Ocular Oncology in Ranchi
Expert diagnosis and management of eye tumors and ocular cancers by Dr. Dibya Prabha — Retina & Vitreous Specialist — at Neurovision Clinic, Ranchi.
What is Ocular Tumors?
Ocular oncology is the subspecialty of ophthalmology focused on the diagnosis and management of tumors and cancers affecting the eye and its surrounding structures. Ocular tumors can be benign or malignant (cancerous), primary (arising within the eye) or secondary (metastatic — spreading to the eye from another organ). The most common primary intraocular malignancy in adults is uveal (choroidal) melanoma. In children, retinoblastoma is the most common primary eye cancer. Other tumors include conjunctival melanoma, intraocular lymphoma, eyelid cancers (basal cell carcinoma, squamous cell carcinoma), and orbital tumors. Advances in imaging (OCT, OCTA, wide-field photography) now allow for highly accurate, non-invasive diagnosis and monitoring. Treatment has evolved from primarily removing the eye (enucleation) to eye-sparing approaches including radiation (plaque brachytherapy), laser, and in some cases, targeted molecular therapies.
Symptoms of Ocular Tumors
- •A visible dark spot or growth on the iris or conjunctiva
- •Blurred or distorted vision — especially if caused by a tumor near the macula
- •Flashes of light or floaters — if the tumor causes retinal detachment
- •A shadow or curtain in peripheral vision
- •Change in the size or shape of the pupil
- •A bulging eye (proptosis) — for orbital tumors
- •A choroidal nevus or mole seen during routine eye examination that shows signs of growth or change
- •Many early ocular tumors have NO symptoms — found during routine dilated eye exams
Clinical Observations at Neurovision
Dr. Dibya Prabha at Neurovision sees retinoblastoma in Jharkhand children at advanced stages — Reese-Ellsworth group D and E — where the tumour has already filled most of the eye. Delayed diagnosis occurs because families from rural districts interpret the white pupillary reflex (leukocoria) as 'nazar dosh' (evil eye) rather than a medical emergency, and seek traditional healing before consulting a doctor.
Standard medical literature states:
Standard ocular oncology literature describes retinoblastoma as the most common primary intraocular malignancy of childhood, with survival rates exceeding 95% in developed countries when diagnosed early.
We educate paediatricians in Ranchi and district hospitals to check for leukocoria with a simple pen-torch test during every child's routine check-up and counsel parents in Hindi that 'bachche ki aankh ki putli mein safed chamak dikhe toh turant aankh ke doctor ko dikhayein' (a white glow in a child's pupil means see an eye doctor immediately).
— Dr. Dibya Prabha
Causes & Risk Factors
- •Genetic factors — certain gene mutations (e.g., BAP1 in uveal melanoma, RB1 in retinoblastoma)
- •Excessive UV light exposure — linked to conjunctival and eyelid cancers
- •Light eye color (blue, green, gray) — higher risk for uveal melanoma
- •Fair skin that burns easily — risk factor for eyelid and conjunctival cancers
- •Advanced age — most ocular cancers are more common with increasing age
- •Immunocompromised status — higher risk for ocular lymphoma
- •Metastasis from other primary cancers — breast and lung cancers most commonly spread to the eye
- •Certain hereditary syndromes — e.g., Familial Atypical Mole and Melanoma (FAMM) syndrome
- •Childhood genetic mutation — retinoblastoma is caused by RB1 gene mutation
Diagnostic Tests
Fundus Photography
High-resolution color imaging of the retina and choroid. Essential for documenting tumor size, location, and characteristics. Serial photography allows detection of even subtle growth — a key feature differentiating benign nevi from early melanoma.
OCT (Optical Coherence Tomography)
Provides microscopic detail of the retina overlying a tumor, detecting subretinal fluid, retinal edema, photoreceptor loss, and other signs that help distinguish active tumors from inactive lesions.
OCTA (OCT Angiography)
Visualizes the tumor's internal blood vessel pattern without dye injection — patterns can help differentiate between benign and malignant lesions and monitor response to treatment.
Treatment Approach
Dr. Dibya Prabha provides expert evaluation, diagnosis, and management planning for ocular tumors:
- Comprehensive Diagnostic Evaluation
- Thorough clinical examination plus multimodal imaging (fundus photography, OCT, OCTA, ultrasound) to characterize the lesion — size, location, internal features, and evidence of activity or growth. This evaluation determines whether a lesion is benign and can be observed, or concerning and requires treatment.
- Serial Observation & Monitoring
- For benign lesions (choroidal nevi, certain vascular tumors), regular follow-up with standardized imaging at defined intervals (typically every 6-12 months) to detect any change that might indicate malignant transformation.
- Treatment Coordination
- For malignant or vision-threatening tumors, Dr. Prabha coordinates with ocular oncology centers for treatments including plaque brachytherapy (targeted radiation delivered via a disc placed on the eye), proton beam therapy, laser treatments (transpupillary thermotherapy), and when necessary, surgical excision or enucleation.
- Long-Term Surveillance
- Regular follow-up after treatment to monitor for recurrence. For malignant tumors like choroidal melanoma, coordination with oncologists for systemic surveillance (liver imaging, etc.) since these tumors can metastasize.
When to See a Doctor
- !If you notice a new, growing, or changing dark spot on the white of your eye or iris
- !If you have a choroidal nevus (eye mole) — ensure it is being monitored with regular imaging
- !If you experience unexplained, persistent blurred vision or visual distortion in one eye
- !If you notice a bump, lump, or thickening on your eyelid that doesn't heal
- !Annual comprehensive dilated eye exam for everyone — many eye tumors are found incidentally
- !If you have a history of skin melanoma — you need annual eye exams (higher risk of eye melanoma)
Frequently Asked Questions
What types of eye tumors are treated at Neurovision Clinic?
Dr. Dibya Prabha evaluates and manages a range of ocular tumors including choroidal melanoma (the most common primary intraocular cancer in adults), choroidal nevus (benign mole in the eye requiring monitoring), retinoblastoma (childhood eye cancer), conjunctival tumors, eyelid tumors, and metastatic tumors to the eye from other cancers. Accurate diagnosis is the critical first step.
Is every eye tumor cancerous?
No. Many eye tumors are benign (non-cancerous) — like choroidal nevi (eye freckles) and some vascular tumors. However, benign tumors can still threaten vision depending on their location and size. Any suspicious lesion needs thorough evaluation by a retina specialist. Dr. Dibya Prabha uses advanced imaging to distinguish between benign and malignant lesions.
What diagnostic tests are used for eye tumors?
Evaluation includes detailed fundus examination, fundus photography (for documentation and serial comparison), OCT (for assessing retinal involvement), OCTA (for evaluating tumor vasculature), and ultrasound B-scan (for measuring tumor dimensions and internal characteristics). Dr. Prabha coordinates additional systemic workup when needed.