Surgery for eye cancer (ocular melanoma)

Surgery may involve removing just the tumour, a small part of the eye, or sometimes the whole eye.

About surgery for eye cancer

This may involve removing just the tumour, a small part of the eye, or sometimes the whole eye. The type of surgery you have depends on the size and position of the tumour.

Conjunctival melanoma is often treated with surgery. The specialist surgeon is usually able to remove the tumour from the surface of the eye. You may only need a local anaesthetic to have this small operation.

If you need surgery to remove a uveal melanoma, you will have a general anaesthetic and a slightly longer operation.

The thought of having any type of surgery to your eye can be frightening, and you may have worries about how your sight will be affected. Your eye surgeon or specialist nurse will explain what to expect and answer any questions before your operation.

Rarely, some people will need a bigger operation to remove the whole eye, or the eye and nearby tissue. Your surgeon will always try to keep your eye if possible. They will only advise this type of surgery if it is really needed.

You may need to talk this over carefully with your doctor and specialist nurse more than once before you make a decision. They may arrange extra support to help you cope, such as counsellors or patient support groups.

Removing the eye (enucleation)

This operation is not common but is sometimes used to treat uveal melanoma. The surgeon may advise removing the whole eyeball if:

  • the cancer is large
  • the cancer is in a difficult position
  • you are already blind in the affected eye and it is painful.

During the operation, the surgeon removes the eyeball, puts an eye-shaped implant into your eye socket. They then cover the implant with healthy surrounding tissue. The implant fills the space where your eyeball was. The surgeon attaches your eye muscles to the implant. This makes it move like your eye.

Several weeks after the operation, you have an artificial eye (prosthesis) made. An artist makes the prosthesis to match your other eye as closely as possible. You wear the prosthesis over the implant. Because the implant moves, your prosthesis should also move quite naturally.

Removing the eye and nearby tissue (orbital exenteration)

This type of surgery is rarely needed. But it may be used to treat a large conjunctival melanoma that has spread to areas around the eye. The surgeon removes the eyeball and nearby tissue, such as the eyelids.

After the operation, you may have a facial prosthesis made. This is an artificial part of your face that covers the eye socket with false eyelids, lashes and an artificial eye. The false eye will not be able to move or blink. The prosthesis can be worn on a pair of glasses, or fixed to your face with special glue. Sometimes, the prosthesis can be fitted to studs that the surgeon fixes into the bone around the eye socket.

If you need this operation you will get a lot of support from your healthcare team before surgery. You may meet a counsellor or psychologist for more specialised support.