My doctor says I have a nevus in my eye. Will it become a cancer?
Just like a raised freckle on the skin, a nevus can occur inside your eye. And, like a nevus on the skin, a choroidal nevus can grow into a melanoma. This is why your ophthalmologist will examine your eyes on a regular basis (at least every six months) and use photography and echography to check if the nevus has changed in size.
Is ocular melanoma the same as skin melanoma?
What causes ocular melanoma?
Will a biopsy be performed to make sure that the tumor is a cancer?
Can the laser be used to treat ocular melanoma?
Can an ocular melanoma tumor be surgically removed without radiation therapy or removing my eye?
Will the cancer spread to other parts of my body?
I just had a physical examination a few months ago. Why do I need to see a radiation
oncologist before plaque surgery?
What can I expect during radiation plaque surgery?
Procedures differ from hospital to hospital, but usually you will be asked to arrive at the hospital several hours before the time of your scheduled surgery. A member of the surgical team will meet with you to answer any questions and prepare you for your operation. After changing into a hospital gown, the anesthesiologist will meet with you and begin to administer the anesthetic.
Anesthesia is used so that surgery can be performed without unnecessary pain. Local anesthesia selectively numbs only a part of your body. During general anesthesia you will be unconscious during the entire surgery. Because general anesthesia is associated with a higher risk for patients both during and after surgery, in most cases, local anesthesia is recommended for radiation plaque surgery. Under local anesthesia you are "awake" during the surgery, but will be given medication to relax and you will not be in pain. While you may be aware of sounds in the operating room, your "good" eye will be covered so you will not see what is happening during surgery.
What will it be like during my hospital stay after radiation plaque therapy?
Most patients report that they have some discomfort the first night after surgery. Your doctor will leave orders for appropriate pain medication to keep you as comfortable as possible. There will be a patch over the operated eye and the nurse will administer eye medication to prevent infection. The day after surgery you probably will be encouraged to get out of bed and sit up for a while.
Some patients suggest bringing a Walkman and listening to audiobooks (available at bookstores or your local library) is more comfortable than reading or watching television. Most hospitals permit visitors during hospital visiting hours If you have a radiation plaque, visitors may be requested not to come into close contact with you for any length of time. Young children and expectant mothers should not visit. You will need to arrange for transportation home, since you will be unable to drive immediately following surgery.
What are the side effects of the radiation therapy?
The effects of the radiation delivered to your tumor and eye will continue to be observed for months and years after treatment. Radiation plaque therapy may cause eventual blurring, dimming, or rarely a total loss of vision in the treated eye. Plaque radiation does not affect the vision in the other eye. The amount of vision loss depends on what your vision was before treatment, how close the tumor is to the center of your eye, and how sensitive your tissues are to radiation. Most people maintain some central vision, and almost all retain peripheral vision.
What happens after I leave the hospital?
When will the doctor know if the radiation plaque treatment has been successful?
How often will I need to see my eye doctor after surgery?
What should I expect during surgery to remove my eye?
The enucleation procedure is usually performed under local anesthesia, which involves numbing the entire eye and socket tissues prior to surgery. The operation is relatively simple to perform. Immediately after the eyeball is removed, an orbital implant, only slightly smaller than the natural eye, is inserted deep in the socket. In some instances a plastic shell called a conformer is placed over the implant to preserve the shape of the eye. The conformer would later be replaced by a permanent prosthesis.
After enucleation, a pressure patch is applied over the eyelid. This patch is intended to minimize the swelling of the socket tissues. The pressure patch is generally kept in place for about 12 hours after the surgery. While the pressure patch is in place, you may have difficulty opening the lids of the unoperated eye. Fortunately, the difficulty in opening the eyelids generally resolves itself after the first post-operative day. It may hurt when you jerk your good eye to one side or another because the muscles of both eyes always move together and although your eye has been removed, your eye muscles move as if your eye was still there. Moderate post-enucleation pain in the socket generally occurs during the first 24 hours; pain relievers are prescribed as needed to reduce this discomfort.
What will I look like after my eye is removed?
Initially if you open your eyelid, you will see the moist, pink socket lined with conjunctiva. It will look like the inside of your mouth. If there is a conformer (shell) in place, you will see the clear plastic with a hole in the center. The shell is only there temporarily until the socket heals and an artificial eye can be fitted.
What will my prosthesis look like?
What's involved in taking care of a prosthesis?
How soon after enucleation surgery can I return to normal activity?
Will I be able to lead a normal life with only one eye?
Will I be blind or visually impaired from my eye cancer?
Most people who have an eye cancer do NOT become blind or significantly visually impaired. Our visual function usually is described in terms of visual acuity and visual fields in BOTH eyes.
Visual acuity is expressed as a fraction; the top number refers to the distance you are from the eye chart (usually 20 feet). The bottom number indicates the distance at which a person with normal eyesight could read the line. For example, 20/40 means that the line you correctly read at 20 feet could be read by a person with normal vision at 40 feet. Normal visual acuity is 20/20.
Visual fields, or fields of vision, refers to the full extent of the area visible to an eye that is looking straight ahead. A normal visual field is 170 degrees.
A person is considered LEGALLY blind when the best corrected vision in BOTH eyes is 20/200 or more or if the visual field is 20 degrees or less. Low vision usually refers to those who have a visual acuity of 20/70 or worse in the better eye with correction. Many people with vision problems benefit from an evaluation at a Low Vision Center to learn about magnification aids, electronic reading technology, and print enhancing computer software.
My vision is 20/50 in my better eye. Is it okay for me to drive?
Remember, just because you can legally drive doesn't mean that it is safe for you to drive.
I have been so worried since I was diagnosed with cancer that I haven't been able to think about anything else. Is this normal?
For most people, diagnosis of cancer creates emotional distress. Fear of treatment and fear of the future can produce apprehension, anxiety, confusion and depression.
Some degree of depression is common in people diagnosed with cancer. About a fourth of those with cancer suffer from a clinical depression that interferes with day-to-day activities. Feelings of sadness that interfere with normal functioning, a change in eating or sleep patterns, difficulty concentrating, or a loss of interest in ordinary activities, may be symptoms of clinical depression. You should consult a physician about treatment options, including counseling and/or medication to improve your quality of life. Clinical anxiety also can interfere with daily functioning. Symptoms of clinical anxiety include uncontrollable worrying, difficulty concentrating, feelings of restlessness, racing heart, shortness of breath, sweating, dry mouth, irritability and changes in eating and sleeping. Counseling and/or medication can be helpful for clinical anxiety.
My spouse has just been diagnosed with ocular melanoma. I keep trying to reassure him that he's
going to be fine, but nothing I say seems to help. Is this normal?
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