Lymphoma of the Eye

Lymphoma of the Eye

Ocular lymphoma is a type of eye cancer that generally develops in the retina and eye fluid. In addition to causing problems in the eyes, lymphoma of the eye often causes lymphoma in the brain which can cause more severe symptoms.

Eye lymphoma is also called ocular lymphoma. Ocular lymphoma can happen to anyone. However, this condition occurs more often in people who are elderly or suffer from diseases that weaken the body's immunity, such as HIV/AIDS .

Types of Ocular Lymphoma

Eye lymphoma or ocular lymphoma is divided into three types, namely:

  • Intraocular
    lymphoma Intraocular lymphoma is the most common type of eye lymphoma. This type of eye lymphoma can occur in the back of the eye (retina), the fluid inside the eyeball (vitreous), or the optic nerve. Generally, this type is included in lymph node cancer, which is non-Hodgkin's lymphoma.
  • Uveal
    lymphoma Uveal lymphoma is a lymphoma that occurs in the uvea, which is the middle layer of the eye. Uveal lymphoma can attack the middle layer of the eye which consists of the membrane of the iris (iris), the blood vessel layer of the eye (choroid), and the connective tissue between the iris and choroid (ciliary body).
  • Ocular adnexal
    lymphoma Ocular adnexal lymphoma is a type of eye lymphoma that occurs outside the surface of the eye. This type can attack the cavity of the eyeball, the surface layer of the eye (conjunctiva), tear glands, and eyelids.

Causes of Ocular Lymphoma

Ocular lymphoma is caused by changes or mutations in DNA in white blood cells called lymphocytes . This DNA mutation can cause lymphocytes to not function properly.

It is not yet known exactly why this DNA mutation can occur. However, there are several risk factors that can increase a person's eye lymphoma, namely:

  • Suffering from HIV or AIDS
  • Suffering from autoimmune diseases , such as rheumatoid arthritis
  • Having certain medical conditions that attack the immune system
  • Consuming immunosuppressive drugs , which are drugs that can reduce the work of the body's immune system

Symptoms of Ocular Lymphoma

The initial symptoms that appear in patients with eye lymphoma are not very specific and can be considered as other eye diseases. As for the symptoms of eye lymphoma depending on the type, namely:

Intraocular lymphoma

Symptoms of intraocular lymphoma generally develop quickly. Some of the symptoms are:

  • Blurred vision
  • There are lines or spots in the view ( floaters )
  • Vision is not sharp
  • Red eye

Uveal lymphoma

Unlike intraocular lymphoma, uveal lymphoma develops slowly. Symptoms that can arise include:

  • Recurrent blurred vision
  • A change in the color of the white part of the eye becomes yellowish
  • Red eyes, but no pain
  • Visual disturbances in the form of changes in the shape of objects seen, such as seeing straight lines as bent

Ocular adnexal lymphoma

Ocular adnexal lymphoma can grow slowly. Some of the symptoms that can arise are:

  • Eyes stand out
  • Double vision
  • Swollen eyelids
  • Decreased vision
  • There is flesh growing on the surface of the eye

Symptoms of eye lymphoma usually occur in both eyes, but the symptoms that appear are more visible in one eye.

When should you go to the doctor?

Check with your doctor if you experience the symptoms above continuously, the symptoms do not improve despite receiving treatment, or if the symptoms get worse .

It should be noted that the sooner eye lymphoma is detected, the easier it is to treat. The chances of the treatment being successful will also be higher.

Ocular Lymphoma Diagnosis

To diagnose lymphoma of the eye, the doctor will ask questions about the patient's symptoms and disease history, as well as when the symptoms started to appear.

Next, the doctor will perform a physical examination with ophthalmoscopy , to clearly see the inside of the eye, such as the retina and blood vessels. Ophthalmoscopy can detect early types of eye diseases that have complaints.

In addition, additional examinations may be needed to diagnose eye lymphoma, including:

  • Photo of the fundus (back of the eye) or USG of the eye
  • Fluorescence angiography, to see the condition of the blood vessels of the eye
  • Biopsy , to confirm the presence of eye lymphoma
  • X-ray, MRI, or CT scan of other parts of the body, such as the brain, digestive tract, lungs and heart, as well as the reproductive organs, to detect if lymphoma from the eye has spread

Ocular Lymphoma Stage

Through the results of the examination above, the doctor can determine the stage or severity of eye lymphoma in the patient. Here is the explanation:

  • Stage 1
    At this stage, cancer cells attack a lymph node in the eye.
  • Stage 2
    In stage 2, cancer cells attack two or more lymph nodes in one eye and are not found in other organs.
  • Stage 3
    At this stage, the cancer cells have attacked the lymph nodes located far from the eyes, precisely in the lower body (stomach down).
  • Stage 4
    In stage 4, the cancer has invaded outside the lymph system, for example in organs or bone marrow.

Ocular Lymphoma Treatment

Eye lymphoma treatment aims to destroy cancer cells and stop their spread. Some of the treatment methods are:

Radiotherapy

Radiotherapy aims to kill cancer cells using high-energy rays. This treatment is usually used on both eyes.

Radiotherapy can also be used on the brain and spinal cord to destroy cancer cells that may have spread.

Chemotherapy

Chemotherapy is the administration of drugs to kill cancer cells. Chemotherapy drugs can be given through a vein, cerebrospinal fluid , direct injection into the eye, or through an ointment used on the surface of the eye.

Chemotherapy drugs used in eye lymphoma include:

  • Methotrexate
  • Procarbazine
  • Vincristine
  • Thiotepa
  • Cytarabine
  • Mitomycin

Surgery

Surgical procedures are usually performed on lymphomas that attack the conjunctiva (the clear membrane on the surface of the eye) so that the lymphoma does not spread. Surgery can be done in two ways, namely:

  • Cryosurgery , to remove the cancerous part only
  • Resection of the eye (removal of the entire eye) if the area affected by the lymphoma is too extensive

Complications of Ocular Lymphoma

Complications of eye lymphoma can occur as a result of the treatment or as a result of the condition getting worse. Some of the complications that can occur are:

  • Cataracts
  • Corneal ulcer
  • Glaucoma
  • Inflammation of the optic nerve ( optic neuritis )
  • Blindness
  • Changes in facial structure

Lymphoma of the eye can also spread to the brain. These conditions can cause the following conditions:

  • Turn
  • Numbness
  • Muscle weakness on one side of the body
  • Disturbance of body balance
  • Decreased brain function
  • Convulsions

Prevention of Ocular Lymphoma

Eye lymphoma can be avoided by avoiding risk factors. Some of the efforts that can be made are:

  • Avoiding HIV/AIDS risk factors, such as the use of illegal drugs, the use of syringes, and sexual intercourse freely without protection
  • Implement a healthy, nutritious and balanced diet
  • Reduce the consumption of fast food or processed food
  • Maintain an ideal weight
  • Exercise regularly
  • No smoking
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