Definition

Iris tumors are lumps or masses located on the iris. They are a type of eye growth and can be either benign or malignant. These tumors can be either cystic, resembling a cyst, or solid, with about 20% being cyst-like and 80% being solid masses.

Causes

The cause of iris tumors is currently unknown. However, it is suspected that iris tumors and other eye tumors arise due to genetic mutations in eye tissues, particularly in genes that regulate cell growth.

Risk Factor

Several risk factors are considered to increase the risk of tumors in the eye, including age over 50 years, pale skin, light-coloured eyes (such as blue or green), and family history of cancer. Some studies also mention exposure to dangerous chemicals, sunlight or UV rays exposure are associated with the risk of eye tumors development.

Symptoms

Symptoms of eye tumors vary depending on the type and can resemble other eye conditions or disorders. Sometimes, eye tumors may not cause any symptoms initially. General symptoms of eye tumors include:

• Dark spots on the iris
• Visual impairment
• Narrowing of the visual field
• Seeing flying objects (floaters), streaks, or spots
• Seeing flashes of light
• Changes in pupil size and shape
• Strabismus or crossed eyes
• Protruding eye
• Eye pain
• Red or irritated eyes

Diagnosis

Diagnosis of an iris tumor involves an in-depth interview regarding the patient's complaints and symptoms. This can comprise the onset of symptoms, what can trigger or relieve the symptoms, as well as the patient's medical history. Physical examination can include visual acuity tests, visual field tests, and eye movement assessments. Eye examinations may use special tools such as an ophthalmoscope, slit lamp, and lens gonioscopy to evaluate the condition of the eyes. These examinations aim to know the visual function, eye movement and the condition of the ocular blood vessels. If the results of the examinations indicate the possibility of a tumor or cancer in the eye, further tests can be recommended to help confirm the diagnosis. These may include eye ultrasound, CT scan and MRI, to determine the location and size of tumor cells. Biopsy can also be performed to take samples of eye tissue suspected of abnormalities to be examined in the laboratory.

Management

The chance of treating iris tumors depends on the size of the tumor, the severity of the condition, and the affected areas of the eye. In some patients, recurrence can also occur after treatment and remission. Treatments of various eye tumors aim to maintain eye functions, prevent the spread of cancer cells to other parts of the body, and prevent recurrence after treatment. There are some treatment options, one of them is surgical procedure. The type of surgery will be chosen based on the locations and size of the existing tumor tissues. Patients will undergo general anesthetics before the surgery. Some surgical procedures options include:

• Iridectomy: Removal of part of the iris, generally done in small tumors and malignant iris tumors.
• Iridotrabulectomy: Removal of part of the iris along with the surrounding tissues outside of the eyeball.
• Iridocyclectomy: Removal of part of the iris along with part of the ciliary body.
• Enucleation: Removal of the entire eyeball, generally in large tumors or in patients who have lost their vision.
• Eye exenteration: Removal of the eyeball and several other surrounding tissues, such as the eyelids, muscles, nerves, and other tissues in the eye socket.

Radiotherapy is a treatment carried out by shooting high-energy X-rays at tumor tissue. With radiotherapy, the risks of eyeball damage or loss and vision loss can be reduced. Laser therapy can help destroy cancer tissue with lasers. Chemotherapy is a treatment option for eye tumors using chemical drugs. The medicines can be injected directly into the eye or the cerebrospinal fluid, or injected intravenously via infusion. If chemotherapy is not effective, immunotherapy and targeted therapy drugs can be given. Lastly, cryotherapy or treatments for eye tumors by freezing tumor tissues.

Complications

Complications that can occur with iris tumors include vision loss or blindness, glaucoma, and metastasis (spread of cancer cells to other distant body organs).

Prevention

The exact causes of most eye tumors are still unknown, making tumor prevention difficult. The best approach includes early examinations, especially if there is a family history of similar diseases, and monitoring any visual symptoms. Routine eye examinations should be conducted regularly, particularly for those with higher risk factors.

When to See a Doctor?

Due to the non-specific nature of symptoms, it is advisable to consult a doctor if you experience any of the described symptoms, especially if the symptoms persist for more than 2 weeks. Routine examinations with an ophthalmologist are highly recommended for individuals with risk factors for developing eye tumors. Annual examinations are advised to facilitate early detection of cancer.

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