Intraocular Tumors and Glaucoma

Updated: April 16, 2024

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Background

Intraocular tumors refer to abnormal growths or masses in the eye. 

The two types are benign, i.e., non-cancerous, and malignant i.e., cancerous tumors. It can occur in the ciliary body, choroid, or iris of the eye.  

An elevated intraocular pressure generally causes glaucoma. It harms the visual nerve and is a major reason for permanent blindness. 

The angle-closure glaucoma results from sudden blockage of drainage angle. In the early stages it has no symptoms. 

Epidemiology

Intraocular Tumors is a rare disorder for a small percentage of eye conditions. The incidence and prevalence vary based on tumor type. 

Glaucoma is a major reason for permanent blindness. The incidence and prevalence increase with age, especially in older adults. 

Genetic factors, age, ethnicity, family history, and systemic diseases are considered as additional risk factors. 

 

Anatomy

Pathophysiology

Tumor Impact on Ocular Structures which compromises the drainage and cause high intraocular pressure. Melanomas can induce a melanophagic response. It affects pigment uptake and pressure. 

Certain tumors can trigger hemolytic processes. They disrupts eye function and increase pressure. Tumors can cause secondary glaucoma by inducing uveitis. 

 

Etiology

Genetic predispositions lead to intraocular tumors and glaucoma. The shared genetic factors can increase its susceptibility. 

Secondary intraocular tumors may increase intraocular pressure (IOP) through metastasis mechanisms. The cancer origin and characteristics influence metastasis. 

Tumor-associated inflammatory and vascular factors can cause vascular dysregulation and ischemia. 

Genetics

Prognostic Factors

The different prognosis for malignant tumors like uveal melanomas. Intraocular involvement is crucial. The larger tumors have worse prognosis. 

Tumors is critical in ciliary body or optic nerve head may have worse prognosis. 

Clinical History

Age Group:  

Retinoblastoma is a common intraocular tumor in children. 

Pediatric glaucoma may present with photophobia, tearing, and enlarged corneas.  

In adolescents and young adults group intraocular melanoma is more common. 

Primary open-angle glaucoma is associated with elevated IOP and may start in young adults.  

Physical Examination

External Examination 

Pupillary Examination  

Anterior Segment Examination  

Fundus Examination 

Ocular Imaging 

Age group

Associated comorbidity

Genetic Predisposition: 

  • Patients with a family history of retinoblastoma may have a higher risk, especially in childhood. 
  • A key risk factor for glaucoma is a family history of the condition, which may have a genetic component. 

UV Exposure: 

  • Individuals with a history of prolonged exposure to ultraviolet (UV) radiation may be at a higher risk of developing ocular melanomas. 
  • UV exposure is not only a risk factor for intraocular tumors but can also contribute to cataracts and other ocular conditions. 

Medical Conditions: 

  • Patients with a history of systemic cancer may be at risk of intraocular metastasis. 
  • Systemic conditions such as diabetes and hypertension may be associated with the development or progression of glaucoma. 

Associated activity

Acuity of presentation

Intraocular Tumors and Glaucoma: Symptoms and Progression 

The Sudden and severe symptoms may occur due to tumor complications or rapid glaucoma progression. 

Both intraocular tumors and glaucoma have gradual onset and progression. 

An early symptom emphasizes the importance of regular eye examinations. 

Differential Diagnoses

Retinoblastoma 

Uveal Melanoma   

Choroidal Hemangioma 

Retinal Hemangioblastoma  

Laboratory Studies

Imaging Studies

Procedures

Histologic Findings

Staging

Treatment Paradigm

Conduct accurate diagnosis of intraocular tumor and glaucoma through comprehensive eye examinations, imaging studies, and other diagnostic tests. 

Topical or oral medications to reduce intraocular pressure.  Laser trabeculoplasty or cyclophotocoagulation procedures helps to improve aqueous humor drainage and reduce IOP. 

by Stage

by Modality

Chemotherapy

Radiation Therapy

Surgical Interventions

Hormone Therapy

Immunotherapy

Hyperthermia

Photodynamic Therapy

Stem Cell Transplant

Targeted Therapy

Palliative Care

use-of-a-non-pharmacological-approach-for-treating-intraocular-tumors-and-glaucoma

Surgical creation of a new drainage channel for aqueous humor, aimed at reducing intraocular pressure (IOP).  

The implantable devices are used in cases where trabeculectomy is not suitable.  

The trabecular meshwork can be laser-treated to improve aqueous humour outflow and lower intraocular pressure.  

One should modify the sleeping positions to avoid putting pressure on the eye, especially if angle closure is a concern.  

For individuals with visual impairment, rehabilitation services can help maximize the use of remaining vision and adapt to daily activities. 

Use of Anti-VEGF Agents in the treatment of Intraocular tumors and glaucoma

Bevacizumab is a monoclonal antibody which binds to vascular endothelial growth factor. It is an important component in the process of angiogenesis, i.e., the development of new blood vessels. 

use-of-intervention-with-a-procedure-in-treating-intraocular-tumors-and-glaucoma

In laser photocoagulation it targets the tumor with laser therapy to reduce its size or destroy abnormal tissue.  

In laser trabeculoplasty it addresses glaucoma by improving aqueous humor drainage.  

