Supportive care for eye cancer

Supportive care helps with the physical, practical, emotional and spiritual challenges of cancer. This important part of cancer care focuses on improving the quality of life of people with cancer and their loved ones, especially after treatment has ended.

Adjusting to life after treatment is different for everyone. Your recovery will depend on many different factors, such as where the cancer was in your body, the stage of the cancer, the organs and tissues removed during surgery, the type of treatment and side effects.

If you have been treated for eye cancer, you may have the following concerns.

Self-esteem is how you feel about yourself. Body image is how you see your own body. They are often closely linked. Eye cancer and its treatments can affect your self-esteem and body image. Often this is because cancer or cancer treatments change your body in different ways, such as:

• changes to your appearance, including how your eye or face looks
• changes to your vision or no longer being able to see
• loss of an eye
• having to wear a prosthesis
• scars
• hair loss
• skin problems

Some of these changes can be temporary. Others can last for a long time or be permanent.

But treatment can affect your self-esteem or body image even if it doesn’t affect how you look. Other people may not be able to see changes to your body, but you may still worry about how they now see you. This may affect your self-esteem, making you feel angry or upset, afraid to go out or worried that others will reject you.

Find out more about coping with body image and self-esteem worries.

Eye cancer or its treatment can lead to changes in your vision. They can range from minor changes (for example, you find it harder to see in the dark than you used to) to the loss of an eye or complete loss of vision in part or all of your visual field. Some changes may only be temporary. Some will be permanent. The kind and degree of change you experience depends on the type of eye cancer, how much of the eye was affected and what kind of treatments you had.

Vision changes can affect everyday activities such as reading and writing. They can also affect your hand-eye coordination and how you get around (mobility). You may require more support, or you may need to use assistive devices to do the things you used to do. Depending on your needs, your healthcare team may suggest:

• new prescription glasses or contact lenses to help correct your vision
• large print books or increasing text sizes on electronic devices like smartphones and tablets to help you see text more easily
• audiobooks or programs that read text aloud (called text-to-speech programs)
• a guide dog

Changes to your vision can affect your ability to drive or how you drive. For example, you may need to turn your head more if you have lost peripheral vision (the outer area of your field of vision). Depending on the changes to your vision, you may also need to notify the government agency that issues drivers’ licenses as well as your car insurance company. You may have to take a vision test or you may have restrictions on when, where or for how long you can drive.

Changes to your vision can be distressing and have a big impact on your life. Adjusting to them usually takes time. Your healthcare team can help you to find ways to cope.

Find out more about eye and vision problems.

Prostheses are used to replace an eyeball (and other tissue) that was removed during surgery for eye cancer. Prostheses can’t replace vision, but they can help you feel more confident in your appearance.

An ocular prosthesis replaces an eyeball that was removed by surgery. It can also be called an artificial or “glass” eye.

An orbital prosthesis may be worn after orbital exenteration surgery, which removes the entire eyeball and surrounding tissues and structures. This can include the eyelids, muscles, nerves, fat and bone of the eye socket (orbit). An orbital prosthesis replaces the eyeball and the tissues and structures that were removed, including eyebrows and eyelashes. Sometimes, facial reconstructive surgeries can be done so that you don’t need an orbital prosthesis.

Ocular and orbital prostheses are custom made to fit your face precisely. They are then painted to look as natural as possible. People who don’t know you may not even notice your prostheses.

Getting an ocular or orbital prosthesis is a long process. You can’t be fitted for an artificial eye or facial prosthesis until after you have healed from surgery. In the meantime, you may have to wear a temporary prosthesis. Once healed and fitted with your ocular or orbital prosthesis, you can leave this prosthesis in place while you do most of your daily activities. You may need to remove it to sleep, exercise, bathe and swim.

Your healthcare team will teach you how to clean and care for your prosthesis and the skin around and beneath it. They may recommend that you wear protective glasses or other eyewear to protect your remaining eye, particularly while playing sports.

It takes time to adjust to the loss of an eye and wearing a prosthesis. You may feel frustrated, angry or sad, or self-conscious and worried about what others may think about your prosthesis or how you look. Some people find it helps to talk to others about changes to their sight or appearance. You may also be coping with new sensations, such as feeling like the eye is still there when it has been removed. Talk to your healthcare team about the support groups available to help you cope with your emotions and daily life with a prosthesis after eye cancer.

To make decisions that are right for you, ask your healthcare team questions about supportive care.