Miguel N. Burnier Jr., MD, PhD, FRCSC, Chairman, Ophthalmology, McGill University, Montreal, QC.
Vinicius S. Saraiva, MD, PhD, Fellow, Ocular Oncology & Pathology, McGill University, Montreal, QC.

Second malignant neoplasms (SMN) are nonmetastatic malignancies occurring in patients previously diagnosed with another malignant neoplasm. This clinical entity is becoming increasingly more frequent with the aging of the overall population and better diagnosis and treatment of cancers. Although a reasonable percentage of cases may be explained by genetic, iatrogenic, and/or shared environmental exposure, it is estimated that the majority of cases are sporadic. Recognizing the possibility of SMNs is essential for appropriate and timely diagnosis and treatment, but even more important for the development of preventive strategies.
Key words: oncology, second malignant neoplasms, ophthalmology, eye tumours.

E. Rand Simpson, MD, Associate Professor of Ophthalmology, University of Toronto; Director, Ocular Oncology, Princess Margaret Hospital, Toronto, ON.
Larry Ulanski II, MD, Ocular Oncology Fellow, University of Toronto, Princess Margaret Hospital, Toronto, ON.

Ocular malignancies in the elderly are often difficult to diagnose and manage. The five main cancers found in association with the eye are basal, squamous and sebaceous cell carcinomas, uveal melanoma and malignant cancers to the orbit. These include malignancies from breast, lung, GI, prostate and myelogenous proliferations. This article briefly reviews the most common forms of ocular cancer and brings the general practitioner up to date on the most current data from the Collaborative Ocular Melanoma Study (COMS). We use clinical photos to demonstrate specific clinical signs of cancerous disease. By maintaining a high level of suspicion when treating patients with acute visual symptoms, unnecessary morbidity and mortality may be avoided.
Key words: ophthalmology, cancer, radiotherapy, malignancy.