An elderly woman (above) has her eyes checked at Mulago hospital recently. Photo | File
Preventing eye cancer involves a combination of health education, risk reduction, and early detection, all of which are crucial in Uganda’s context. Routine eye screening should be promoted, especially for children with a family history of eye cancer, as well as for HIV-positive individuals who require regular ophthalmologic assessments as part of their comprehensive care.
It is also important to encourage protection against ultraviolet (UV) rays. UV-protective sunglasses and wide-brimmed hats should be promoted, particularly among farmers, motorcycle riders (boda-bodas), and street vendors. To ensure broader access, government programmes could subsidise or distribute protective eyewear to communities at high risk. Public health education campaigns should be expanded, using platforms such as radio, television, and local community leaders to raise awareness.
These campaigns should inform the public about the early signs of eye cancer, such as a white pupil, persistent redness, and painless lumps. Additionally, the risks of self-medication and reliance on herbal remedies should be highlighted, emphasising the importance of professional eye care. Strengthening HIV and HPV prevention programmes is another key strategy.
Expanding access to antiretroviral therapy (ART) is essential to reduce immune suppression linked to HIV, and promoting HPV vaccination, particularly among adolescents, could help reduce the incidence of HPV-associated eye cancers. Integrating eye health into primary care is essential, with health workers at health centres being trained to detect early signs of ocular malignancies. Ensuring that patients with eye complaints are referred promptly for specialist review will further strengthen prevention and treatment efforts.
Treatment options
In Uganda, treatment options for eye cancers are available through institutions such as the Uganda Cancer Institute (UCI), Mulago National Referral Hospital, and Mengo Eye Hospital. These treatment options are tailored to the type, size, and stage of the tumour. Surgical options include enucleation, which is the removal of the eye and is often necessary for advanced retinoblastoma and ocular melanoma, as well as tumor excision, which removes conjunctival tumors while preserving eye function. In some cases of orbital tumours spreading beyond the eye, orbital exenteration may be required. Chemotherapy options include systemic chemotherapy, typically used for bilateral or advanced retinoblastoma in children. Topical chemotherapy, such as mitomycin C eye drops, is used for localised conjunctival squamous cell carcinoma (SCC). Intravitreal chemotherapy, a newer technique, involves injecting drugs directly into the eye. Radiotherapy is also a common treatment, with external beam radiation used for orbital tumours and melanomas. Brachytherapy, which involves placing radioactive plaques near the tumour, is typically used in ocular melanoma but is not yet widely available in Uganda.
The launch of ocular surgical oncology services
A significant advancement in eye cancer care in Uganda has been the launch of the UCI’s dedicated ocular surgical oncology service. This is the first of its kind in the country and offers advanced eye cancer surgery, including complex tumour resections, orbital reconstruction, and cosmetic restoration. Multidisciplinary clinics are held, where ophthalmologists, oncologists, radiation experts, and palliative care teams collaborate to provide comprehensive care. Onco-pathology support is available on-site to improve treatment precision, and training programmes, including fellowships and workshops, help build a cadre of ocular oncologists in Uganda and the region. The impact of these developments has been significant. Fewer patients need to be referred abroad for eye cancer surgery, and rural patients now have better access to care through tele-ophthalmology consultations. Survivors of eye cancer benefit from improved quality of life through cosmetic and prosthetic support.
The writer is the executive director, Uganda Cancer Institute
