Eye Cancer Diagnosis

Eye cancer is a malignant tumor affecting the eyeball and surrounding tissues, including uveal melanoma, retinoblastoma, and orbital tumors. The disease develops insidiously and is easily confused with common eye conditions in the early stage. Delayed diagnosis may not only lead to permanent blindness but can also spread to the brain, liver, and other areas, becoming life-threatening. Timely clarification of the lesion’s nature and extent helps select appropriate treatment plans and improve survival quality.

Diagnostic Basis

1. Visual acuity and slit-lamp examination
Preliminary examinations are usually performed by ophthalmologists. Visual acuity tests and slit-lamp microscopy can detect abnormalities in the iris or anterior chamber fluid. For uveal melanoma, fundus examination after pupil dilation may reveal dark masses or retinal elevations.

2. Fundus examination and OCT imaging
Fundus examination allows direct observation of the retina and optic disc, helping locate the tumor and determine its boundaries. Optical coherence tomography (OCT) scans the retina and choroid layer by layer, clearly showing tumor morphology, thickness, and exudation, serving as an important tool for early screening of retinoblastoma.

3. B-scan and A-scan ultrasonography
Ultrasound examinations are suitable when the eye is opaque or direct observation is not possible. B-scan can depict intraocular structural abnormalities and assess whether tumors cause retinal detachment or vitreous hemorrhage. A-scan measures tumor density and echo intensity, assisting in determining malignancy.

4. CT and MRI scans
When tumors are suspected to involve the orbit, optic nerve, or intracranial structures, CT can show bone destruction or calcification, useful for retinoblastoma assessment. MRI provides better visualization of soft tissue invasion, evaluating anatomical relationships with surrounding tissues, and is especially important for preoperative assessment and surgical planning.

5. Tissue biopsy and cytological analysis
For accessible sites such as conjunctival or lacrimal gland tumors, biopsy samples can be taken for pathological analysis to determine tumor type and differentiation. Intraocular tumor biopsy carries higher risk but, if necessary, vitrectomy or fine-needle aspiration may be used for cytology. This is considered the “gold standard” for confirming malignancy.

6. Molecular testing and genetic analysis
In pediatric cases, especially retinoblastoma, RB1 gene testing can aid in diagnosis and assess hereditary risks. For adults considered for targeted therapy, molecular testing helps identify actionable mutations, supporting personalized treatment planning.

7. Systemic screening for metastasis
If eye cancer has progressed locally, systemic examinations such as liver ultrasound, bone scans, and chest-abdominal CT are needed to detect distant metastases. Uveal melanoma tends to metastasize to the liver, requiring close monitoring.

Conclusion

Experts at United Life International Medical Center emphasize that eye cancer diagnosis requires integrating ophthalmic inspection, imaging, tissue biopsy, and genetic testing. Only early detection and accurate diagnosis can provide valuable time for immune reconstruction cell therapy and other treatments, effectively improving eye preservation rates and patient prognosis.