To diagnose eye cancer, an ophthalmologist (Eye M.D.) will ask about symptoms and check vision and eye movements. During the eye exam, the Eye M.D. will use an ophthalmoscope—an instrument with a light and a small magnifying lens—to get a good look inside the eye.
Certain imaging tests may be done, including:
- Ultrasound: helps the Eye M.D. assess the tumor.
- MRI scan: helps the doctor to see the eye better and look for lymphoma in the brain or spinal cord, where this cancer commonly spreads.
- Positron emission tomography (PET) scan: helps give the Eye M.D. a better idea of whether the cancer has spread to lymph nodes or other parts of the body. In this imaging test, a radiolabeled substance (usually a type of sugar) is injected into the blood. Since the body’s cancer cells often absorb larger amounts of sugar than other cells, a special camera can then take pictures of the areas where the signal shows up. This imaging technique helps identify whether abnormal areas seen on other tests (such as MRIs) may be cancer.
To confirm an eye lymphoma diagnosis, a biopsy is usually needed, where a sample of tissue or cells is removed and examined in a lab under a microscope and tested. The person undergoing a biopsy may be sedated and get local anesthesia (numbing medicine) or may get general anesthesia (to be put in a deep sleep).
For a biopsy, the Eye M.D. usually does a procedure called a vitrectomy. In this procedure, he or she will insert tiny instruments into the eye, cut the vitreous—the clear, jelly-like substance that fills most of the eye—then suck a sample of it out. This sample is then sent to the lab for examination and testing.
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