Lymphoma of the Eye: What You Need to Know

When we think about lymphoma, a type of cancer that affects the lymphatic system, we most likely imagine it occurring in places like lymph nodes or bone marrow. But did you know that lymphoma can also develop in the eye? Though rare, ocular lymphoma targets the tissues in and around the eye, typically the conjunctiva, retina, the vitreous (the gel-like substance inside the eye) and the optic nerve. While it can affect anyone, it's more common in older adults and people with weakened immune systems.

Julio Chavez, MD

"Ocular lymphoma can be challenging to diagnose because its symptoms often mimic other, more common eye problems," says  Julio Chavez, MD, a medical oncologist in the Malignant Hematology Department at Moffitt Cancer Center. "It's crucial to pay attention to your eye health and see a physician and/or ophthalmologist if you notice any changes."

Ocular lymphoma usually affects one eye. If it does affect both eyes, symptoms may be more obvious in one eye. Chavez says common signs to watch for include:

• Blurred vision or loss of vision that doesn’t improve with corrective lenses
• Floaters (small spots or shapes that drift across your vision)
• Persistent eye redness, itchiness or discomfort
• Foreign body sensation in the eye
• Increased sensitivity to light
• Eye pain

Treating lymphoma of the eye can be tricky because the eye is delicate and complex, but it is generally treated using radiation, chemotherapy or immunotherapy, the same way lymphoma is treated elsewhere in the body. Treatment decisions are made based on the extension and location of the disease in the eye. Radiation therapy is the most common approach because it is very effective, and the disease is usually localized. In general, radiation is very safe and precise, which is important for protecting the healthy tissue surrounding the eye. Some people may experience side effects like dry eyes, cataracts or changes in vision.

Chemotherapy can be administered directly into the eye or intravenously through the bloodstream. The direct approach targets the cancer more precisely and may have fewer side effects, but if the disease has spread beyond the eye, systemic chemotherapy is used to treat the whole body.

Immunotherapy is a newer approach that helps the immune system fight cancer more effectively. This treatment is especially useful for people who haven’t responded to other therapies or have certain genetic markers that make this option more effective.

While ocular lymphoma is rare, Chavez says it is important to know that it is treatable, especially when caught early, and suggests staying on schedule with your annual eye exams.