s an excellent way to ensure that you and your guests get plenty of zeaxanthin and lutein, two nutrients that help protect your central vision. Adding kale, spinach, or romaine lettuce to salads helps your eyes absorb damaging blue light, combats the effects of cigarette smoke and pollution, and also decreases your risk of developing 
Turkey and lean beef, two of the main ingredients in many holiday meals, keep your eyes strong and healthy. Both foods are high in zinc, a nutrient important to the retina and the choroid layer under the retina. 
Zinc is essential for good night vision. Eating foods that are high in the nutrient can also reduce your risk of cataracts and AMD. Other foods that contain zinc include pork, dairy products, chick peas, black-eyed peas, crab, oysters, beans, spinach, mushrooms, cashews, and almonds. 
It wasn’t an old wives tale, it is true Carrots are good for your eyes! They contain beta carotene, a substance that turns into vitamin A when eaten. Eating carrots can benefit your night vision and could possibly reduce your risk of cataracts, AMD, and dry eyes. Other foods that contain beta carotene include pumpkin, sweet potatoes, and butternut squash. All great ingredients to include into your holiday feast. 
Fish contain omega-3 fatty acids, which can reduce your risk of developing AMD, dry eye, and glaucoma. Salmon, mackerel, flounder, tuna, halibut, herring, and sardines would be a great addition to your holiday meals.
Whole grains reduce your risk of heart disease, obesity, and type 2 diabetes and can also decrease your risk of AMD. Substituting whole grain flour for white flour in holiday breads and muffins is a simple way to boost your whole grain intake. Other good whole grain sources include wild rice, brown rice, popcorn, oatmeal, bulgur, barley, buckwheat, and couscous. 
Fruits high in vitamin C, such as strawberries and oranges, also offer important vision benefits. Vitamin C is an antioxidant, a substance that can prevent cell damage caused by free radicals. Vitamin C-rich foods help keep the collagen in your cornea healthy and reduce the risk of cataracts and AMD. You can also find vitamin C in grapefruit, kiwi, blueberries, peas, broccoli, and tomatoes.
The National Eye Institute has recommended that people who are high-risk for developing AMD eat diets rich in green leafy vegetables, whole fruits, any type of nuts and omega 3 fatty acids. Many of these foods have anti-oxidant properties that help to “turn off” genes involved with inflammation, an important factor of retinal diseases. Salmon, mackerel and sardines have the highest levels of omega-3 fatty acids. An analysis that combined the data from 9 different studies showed that fish intake at least twice a week was associated with reduced risk of early and late AMD. Other studies show that Omega-3 fatty acids improve mitochondrial function, decreases production of reactive oxygen species (free radicals that damage cells) and leads to less fat accumulation in the body. The green leafy vegetables contain important protective macular pigments (carotenoids) called lutein and zeaxanthin that reduce the risk of AMD by 43%. High levels of lipid or fat deposits in the body (obesity) can “soak-up” the lutein and zeaxanthin so that they are not available to protect the retina.