Treatments for squamous cell carcinoma of the eye

The following are treatment options for squamous cell carcinoma (SCC) of the eye. Your healthcare team will suggest treatments based on your needs and work with you to develop a treatment plan.

Surgery is the main treatment for SCC of the eye in the conjunctiva. Whether you are offered surgery and what surgery you have depends on the size of the tumour and how much surrounding tissue is affected.

Surgical excision removes the tumour along with some normal tissue around it (called the surgical margin) .

Cryosurgery uses extreme cold to freeze and destroy cancer cells. It is used along the margins after surgical excision to kill any cancer cells that may have been left behind.

An orbital exenteration removes the eyeball and surrounding tissues and structures. Orbital exenteration is used much less often than it once was. It is usually only used when SCC is very thick, it has spread outside of the eye or it is high-grade.

Find out more about surgery for eye cancer.

Radiation therapy uses high-energy rays or particles to destroy cancer cells. It may be offered after surgery for SCC of the eye (called adjuvant therapy). It is given as brachytherapy.

Brachytherapy (plaque therapy) gives radiation therapy by placing a container shaped like a bottle cap (called a plaque) on the surface of the eye over the tumour. The plaque contains small radioactive particles that are called seeds.

Find out more about radiation therapy for eye cancer.

Chemotherapy uses drugs to destroy cancer cells. It is a common treatment for SCC of the eye in the conjunctiva. It is given as eye drops (a form of topical chemotherapy). You may have the following drugs as topical chemotherapy:

• mitomycin C
• fluorouracil (also called 5-fluorouracil or 5-FU)

Find out more about chemotherapy for eye cancer.

Immunotherapy helps to strengthen or restore the immune system’s ability to fight cancer. You may be offered immunotherapy for SCC of the eye.

Interferon alfa-2b (INF2b) may be given to treat for SCC of the conjunctiva. It is a form of topical immunotherapy that is given as eye drops.

You may also be offered cemiplimab (Libtayo) for conjunctival SCC. This is a systemic therapy given by injection into a vein (intravenous). Cemiplimab can be used to treat thick or high-grade SCC instead of having an orbital exenteration.

Find out more about immunotherapy for eye cancer.

You may be offered active surveillance for SCC of the eye if you are not well enough to have other treatments or if the tumour is very small and not causing any symptoms. The goal of active surveillance is to help you keep a good quality of life while delaying other treatments that can cause side effects for as long as possible. Your healthcare team will use tests and exams to see if the eye cancer is growing or spreading. You will be offered other treatments if you develop symptoms or the cancer changes.

Find out more about active surveillance for eye cancer.