Types of surgery for eye cancer

How you have surgery for eye cancer

Surgery for eye cancer is a specialised operation. You usually have surgery under general anaesthetic. So you will be asleep for the whole operation.

Before your surgery your ophthalmologist (eye surgeon) will explain the operation. They will discuss how it might affect you afterwards.

Your surgeon will preserve as much sight as possible. If your surgeon needs to remove your eye (an enucleation) then you will lose the sight in that eye.

Losing the sight in an eye can come as quite a shock. You will need time to come to terms with this change. Your healthcare team will help you. And there are organisations that can support you during this time. Ask questions as often as you need to, especially about your sight and appearance after the operation.

Removing part of the eye

Surgery to remove a cancer from the eyeball or around the eye is known as a tumour resection. The operation can also involve removing a small amount of healthy tissue around the cancer (a margin). This is to make sure all the cancer has been removed.

You may hear your specialist refer to this as eye sparing or eye conserving surgery. After your operation, you might have chemotherapy or radiotherapy or both. 

The type of operation you have depends on where your cancer is. For example, you might need to have part of the choroid removed (a choroidectomy). Or, for small melanomas of the iris, you might have one of the following:

• removal of part of the iris – iridectomy

• removal of the iris and the ciliary body (the muscle that focuses the eye) - iridocyclectomy

See diagrams of the eye

Mohs micrographic surgery

Mohs micrographic surgery is used to remove skin cancers. It aims to remove all the cancer, while sparing as much healthy tissue around it as possible. You may also hear this called Mohs surgical technique.

Your surgeon might use this surgery to remove skin cancers from delicate areas around your eye, such as the eyelid. For example squamous cell or basal cell skin cancers of the eye.

The surgeon removes the cancer with a very small margin around it and examines it under the microscope. If cancer is seen at the edge the surgeon removes a little more. They repeat this until they remove all the cancer. 

The surgeon that does this operation is a specialist that is also trained in looking at specimens (pathologist).

Read more about Mohs micrographic surgery

Risks of surgery

All types of surgery have risks. Your surgeon will explain the risks to you in detail. These will include the risk of partial or total loss of eyesight due to various reasons, as well as infection and bleeding.

Ask your surgeon if you are unclear or concerned about any of the risks.

Removing part of the eye means there is a risk of cancer cells breaking away from the cancer and spreading to the surrounding tissue. This is rare and your surgeon will do all they can to reduce this risk.

Your nurse will monitor you regularly while you are in hospital. Before you go home, your team will go through what to look out for. And you should have a contact number to ring if you have any questions or concerns.

How you might feel after eye surgery

After eye surgery you can go through a range of emotions. It can take time to adjust and come to terms with how you feel, as well as managing practical changes.

Loss of sight in an eye can cause changes in depth perception. This is how you judge distance between things. In time you will get used to these differences. Your healthcare team will support you. And there are other organisations who can offer information and support. 

Read more about organisations that can help and support you