Eye Cancer Surgery` : Detailed view
a) `About an Eye` :
There are sections on: -
• The `Eye` itself (globe);
• The `Eyeball`;
• The front of the eye;
• The uvea;
• The tissues surrounding the eyeball (Orbit);
• The accessories structures (eyelids and tear glands).
1) `The globe of an Eye` consists of two main areas: -
The front part;
The part at the back of an eye.
There are 3 layers continuing round from the eyeball, but they make up different structures in the front of the eye to have crystal clear vision of an object
The fibrous sclera becomes clear, instead of white. This part of it is called the cornea and covers your pupil and iris.
The middle choroids layer becomes the iris and the ciliary’s body. The iris is the colored part around your pupil that covers the lens of the eye. It controls how much light enters your eye and checks the contrast spectrum of bright & light lights adjustments.
The ciliary’s body lies just behind the iris. It has two functions. It is the muscle that controls the focusing of the eye. And it makes the clear fluid (aqueous humor) that fills and shapes the front of your eye. It defines the structural beauty of a person with accurate facial tolerance matching at the same time with it. The back part indeed! Itself is the cause of variations of the layers in the beginning to reach to the complete muscle-blood-veins connection for the back portion of an `Eye`! It’s defined as `Posterior part` of an eye which is utmost important for the vision purposes (main site of ‘Eye cancers’).
2) `The Eyeball` :
The eyeball has three layers sandwiched together: -
• The outer white fibrous layer, the sclera;
• The middle blood rich layer, the choroids;
• The inner colored (pigmented) layer, the retina.
The eyeball is filled with a clear jelly like substance called `Vitreous humor`. This and the fibrous white sclera help to keep the shape of your eyeball. The blood vessels that run carry food and oxygen to the cells of the eye. The retina lines the nerve layer of the eye. The cells of the retina react to light. They send messages to the brain through the optic nerve, making it possible for you to see.
3) `The Uvea` : The middle layer of an eye is called `uvea`. The front (or ‘anterior’) uvea includes the iris and ciliary’s body. The back (or ‘posterior’) uvea is the choroids. This layer is the main site of eye cancers.
Melanoma of the eye:
The cells that become cancerous in melanoma are called 'melanocytes'. Melanocytes are cells that make pigment or coloring. There are melanocytes in our skin, lips and the lining of organs such as the eye.
4) `The Tissues surrounding the Eyeball` (orbit) :
It includes.
• Muscles that allow the eyeball to move in different directions;
• Nerves attached to the eye.
5) `The accessory structures` : These include the eyelids and tear glands. They are also called ‘adnexal’ structures. So doctors call cancers that develop in these tissues adnexal cancers.
b) `Risks and Causes of Eye Cancer` :
1) `Ocular Cancer` : Ocular is the medical term for an Eye. Sometimes, it’s called as such in place of Eye Cancer. Cancers that affect the outer or front part are called `Intra ocular` and outside as `Extra ocular`!
`Cancers of the Eyeball`
Intraocular cancers include
• Melanoma of the Eye
• Lymphoma of the Eye
• Rare cancers found in children including (Infant Eye disease).
Melanoma of the eye
`Melanoma cells` are called upon as `Cancerous cells. They make pigment or coloring of an Eye. Melanocytes are found in our skin, lips and the lining of organs.
Most melanomas can start in the skin but they also develop in other parts of the body organs including the eye.
`Places of the Eye effect by `Melanoma`:
• Eyeball Globe
• Conjunctiva (covering of the front of the eyeball)
• Eyelid
Your specialist may call it `uvea` or choroids melanoma because it grows in the tissues in the middle layer of the eyeball, the choroids. This layer is sometimes called the uvea and includes the iris and ciliary’s body.
The melanoma starts in the choroids or the ciliary’s body in almost 95 out of every 100 cases (95%) of eyeball melanoma. The other 5% begin in the iris.
Lymphoma of an Eye
As Lymphoma of an Eye is an extremely lower contingency of Eye problems it usually affects the entire immune system of the body rather than experienced in the rare cases affecting an Eye? If it does it only affects the inner parts of an Eye.
Intraocular Eye cancers in children
There are 2 main types of cancers of the eyeball that develop in children. These are
• Retinoblastoma
• Medulloepithelioma
`Retinoblastoma` is the rare disease of an eye as well that happens/occur in the tiny-totters of age 5. This may turn out to be as a `Tumor` in sexagenarians or octogenarians (40-60) of age in particular. The surgery done can cure 90% of the disease in the children so far. One or both eyes can be affected by it. This is called as `Unilateral or Bilateral` retinoblastoma. Children with one eye affected are usually diagnosed in the first year of life. But those with both eyes affected tend to be diagnosed a bit later - between 24 and 30 months. Less than 1 out of every 100 children diagnosed is over 5. Some children are born with a faulty retinoblastoma gene that they inherited from one of their parents. This gene is known as the `Rb` gene.
