Biopsy of the eye

A biopsy of the eye is a test where your eye specialist (ophthalmologist) takes a sample (biopsy) of fluid or tissue from your eye. 

Why you might have it

Your specialist might take a biopsy from your eye to check for cancer cells.

A biopsy is not usually used to diagnose melanoma of the eye.  A specialist can use other tests (such as an examination or ultrasound) to help diagnose this type of eye cancer.

If you do have a biopsy, you might have a fine needle aspiration or vitreous biopsy.

A biopsy can help them to see if there are any genetic changes in melanoma cells. This helps your specialist decide which cancer drugs would work best for your cancer. The results from the biopsy can also tell them how likely the melanoma is to spread.

You may also have a fine needle aspiration or vitreous biopsy if your eye specialist thinks you have lymphoma of the eye.

Fine needle aspiration

A fine needle aspiration biopsy is the removal of a sample of tissue or fluid using a syringe and needle.

Preparing for the test

You usually have this in the operating theatre. You do not need any special preparation before you arrive. Your hospital letter will tell you what to do.

What happens?

You lie on a couch with your head in a comfortable position. After you have the local or general anaesthetic, the specialist puts a thin needle attached to a syringe into your eye. They draw out some cells from the tumour. 

This usually takes a few minutes. If you have a local anaesthetic, you may be aware of something going on, but you shouldn’t have discomfort or pain. Let your doctor know if you can feel anything or if it is painful.

The biopsy goes to the laboratory, where a specialist doctor looks at the cells closely. This can show whether there is a cancer or another type of eye condition. It can take some time to get the results. You will have an appointment to see your specialist to discuss the results with you. 

After your biopsy

You can go home soon after the biopsy. You can take paracetamol if your eye is sore. Your doctor or nurse will let you know how to look after your eye after the biopsy. Sometimes you may have eye drops to take for a few days after. Your nurse will show you how to do this.

Possible risks

A needle biopsy is a very safe procedure. But your nurse will tell you who to contact if you have any problems afterwards. This is usually a number for the ophthalmology department or a ward. It is important to let them know if you notice any of the following around your eye:

• redness

• pain

• swelling

• bleeding

Your specialist will tell you about any other risks if you are worried.

Vitreous biopsy

A vitreous biopsy is a small procedure to remove some of the vitreous gel in the eye. The gel is also known as humour, it gives your eye volume. You may hear your doctor talk about vitreous humour.

Preparing for the test

You usually have this test in the operation theatre using a local anaesthetic or a general anaesthetic. Your hospital letter will tell you if there is any preparation you have to do.

Your specialist will explain what happens and ask you to sign a consent form. Do ask any questions you may have.

You may have another eye examination just before the biopsy.

What happens?

Your eye specialist takes a sample of the vitreous gel from inside the eye. Using a special instrument, a cut is made into the eye. A sample of the vitreous gel is taken using a needle and syringe.

Afterwards, the sample goes to the lab. A pathologist looks at it under a microscope.

After your biopsy

It is likely you will need to wear a patch over your eye for a short time after surgery. Your surgeon will tell you when you can stop wearing this. 

It is usual to have blurred vision in the eye that had the surgery. This can last a few days. 

You may have a red and swollen eye. This is common after this type of surgery and it may take up to a couple of weeks to improve. You may notice bruising around the eye. This will also improve over 2 weeks. 

You have eye drops for a few weeks after surgery. These help to reduce redness, swelling and the risk of infection. You usually start them in hospital and continue with them at home. Your nurse will show you or your relative how to put these in.  

As your vision could be affected you should avoid driving for a time. Ask the eye specialist when you can start driving.

Possible risks

A vitreous biopsy is a safe procedure. Your specialist will tell you about any risks.

Looking after your eye at home

Your specialist or nurse will advise you how to look after and protect your eye at home, for example:

• instructions for using your eye drops
• try to avoid getting shampoo and soap into your eye
• you should not go swimming for 6 weeks
• avoid contact sports
• avoid using eye makeup

You will have an appointment to return to the hospital for the results. At this time your eye specialist will also let you know when you can start using eye makeup and resume sports.

Getting your results

You will have to wait to get the results. Ask your doctor or nurse how long it will take to get them. Contact the doctor who arranged the test if you haven’t heard anything after a couple of weeks.

Waiting for results can make you anxious. It may help to talk to a close friend or relative about how you feel.

You might have contact details for a specialist nurse. You can contact them for information if you need to.