Treating Intraocular (Eye) Lymphoma
These lymphomas are often linked with lymphomas of the brain, which are known as primary central nervous system (CNS) lymphomas. Because lymphomas of the eye often spread to the brain or have already spread when the cancer is first diagnosed, in many cases both the eye and the brain are treated. For more detailed information on the treatment of CNS lymphomas, see Non-Hodgkin Lymphoma.
Because these cancers are rare, they have been hard to study. A number of approaches can be used, but the best course of treatment is not known, so it is very important to go to a doctor experienced in treating eye lymphoma.
Surgery is not used to treat eye lymphomas because it is likely that the disease has already spread beyond the eye by the time it is found. Most often, doctors treat these cancers with external radiation therapy, chemotherapy (chemo), or a combination of the two.
The radiation therapy may be given only to the eye, or it may also include the brain and spinal cord. Radiation to both eyes may also be recommended, because often the lymphoma is in both eyes. Radiation therapy to the brain and spinal cord can help prevent the lymphoma from spreading there (or help destroy cancer cells that may already be there but haven’t been detected). But it can also cause side effects, leading to problems with thinking, concentration, and memory.
Chemo can be given into a vein (systemic chemo) or directly into the cerebrospinal fluid (intrathecal chemo). It can also be given directly into the eye (intraocular chemo), which gets higher doses of the drug to the tumor. Methotrexate is usually the main chemo drug used. Monoclonal antibodies such as rituximab may also be given directly into the eye. The best combination and dosage of drugs is not yet known, and the choice may be influenced by the exact cell type (classification) of lymphoma. Because recurrence rates are high if chemo is given only systemically (into a vein), therapy is usually given directly to the eye with either radiation or intraocular chemo as well.
If the lymphoma does not respond to treatment or if it comes back (recurs), high-dose chemotherapy followed by a stem cell transplant may be an option for some people.
Last Medical Review: December 9, 2014 Last Revised: February 5, 2016