`Medulloepithelioma` is a surgery to remove an Eye.
`Cancers` that develop in parts of the eye are cancers of muscle, nerve and skin tissue. ‘Rhabdomyosarcoma’ is a rare type of cancer that can start in the muscles that move the eye, usually in children.
`Secondary Eye Cancers` can spread from one part of the body organ towards the areas of the Eye and are called Secondary as in ‘women` they are found in the form of `Breast Cancers` and in men the disease/cancer of ‘Lungs’!
`Symptoms of Eye Cancer` :
There are several symptoms for eye cancer. Other eye conditions that aren’t eye cancer can cause many of these symptoms. But it is important that you report any of them to your doctor. People with eye cancer may have as follows: -
• Bulging of one eye; itch; blinking; Photophobia; Infection; Numbness
• Complete or partial loss of sight; Dark circles; Optic nerve damage;
• Pain in or around the eye (rare with eye cancer); Bleeding; Squint;
• Watery eyes; Bloodshot eyes; Cataract/Myopia; Paralysis; Raccoon;
• Blurred vision(seeing abnormal lights/flashes); Tears; Puffy; Wide-set eyes;
• Eye Discharge; Swelling; Blueness; Eyelid coldness; Twitch; Eyelashes loss;
• Yellow eyes; Cotton wool spots; Corneal ulcer; Lens dislocation; Pupil Dilation;
`Eye cancer` can also cause :
• Seeing spots, flashes of light or wiggly lines in front of your eyes. These are called floaters. They are also a natural part of getting old and for wrinkles.
• Blinkered vision (loss of peripheral vision) – you can see what is straight ahead clearly, but not what is to the sides; an object
• A dark spot on the colored part of the Eye- ‘The Iris’ i.e. getting bigger & bigger.
Note: (Pain is quite rare unless the cancer has spread to the outside of the eye).
`Screening for Eye Cancer` :
Screening means testing people for early signs of cancer before they have any symptoms of Eye cancer. If no accurate screening test is available, it is not possible to screen for a cancer. The test must be reliable at picking up cancers. It must not give false results in people who do not have cancer. Screening is a very costly test performed over and over with multiplicity of payments considered together and it would cost a lot of money to screen everyone for a disease only a few people get. So any screening test must be simple and cheap to do. With uncommon diseases, it is most cost effective to screen people who are at higher risk of the disease. But first we must be sure we know:
`Who is at the Higher Eye Cancer Risk and how the treatment be made possible`?
`Screening requires a `Routine Eye Examination and Tests` of an Eye`!
`Question and Answers to Doctor/ophthalmologist (Eye Cancer) `
• Am I more likely to contract an eye cancer than other people?
• How would I know if I have an acute eye cancer?
• How many different types of eye cancers are there?
• Can I be screened for eye cancers easily?
• Do eye cancers run in the family (congenital disease)?
• What can I do to reduce my risk of having eye cancers?
• What kind of unwanted changes could appear after an `Eye Surgery`?
Q. Can I use `Laser Treatment` for Eye melanoma?
Q: Can you surgically remove the tumor and leave along my Eye?
Q: How long shall I be treated as a patient for an Eye disease?
Q: What are the standards treatment options for the disease?
Q: What are the forms of researches being conducted with expertise?
Q: What usually happens to an individual’s eye? (After care)
Q: Will the tumor of an Eye spread to other parts of my body.
Q: If I must lose my eye forever, will it really hurt for a very longer period?
Q: When will I get a prosthetic Eye?
Q: How are most large sized Tumors be treated after removal of an Eye?
Q: What sort of soft and subtle care is required for an eye after I go home?
Q: When can I get back to normal `Daily activities` of my schedule?
Q: Can I volunteer to help those patients who’re going under the operation?
Q: What is an `Eye Care Foundation`?
`Ophthalmic Radiation Therapy` :
Q: Am I radioactive after the plaque is removed from an Eye?
Q: How quickly my `Tumor` go away after plaque radiation?
Q: What is a `Radioactive Eye Plaque and Therapy`?
Q: What is `Proton beam Radiation Therapy`?
Q: Why does the Radiation Plaque stays up till 7 days tenure?
Q: Until what age a child can develop a symptom of a `Retinoblastoma`?
Q: What are the most common symptoms related to it in the first stand?
Q: Who contracts the effect of `Retinoblastoma in early/ later age of life?
Q: What are stereo tactic radio surgery and stereo tactic radiotherapy?
Q: What are low-LET and high-LET radiations?
