Yes, eye cancer exists. It’s uncommon, but cancers can start inside the eye or spread there from other parts of the body. The most common type in adults, uveal melanoma, occurs at a rate of about 5 cases per million people per year, making it rare compared to skin or lung cancer but still a real and well-studied disease.
Types of Eye Cancer in Adults
The most common cancer that originates inside the eye is ocular melanoma, sometimes called uveal melanoma. It develops in the uvea, a layer sandwiched between the white outer wall of the eye and the retina. Nearly all uveal melanomas start in a specific part of the uvea called the choroid, though a smaller number begin in the iris (the colored part of your eye).
A second, rarer type is primary intraocular lymphoma, a cancer of white blood cells that forms inside the eye. This type is closely related to lymphoma of the central nervous system. When it’s diagnosed, doctors typically check the brain and spinal fluid because the cancer has a tendency to involve the nervous system over time. Outcomes depend heavily on whether that spread has occurred.
Eye Cancer in Children
Retinoblastoma is the primary eye cancer that affects kids, most commonly those younger than 5. It’s caused by a genetic mutation and starts in the retina, the light-sensing tissue at the back of the eye.
The most recognizable sign is a white glow in the pupil, especially visible when light shines into the eye. Parents often notice it first in flash photographs: instead of the typical red-eye effect, one pupil appears white. This white reflex, called leukocoria, is the reason pediatricians check a child’s red reflex at well-child visits.
Cancer That Spreads to the Eye
Not all cancer found in the eye started there. Cancers from elsewhere in the body can metastasize to the eye, and this is actually more common than primary eye cancer. Breast cancer is the leading source, accounting for about 47% of eye metastases. Lung cancer follows at roughly 21%, with gastrointestinal cancers making up a smaller share. Most people who develop eye metastases already have a known history of cancer treatment.
Symptoms to Recognize
Eye melanoma often causes no symptoms in its early stages, which is one reason routine eye exams matter. When symptoms do appear, they can include:
- Flashes of light or floaters (specks drifting across your vision)
- A growing dark spot on the iris
- A change in pupil shape
- Blurry or poor vision in one eye
- Loss of peripheral (side) vision
None of these symptoms are unique to cancer. Floaters, for instance, are extremely common and usually harmless. But a new combination of these changes, particularly in just one eye, is worth getting checked.
Risk Factors
The two best-established risk factors for uveal melanoma are UV light exposure and genetics. Some research links sun exposure and tanning bed use to higher risk, though the connection isn’t as strong as it is for skin melanoma. Certain inherited DNA changes passed from parents to children also raise the likelihood.
Incidence varies significantly by geography and ethnicity. Australia has one of the highest rates at 7.6 cases per million, while South Korea reports just 0.42 per million. European countries range widely too, from about 3 per million in some regions to 10 per million in the United Kingdom. Uveal melanoma is far more common in people with lighter skin and eye color.
How It’s Diagnosed
Eye cancers are typically found during a dilated eye exam, sometimes before a patient notices anything wrong. Ophthalmologists use imaging to confirm and characterize tumors. Ultrasound has long been a standard tool, but a technique called optical coherence tomography (OCT) can now detect extremely small tumors, including some less than 1 millimeter thick that ultrasound would miss. OCT produces detailed cross-sectional images of the retina and deeper structures, helping doctors plan treatment and track how a tumor responds over time.
Unlike many other cancers, eye melanoma is often diagnosed based on imaging alone, without a biopsy. The appearance and behavior of the tumor on scans is distinctive enough for experienced specialists to make the call.
Treatment and Survival
The most widely used treatment for uveal melanoma is plaque brachytherapy, a form of localized radiation. A small radioactive disc is temporarily attached to the outside of the eye, directly over the tumor, delivering a precise dose while limiting damage to surrounding tissue. Local control rates with this approach range from about 59% to 98% depending on tumor characteristics, with a meta-analysis of nearly 4,000 eyes finding an overall success rate of 84%. In well-selected cases, control rates can exceed 95%.
The goal of treatment is usually to destroy the tumor while preserving as much vision as possible. In some cases, removal of the eye (enucleation) is necessary, particularly for very large tumors.
Survival depends heavily on the tumor’s location and whether it has spread. Iris melanomas have the best outlook, with five-year survival rates above 95%. Melanomas of the choroid or ciliary body carry a five-year mortality rate of roughly 30% once metastasis occurs. The liver is the most common site for uveal melanoma to spread, and metastatic disease carries a poor prognosis. This makes early detection and monitoring after treatment critical, as catching spread early opens more options.