About eye cancer

There are several different types of cancer that can occur in the eye:

  • Eye melanoma (ocular melanoma) 
  • Lymphoma
  • A childhood cancer called retinoblastoma
  • Squamous cell carcinoma

Although cancers in the eye are quite rare, the most common form of eye cancer is eye melanoma. Eye melanomas can occur in the iris, ciliary body or choroid. These are known as uveal melanomas. They can also occur in the conjunctiva (conjunctival melanoma). 

Cancer that starts in the eye is called primary eye cancer. Sometimes cancer can spread from other areas of the body to the eye. This page is about how we care for primary eye cancer, mainly eye (ocular) melanoma. 

Symptoms of eye cancer vary depending on the type of eye cancer. 

Uveal melanomas – a type of eye melanoma – often develop from a mole (naevus) inside the eye or on the iris. 

Some people with eye melanoma have symptoms, and some people do not.  Often it is only spotted during a routine eye test. 

Symptoms of eye melanoma can include:

  • Shadows, flashes of light, or wiggly lines in your vision
  • Blurred or distorted vision
  • Partial or total loss of vision
  • A dark spot on your iris or white of the eye
  • A change in the shape of the pupil

It is important to see a health professional if you have symptoms or changes in your body that are unusual for you.

Our treatments

At The Clatterbridge Cancer Centre, we provide specialist non-surgical treatment for eye cancer. We also work closely with eye teams and surgical teams in other specialist hospitals to plan and coordinate your care every step of the way. 

Proton beam therapy for eye melanoma

The Clatterbridge Cancer Centre is the UK’s National Centre for Eye Proton Therapy. We are the only centre in the UK offering this specialist treatment. Conditions that can be treated with proton beam therapy include eye melanomas and a benign (non-cancer) condition called haemangioma. 

Patients are referred to us for treatment from all over the UK, Ireland, mainland Europe and the rest of the world. 

NHS patients who need to travel more than an hour’s journey by car might be offered hotel accommodation and transport to appointments at The Clatterbridge Cancer Centre.  

Eye proton therapy is a type of radiotherapy that uses low-energy proton beams to treat cancer. These are different from the x-rays (photons) used to treat other types of radiotherapy. 

Proton beams are particularly good at treating cancers, such as cancers of the eye, that are very close to other important areas of the body – for example, the optic nerve head. This is because the proton beam can target the cancer very precisely while sparing surrounding healthy tissue

If the tumour is inside your eye, you will need a surgical procedure to have tantalum markers placed before proton therapy can begin. This will be done at your specialist referring hospital. Tantalum markers are very small metallic disks which are placed on the white of the eye to define the position of the tumour. They are necessary to deliver the proton beam therapy accurately. You might hear tantalum markers referred to as ‘clips’. 

Radiotherapy for eye lymphoma

Radiotherapy can be used to treat lymphoma in or close to the eye. Sometimes radiotherapy is given instead of surgery. Sometimes it is used to shrink the tumour before, during or after other treatment. It can also be used to relieve symptoms such as pain or discomfort.  

We use different types of radiotherapy, depending on the type, size, location and stage of cancer. Lymphomas tend to be ‘radiosensitive’ – they can respond to relatively low doses of radiation over a short period of time.

The radiotherapy treatments we can use for eye cancer include:

  • External beam radiotherapy – where radiation is delivered from outside of the body, in the form of high energy x-rays
  • Orthovoltage radiotherapy – a low energy form of external beam radiotherapy 

Orthovoltage radiotherapy is more common for eye lymphoma. Low energy x-rays are used as they do not travel far through the body and can target tumours close to or on the skin surface while minimising unwanted side-effects. 

You will come to the Radiotherapy department for a planning appointment where your clinical oncologist will work alongside a radiographer to plan and tailor your treatment. 

About a week later you will have your treatment – treatment length can vary but in most cases you will have two treatment sessions on consecutive days.

You might need eye drops and a specialised lead eye-shield to protect other parts of your eye – this will depend on whereabouts the tumour is. 

We will treat you while you are lying on a bed – you do not need to be able to lie flat. Radiographers will position a small machine over your eye during your treatment, which will only be a few minutes.

As with all radiotherapy, there is nothing to see or feel while the radiation is being delivered, and there will always be a team of radiographers to support you throughout your treatment. 

Find out more about radiotherapy at The Clatterbridge Cancer Centre. 

Clinical trials

Research and trials of new cancer treatments are an important part of our work. Your consultant will tell you about any clinical trials that may be suitable for you.

You are also very welcome to ask us about clinical trials during your appointments. We will be happy to answer any questions you have. 

Find out more about clinical trials. 

Treatment locations

We provide eye proton therapy at in the National Centre for Eye Proton Therapy at our Wirral site:

We provide radiotherapy for eye cancer in two of our three specialist sites: 

Clinical trials for eye cancer are delivered at Clatterbridge Cancer Centre – Liverpool.

The team consists of clinical oncologists, therapeutic radiographers, clinical scientists, engineers, administrative support, and radiotherapy support workers. 

Our operational management team makes sure the service runs smoothly.

Consultants 

Clinical Oncologists

  • Dr Azman Ibrahim
  • Dr Aditya Shenoy
  • Dr Pete Robson 
  • Dr Rachel Brooker

Eye proton therapy team

The Eye Proton Therapy Team consists of professionals with specialist knowledge in this field. The team includes:

Therapeutic radiographers

Therapeutic radiographers are the professionals who will be directly providing your care. The therapeutic radiographer will lead your simulation (planning) session and deliver your treatment. They work closely with the clinical scientists and engineers. 

We have a team of radiographers who rotate through proton eye therapy.  

Administrative support

Our administrative support will be your first point of contact. They will receive your referral and book your initial planning appointment, accommodation and transport where applicable. 

Clinical scientists

The clinical scientists are involved in the planning of your treatment and the testing of equipment before treatment is given. They are also involved in research and the development and introduction of new techniques and equipment.

Engineers

The engineers are responsible for testing, maintaining and updating the highly specialised equipment which is used to give your treatment

Patient information leaflets:

Proton beam therapy to the eye

Patient diary:

Rory Cellan-Jones: My Proton Beam Diary

Useful information and support:

Our Cancer Information and Support Centres can provide individualised help and support for patients and families affected by cancer. The team’s main base is in Clatterbridge Cancer Centre – Liverpool but they also work at our Aintree and Wirral hospitals.

There are also local Macmillan services in other hospitals across our region.

External sites that offer extra support and information about eye cancer include: