Ocular Surface Tumours: Early Signs, Diagnosis, and Treatment Options

Ocular surface tumours are abnormal growths that develop on the conjunctiva or cornea. While some of these tumours are benign, others can be precancerous or malignant, making early detection and treatment crucial for preserving vision and overall eye health. Understanding the early signs, diagnostic methods, and treatment options can help ensure timely intervention and better outcomes.

Early Signs of Ocular Surface Tumours 

Recognizing the early symptoms of ocular surface tumours is essential for prompt medical attention. Some of the most common signs include:

- A persistent growth on the eye – A raised or irregular lesion on the conjunctiva or cornea that does not resolve on its own.

- Redness or irritation – Chronic redness or discomfort that does not respond to usual treatments like artificial tears.

- Foreign body sensation – A feeling of something in the eye, often due to an irregular surface.

- Changes in appearance – Pigmentation changes or white, gelatinous, or vascular growths on the ocular surface.

- Blurred vision – If the tumour encroaches on the visual axis, it can cause visual disturbances.

- Recurrence of pterygium-like growths – Some tumours mimic pterygium but grow more aggressively or recur after surgical removal.

Diagnosing Ocular Surface Tumours 

Accurate diagnosis is essential to determine whether an ocular surface lesion is benign, precancerous, or malignant. The following diagnostic methods help ophthalmologists assess and classify these tumours:

- Slit-lamp examination – A detailed evaluation of the lesion’s size, location, and characteristics.

- Anterior segment optical coherence tomography (AS-OCT) – Provides high-resolution imaging of the lesion’s depth and extent.

- Biopsy and histopathological analysis – When malignancy is suspected, a small tissue sample is taken and analyzed under a microscope to confirm the diagnosis.

Treatment Options for Ocular Surface Tumours

The choice of treatment depends on the type, size, and nature of the tumour. Early intervention often results in better outcomes with less invasive treatment methods.

1. Observation and Monitoring

- Small, benign lesions that are stable may be monitored with regular eye exams.

- If the lesion shows growth or suspicious features, intervention may be necessary.

2. Surgical Excision

- The primary treatment for suspicious or malignant tumours.

- The no-touch technique is often used to prevent tumour seeding.

- May be combined with cryotherapy (freezing therapy) to reduce recurrence risk.

3. Topical Chemotherapy

- Medications such as Mitomycin-C (MMC), 5-Fluorouracil (5-FU), or Interferon alpha-2b can be used to treat pre-cancerous and early malignant lesions.

- These drops help shrink or eliminate tumours without surgery in select cases.

4. Cryotherapy

- Used as an adjunct to surgery to destroy residual tumour cells.

- Can be applied directly to the tumour or surgical margins.

- This is often combined with surgical excision

Conclusion

Ocular surface tumours can range from benign growths to sight-threatening malignancies, making early detection critical. Regular eye exams, awareness of early signs, and prompt medical evaluation can significantly improve outcomes. With advances in diagnostics and treatment options, many of these tumours can be effectively managed while preserving vision and ocular health.