A variety of skin cancers including basal cell carcinoma, squamous cell carcinoma, cutaneous melanoma, and sebaceous cell carcinoma may affect the eyelids. Malignant tumors of the orbit commonly include lymphoma, optic nerve malignancies, metastatic tumors, and malignant tumors secondarily involving the orbit from local periorbital structures. Malignancies of the conjunctiva and cornea include squamous cell carcinoma and melanoma. The primary tumor affecting the adult is choroidal melanoma.

The diagnosis of these conditions includes a detailed examination of the involved structures and many additional diagnostic examinations. Echography or ultrasonography images provide detailed information of the shape, location, and internal characteristics of ophthalmic tumors. Fluorescein angiography and other ophthalmic photographic techniques are readily available in the department. The Molecular Ophthalmology Laboratory provides services when necessary. Additional diagnostic tests including CT scan, MRI, and appropriate laboratory studies are performed and, in many cases, diagnostic biopsy is necessary. Sample tissues are evaluated in the Frederick C. Blodi Ophthalmic Pathology Laboratory.

Services
The treatment of cancer of the eye and orbit includes a variety of techniques. Excision of eyelid cancers is followed by reconstruction of the affected tissues using local myocutaneous flaps or grafting techniques. In many cases, reconstruction follows controlled tumor excision by the members of the Mohs Surgery Service in the Department of Dermatology.

Surgeons use microsurgical techniques to remove or biopsy orbital tumors. When preservation of the eye or orbital tissues is not possible, orbital exenteration may be required. After exenteration of the orbit, facial prostheses are attached to the facial skeleton in a traditional manner or with orbital osseointegration.

Excision of conjunctival cancers followed by reconstruction in association with conjunctival cryotherapy or corneal transplantation is available.

The treatment of ocular melanoma with either radioactive plaque application or enucleation of the eye is performed using the most recent surgical techniques and orbital implants. Board certified ocularists create prosthetic eyes. The department actively participates in the National Collaborative Ocular Melanoma Study and serves as its photograph reading center for North America.

The University of lowa Hospitals and Clinics is the regional referral center for patients with ophthalmic and periocular malignancies. Patients at UI Hospitals and Clinics with ophthalmic oncologic problems receive complete diagnostic and therapeutic services.