Eye Lymphoma

About Eye Lymphoma

Lymphoma is a cancer that originates in the white blood cells called lymphatic cells or lymphocytes and can affect any portion of the eye and surrounding tissues. When lymphoma develops in the retina of the eye, it is called primary intraocular lymphoma (PIOL) or vitreoretinal lymphoma (VRL), and it is frequently a type of non-Hodgkin’s lymphoma called Diffuse Large B cell lymphoma. PIOL/VRL can develop in the retina, the light-sensitive tissue that lines the back of the eye; in the vitreous, the jelly-like fluid inside the eye; or in the optic nerve at the back of the eye. About 80 percent of people who have PIOL develop it in both eyes, and it may also be found in or later develop, in the brain. Other areas of the eye can manifest lymphomas which are different and don’t behave like PIOL/VRL the are managed differently and present with different symptoms.

Risk Factors

Some risk factors to develop PIOL/VRL include advanced age or having an immune system disease such as rheumatoid arthritis, AIDS (acquired immunodeficiency syndrome), or are taking medications that decrease their bodies immune system, like those used for people with transplanted organ.


Intraocular lymphomas have a range of symptoms, making diagnosis sometimes challenging. The most common symptoms for PIOL include:

  • Blurry vision
  • Decrease or loss of vision
  • Floaters (small dots or lines in the field of vision)
  • Redness or swelling in the eye
  • Increased sensitivity to light
  • Eye pain. Although this is rare

While lymphoma usually affects both eyes, symptoms may be more obvious in one eye than the other.


Ophthalmologists diagnose intraocular lymphoma by assessing patients’ symptoms, checking vision and eye movement, examining the inside of the eye using an ophthalmoscope, an instrument with a light and a small magnifying lens, and by removing a sample of cells from the vitreous (a procedure called vitrectomy biopsy) for examination. Ocular oncologists can differentiate between the types of lymphomas around and in the eye and arrange the proper testing and treatment.

The ophthalmologist will work with other specialists to obtain images of the brain and central nervous system to determine if the lymphoma has spread beyond the eye. They will likely also remove fluid from the spine to determine if the lymphoma has spread to the spinal fluid.

Treatments We Offer

Treatment for PIOL usually includes chemotherapy (often the drugs methotrexate and/or rituximab), which may be delivered through a vein (systemically) or directly into the eye (intravitreally) or fluid in the spine (intrathecally).

Radiation therapy uses very high-energy beams to shrink tumors and kill cancer cells. Radiation may be targeted only at the affected eye, both eyes, and brain and spinal cord. This can help prevent cancer from spreading there or help destroy hidden cancer cells.

Why Choose Columbia?

A diagnosis of eye lymphoma can be devastating. Columbia ophthalmologists have the experience and the resources of multi-specialists and cancer experts to correctly diagnose and accurately treat your cancer while making sure you understand the process by answering all your questions and supporting you and your family.