Eye cancer can be visible in photos, but it is easy to mistake it for other conditions. Because of this, doctors often do not diagnose eye cancer until it is advanced.

Eye cancer can develop in the eyeball or in the tissues and structures that surround it. It is a relatively rare type of cancer, with an estimated 3,490 new cases occurring in the United States in 2023. Most often, the cancer is secondary, meaning it results from cancer elsewhere in the body spreading to the eye.

This article will include photos of eye cancer, descriptions of what the symptoms can look like, and details on how doctors diagnose it.

Eye cancer can look different depending on which part of the eye it affects and how large the tumor is. A person may notice:

  • a growing dark spot on the iris, or the colored area of the eye
  • changes in the shape or size of the pupil, the dark center of the eye
  • lumps on, in, or around the eye
  • bulging of the eye
  • changes in the position of the eyeball within its socket
  • changes in the way the eyeball moves within its socket

Eye cancers can also affect how the eyes look in flash photography. Usually, when a person looks directly into a flash from a camera, their eyes reflect a red color. This is typical and often a sign the eyes are healthy.

But if a person only has this red reflection in one eye, or the reflection is another color — such as white, yellow, or black — this can sometimes indicate an eye condition.

However, it is important to note that any of the above symptoms can occur for a wide range of reasons. A person having one or more of them does not necessarily mean they have cancer.

Eye cancer can be visible in photos, but many people do not have any symptoms in the early stages. It is only if the cancer grows in a certain part of the eye or becomes advanced that people may develop symptoms.

Additionally, the symptoms can be easy to mistake for those of other conditions. For example, if a child’s eye has a white reflection in flash photography, it can be a sign of retinoblastoma, which is a very rare type of eye cancer that affects young children.

However, this sign can also be the result of several other eye conditions or of the child looking to one side of the camera lens. To be certain that the photo is accurate, a person must make sure:

  • the child looks directly at the camera lens
  • the background has only dim lighting
  • they turn the camera flash on
  • they switch red-eye reduction off

Similarly, hyperthyroidism can cause eye bulging, and conjunctivitis can cause eye inflammation.

In addition to the visible signs and symptoms of eye cancer, the condition may cause:

  • vision changes, such as blurriness
  • flashes of light
  • floaters, or dots and squiggles in the field of vision
  • eye inflammation and irritation that does not get better
  • partial or complete loss of vision
  • pain in or around the eye, although this is rare unless the cancer has spread outside the eye significantly

Eye cancer signs and symptoms vary considerably depending on the area it starts in, how large it grows, and how far it spreads.

Doctors can use several staging systems to assess the development of eye cancer. The most common are the American Joint Committee on Cancer’s TNM system and the Collaborative Ocular Melanoma Study (COMS) group system.

Both systems mostly focus on how large a person’s tumor is, with the TNM system also factoring in how far a tumor has spread.

In the early stages, eye cancer tumors are usually too small to be visible or cause any obvious vision changes. In the COMS system, a small tumor is only 1–3 millimeters (mm) high and 5–16 mm wide.

Once a tumor has reached an advanced stage, meaning it is large or has spread significantly, it may become visible in an eye exam.

Opticians help fit people with eyeglasses, but they cannot perform eye exams. For this reason, they cannot diagnose eye cancer.

However, an optometrist can perform eye examinations and may sometimes spot signs of eye cancer during one. If this happens, they may refer the person to an ophthalmologist, which is a specialist eye doctor, for further investigations.

The ophthalmologist may ask about a person’s symptoms and check their vision and eye movement. They may also look for signs of enlarged blood vessels outside of the eye, as this can sometimes indicate that there is cancer inside the eye.

The doctor may then use special tools to look inside the eye. This may involve using eye drops to dilate the pupils while they examine the eye using:

  • an ophthalmoscope, which is a handheld magnifying glass with a light
  • a slit lamp, which has a higher magnification than an ophthalmoscope
  • a gonioscopy lens, which is a mirrored lens that goes over the outer part of the eye

If there are signs of cancer, the ophthalmologist may refer a person to an ocular oncologist. They may order medical imaging tests, such as an MRI or ultrasound.

Usually, medical imaging is enough to enable the doctor to make a diagnosis without the need for a biopsy, but they may recommend a biopsy if they want to test for certain genes that could affect the outlook.

If anyone experiences any changes in vision or the appearance of the eyes, it is best to contact a doctor. This is true even if they have recently had an eye exam. Eye cancer symptoms can quickly develop once the tumor reaches a certain stage, so it is important to notify a doctor about any changes.

It is also important for people who have a personal or family history of melanoma, or who have previously had any type of cancer, to seek prompt medical advice if they notice symptoms. Melanoma is the most common type of eye cancer, although it is still rare overall.

In photos of eye cancer, people may see changes in the shape or size of the pupil, a dark spot on the iris that grows in size, lumps around the eye, or bulging. In flash photography, one or both eyes may also not have the typical red reflection but have a white or yellow reflection instead.

However, eye cancer is difficult to initially identify. In the early stages, it may not be visible in photos at all. As a result, people should not rely solely on photos of the eyes to look for signs of cancer. Anyone who has concerns should speak with a doctor.