In cases where the intraocular tumor is operable, then surgical resection may be performed. This procedure may involve collaboration between ocular oncologists and ophthalmic surgeons.  

use-of-phases-in-managing-intraocular-tumors-and-glaucoma

In this phase utilize imaging modalities such as ultrasound, optical coherence tomography (OCT), and fluorescein angiography for detailed visualization of intraocular tumors and assessment of glaucomatous changes.  

Perform tumor resection or apply radiation therapy based on the nature and location of the intraocular tumor. 

Physicians should schedule frequent follow-up appointments to monitor both the tumor status and glaucoma control.  

Medication

Media Gallary

Intraocular Tumors and Glaucoma

Updated : April 16, 2024

Mail Whatsapp PDF Image



Intraocular tumors refer to abnormal growths or masses in the eye. 

The two types are benign, i.e., non-cancerous, and malignant i.e., cancerous tumors. It can occur in the ciliary body, choroid, or iris of the eye.  

An elevated intraocular pressure generally causes glaucoma. It harms the visual nerve and is a major reason for permanent blindness. 

The angle-closure glaucoma results from sudden blockage of drainage angle. In the early stages it has no symptoms. 

Intraocular Tumors is a rare disorder for a small percentage of eye conditions. The incidence and prevalence vary based on tumor type. 

Glaucoma is a major reason for permanent blindness. The incidence and prevalence increase with age, especially in older adults. 

Genetic factors, age, ethnicity, family history, and systemic diseases are considered as additional risk factors. 

 

Tumor Impact on Ocular Structures which compromises the drainage and cause high intraocular pressure. Melanomas can induce a melanophagic response. It affects pigment uptake and pressure. 

Certain tumors can trigger hemolytic processes. They disrupts eye function and increase pressure. Tumors can cause secondary glaucoma by inducing uveitis. 

 

Genetic predispositions lead to intraocular tumors and glaucoma. The shared genetic factors can increase its susceptibility. 

Secondary intraocular tumors may increase intraocular pressure (IOP) through metastasis mechanisms. The cancer origin and characteristics influence metastasis. 

Tumor-associated inflammatory and vascular factors can cause vascular dysregulation and ischemia. 

The different prognosis for malignant tumors like uveal melanomas. Intraocular involvement is crucial. The larger tumors have worse prognosis. 

Tumors is critical in ciliary body or optic nerve head may have worse prognosis. 

Age Group:  

Retinoblastoma is a common intraocular tumor in children. 

Pediatric glaucoma may present with photophobia, tearing, and enlarged corneas.  

In adolescents and young adults group intraocular melanoma is more common. 

Primary open-angle glaucoma is associated with elevated IOP and may start in young adults.  

External Examination 

Pupillary Examination  

Anterior Segment Examination  

Fundus Examination 

Ocular Imaging 

Genetic Predisposition: 

  • Patients with a family history of retinoblastoma may have a higher risk, especially in childhood. 
  • A key risk factor for glaucoma is a family history of the condition, which may have a genetic component. 

UV Exposure: 

  • Individuals with a history of prolonged exposure to ultraviolet (UV) radiation may be at a higher risk of developing ocular melanomas. 
  • UV exposure is not only a risk factor for intraocular tumors but can also contribute to cataracts and other ocular conditions. 

Medical Conditions: 

  • Patients with a history of systemic cancer may be at risk of intraocular metastasis. 
  • Systemic conditions such as diabetes and hypertension may be associated with the development or progression of glaucoma. 

Intraocular Tumors and Glaucoma: Symptoms and Progression 

The Sudden and severe symptoms may occur due to tumor complications or rapid glaucoma progression. 

Both intraocular tumors and glaucoma have gradual onset and progression. 

An early symptom emphasizes the importance of regular eye examinations. 

Retinoblastoma 

Uveal Melanoma   

Choroidal Hemangioma 

Retinal Hemangioblastoma  

Conduct accurate diagnosis of intraocular tumor and glaucoma through comprehensive eye examinations, imaging studies, and other diagnostic tests. 

Topical or oral medications to reduce intraocular pressure.  Laser trabeculoplasty or cyclophotocoagulation procedures helps to improve aqueous humor drainage and reduce IOP. 

Ophthalmology

Surgical creation of a new drainage channel for aqueous humor, aimed at reducing intraocular pressure (IOP).  

The implantable devices are used in cases where trabeculectomy is not suitable.  

The trabecular meshwork can be laser-treated to improve aqueous humour outflow and lower intraocular pressure.  

One should modify the sleeping positions to avoid putting pressure on the eye, especially if angle closure is a concern.  

For individuals with visual impairment, rehabilitation services can help maximize the use of remaining vision and adapt to daily activities. 

Ophthalmology

Bevacizumab is a monoclonal antibody which binds to vascular endothelial growth factor. It is an important component in the process of angiogenesis, i.e., the development of new blood vessels. 

Ophthalmology

In laser photocoagulation it targets the tumor with laser therapy to reduce its size or destroy abnormal tissue.  

In laser trabeculoplasty it addresses glaucoma by improving aqueous humor drainage.  

In cases where the intraocular tumor is operable, then surgical resection may be performed. This procedure may involve collaboration between ocular oncologists and ophthalmic surgeons.  

Ophthalmology

In this phase utilize imaging modalities such as ultrasound, optical coherence tomography (OCT), and fluorescein angiography for detailed visualization of intraocular tumors and assessment of glaucomatous changes.  

Perform tumor resection or apply radiation therapy based on the nature and location of the intraocular tumor. 

Physicians should schedule frequent follow-up appointments to monitor both the tumor status and glaucoma control.  

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