Ocular surface squamous neoplasia (OSSN) is a rare and broad spectrum of tumours that range from benignnot cancerous, can grow but will not spread to other body parts tumours such as epithelial dysplasiathe presence of abnormal cells in a tissue or organ and papillomas, to malignantcancerous, may grow and spread to other areas of the body tumours such as squamous cell carcinomas (SCC) and mucoepidermoid carcinomas. These tumours develop on the ocular surface, which encompasses the cornea and conjunctiva of the eye.
The eye is a sensory organ that allows us to see by reacting to light. Light passes through the cornea (the clear, front layer of the eye) and enters the eye through an opening called the pupil (the black centre of the eye). The amount of light received by the pupil is controlled by the iris (the coloured portion of the eye). This light is then passed through the lens (the clear, inner portion of the eye) and works together with the cornea to focus light onto the retina (a layer of tissue at the back of the eye that is sensitive to light). The retina then activates photoreceptors (image forming cellsthe basic structural and functional unit of all living things) to convert the light to electrical impulses that travel to the brain via the optic nerve, which is then converted into an image.
OSSN is more common in males, and tends to be diagnosed around the age of 56. However, anyone can develop this disease.
Treatment
When cancers are detected, they are staged and graded based on size, metastasiswhen the cancer has spread to other parts of the body, also known as mets, and how the cancera disease where abnormal cells split without control and spread to other nearby body tissue and/or organs cells look under the microscope. Stagingthe process of determining how big the cancer is, where it started and if it has spread to other areas and grading help your doctors determine the best treatment for you. However, because of how rare OSSNs are, there is currently no standard staging and grading system for this disease. Instead of staging and grading, your doctor will recommend a treatment plan based on the following factors:
- Cancer location.
- Whether or not the cancer has metastasised.
- Your age.
- General health.
- Your treatment preferences.
Your doctor may also recommend genetic testinga procedure that analyses DNA to identify changes in genes, chromosomes and proteins, which can be used to analyse tumour DNA to help determine which treatment has the greatest chance of success, which analyses your tumoura tissue mass that forms from groups of unhealthy cells DNA and can help determine which treatment has the greatest chance of success. They will then discuss the most appropriate treatment option for you.
Treatment options for OSSN may include:
- Tumour excisionto surgically remove/cut out.
- Chemotherapya cancer treatment that uses drugs to kill or slow the growth of cancer cells, while minimising damage to healthy cells.
- Radiation therapya treatment that uses controlled doses of radiation to damage or kill cancer cells.
- Immunotherapya treatment that uses a person's immune system to fight cancer.
- Clinical trialsresearch studies performed to test new treatments, tests or procedures and evaluate their effectiveness on various diseases.
- Palliative carea variety of practices and exercises used to provide pain relief and improve quality of life without curing the disease.
Risk factors
While the cause of OSSN remains unknown, the following factors may increase the likelihood of developing the disease:
- Exposure to ultraviolet (UV) B radiation.
- Infections with the human papillomavirus (HPV), human immunodeficiency virus (HIV) and/or hepatitis B or C.
Not everyone with these riskthe possibility that something bad will happen factors will develop the disease, and some people who have the disease may have none of these risk factors. See your general practitioner (GP) if you are concerned.
Symptoms
The symptoms of OSSN may include:
- Fleshy, elevated ocular lesion.
- Red eye.
- Irritation of the eye.
- Inflammation of the eye.
- Pain in the eye.
- Vision loss (extreme cases).
Not everyone with the symptoms above will have cancer, but see your general practitioner (GP) if you are concerned.
Diagnosis
If your doctor suspects you have an OSSN, they may order the following tests to confirm the diagnosisthe process of identifying a disease based on signs and symptoms, patient history and medical test results and refer you to a specialist for treatment:
- Physical examinationan examination of your current symptoms, affected area(s) and overall medical history.
- Eye tests.
- Imagingtests that create detailed images of areas inside the body tests, most commonly an ultrasounda type of medical imaging that uses soundwaves to create detailed images of the body of the eye.
- Biopsyremoval of a section of tissue to analyse for cancer cells.