PURPOSE: To investigate the incidence rate, histopathological types, and time trends of primary eye cancer, eyelid cancer, and ophthalmic lymphoma among the Chinese population. METHODS: The records of patients diagnosed with primary eye and eyelid cancers from 2005 to 2018 in Hong Kong were retrieved from the Hong Kong Cancer Registry. Patient demographics, cancer sites, and histology were recorded. Population-level age-standardized incidences and trends were analyzed by age and sex and compared with existing literature. International Classification of Diseases, Ninth Edition (ICD-9) codes were converted to ICD-10 codes. Eye cancer was defined as malignancy involving the eyeball, intraocular structures, lacrimal system, and orbit. RESULTS: A total of 442 eye cancers and 1103 eyelid cancers were included. Among these cancers, 295 cases were ophthalmic lymphoma. The age-standardized annual incidence rate was 4.04 per 1,000,000 population for eye cancer, 6.30 for eyelid cancer, and 1.89 for ophthalmic lymphoma. The incidence rates increased with age (P <
0.001), but there were no sex differences. The incidence rate of eyelid cancer and ophthalmic lymphoma showed an increasing trend, with annual percent changes of 2.8% and 2%, respectively. In eye cancers, the most common histological type was lymphoma (58.1%), and the most common site was orbit (35.5%). The most common histology for eyelid cancer was basal cell carcinoma, and for ophthalmic lymphoma it was extranodal marginal zone B cell lymphoma. CONCLUSIONS: In the Chinese population, the incidence of eye cancer has remained stable, whereas eyelid cancer and ophthalmic lymphoma are increasing. Lymphoma has been the most common histological type in recent years, in contrast to findings in Western populations.