Which metastatic tumors to the eye may cause glaucoma?

Updated: Jun 25, 2020
  • Author: Andrew A Dahl, MD, FACS; Chief Editor: Hampton Roy, Sr, MD  more...
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The 2 most common sites of primary tumor metastatic to the eye are breast and lung cancers. In 2 large studies, 6% of lung cancers and up to 37% of breast cancers metastasized to the eye.

The posterior uvea is the most common site of metastases, but glaucoma more often is associated with anterior metastases.

In a series of 227 cases of metastatic carcinoma, glaucoma was detected in 7.5% of the total group and 56% of those with anterior segment metastases.

Mechanism of glaucoma includes direct invasion of the trabecular meshwork by tumor cells, secondary angle closure by anterior displacement of the lens-iris diaphragm, and neovascularization of anterior chamber angle.

Squamous cell carcinoma may produce a sheet of tumor cells.

Glaucoma may be the initial presentation in some patients.

Management includes paracentesis with aqueous aspiration for cytologic examination or flow cytometry for diagnosis. Medical management of intraocular pressure coupled with radiation or chemotherapy may be useful. Enucleation is reserved for blind, painful eyes.

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