Q: What are the sources of energy for external radiation therapy? Alfa; Beta & Gamma radiation Therapy for sophisticated `Eye Cancer Surgical` procedures?
`Artificial Eye`
Q: Will other people be able to tell I have an artificial eye?
Q: Can I drive with an artificial eye?
Q: Can I play sport with an artificial eye?
Q: How do I look after my artificial eye?
Q: How does the doctor measure the dose of radiation? Etc..
`How is Eye Cancer Diagnosed`?
`Diagnosis of Melanoma of the Eye` : Patients with eye cancer may have:
`Eye cancer tests at reputed ophthalmologists clinic`!
• decreased ability to see;
• floaters (spots or squiggles drifting in the field of vision) or flashes of light;
• visual field loss (losing part of your field of sight so that instead of seeing all around, you only see part of what is around you)
• a growing dark spot on the iris;
• a change in position of the eyeball within its socket;
• bulging of the eye;
• A change in the way the eye moves within the socket.
• Floaters, for example, may occur as a normal part of the aging process.
Note: (Pain is quite rare except in cases of massive spread outside the eye).
`Tests for Diagnosing the Eye`
`Eye Exam` : `Examination` of an Eye by a re-known ‘Ophthalmologist’ is the important step in diagnosing an Eye. The doctor will look for enlarged blood vessels on the outside of the eye, which can indicate a tumor inside the eye. Using an ophthalmoscope, the ophthalmologist can get a very good look inside the eye and detect a tumor or other abnormalities inside a naked `Eye`. To confirm the diagnosis, imaging tests such as ultrasound may be required. Very rarely will a biopsy also be needed. Sometimes these tumors are missed or grow so fast that they weren’t there when you were examined by an `ophthalmologist`. Examination of the eye and detection of tumors has been improving because of better technology. Also, the ability to take photographs of any abnormality is helpful.
Many people have a benign tumor called a choroidal nevus. These can sometimes be mistaken for eye melanomas and about 1 in 5000 will turn into melanomas. If your ophthalmologist spots one of these, the best approach is watching it to see if it grows and does it consists of `Perennial nature` altogether.
`Ultrasound/X-ray` : Ultrasound is a very common test that is often used in pregnant women to look at the fetus. It can be applied anywhere in the body. This test works by "bouncing" high frequency sound waves off the tumor and reading their pattern. It is especially useful for diagnosing eye melanomas because they have a specific appearance on ultrasound. Using this test, doctors can confirm a diagnosis of melanoma of the eye in more than 80% of cases.
`Angiography`: It’s yet another technique where fluorescent dye is injected into the bloodstream through a vein in the arm. Pictures of the back of the eye are taken with light that causes the dye to fluoresce (glow). Although melanomas do not have a special appearance with this test, some other eye problems do. `Doctors` can trace out whether there’re any symptoms of ‘Melanoma’!
`Computed tomography scan (CT or CAT scan) : The `CT scan` is an x-ray procedure that produces detailed cross-sectional images of your body. It is used to look for spread of your melanoma. Instead of taking one picture, like a conventional x-ray, a CT scanner takes many pictures as it rotates around you. A computer then combines these pictures into an image of a slice of your body (think of a loaf of sliced bread). The machine takes pictures of multiple slices of the part of your body being studied thoroughly and examining to trace the minutest of the cause of any such viral disease. Some people are allergic to `scanning`, a flushed feeling, or rarely, more serious reactions like trouble breathing and low blood pressure can occur. If you have ever had a reaction to any contrast material used for x-rays or demands some `Medications` prescribed by any doctor please! Do comply with the norms and tell the expert immediately to avoid contingencies. `Magnetic Resonance Imaging scans` works just like CT scans itself as MRI scans use radio waves and strong magnets instead of x-rays. A computer translates the pattern of radio waves given off by the tissues into a very detailed image of parts of the body. Radio waves are absorbed and then are been released in a pattern of easily readable text format only to the concerned `Radiologist`! MRI scans take longer -- often up to an hour. Fear of enclosed spaces is felt & a thumping noise emits out of the machine. It’s used for examining `Eye Tumor` and checks the spread of a cancer to detect it efficiently.
`Biopsy` : Biopsy procedure includes a small needle deeply pricked into the skin or passed away into an eye, and cells from the tumor are sucked up into a small syringe. After processing it the expert magnifies and examines it into a `Microscope`. It’s however not recommended for Eye procedures because the slightest mistake could spread the Tumor to the complete eye further risking the Eye Sight! New sophisticated technology has been introduced that may make biopsy safe in situations where the diagnosis is uncertain with the help of a procedure called a vitrectomy can be done by an ophthalmologist, who takes a sample of the vitreous fluid from inside the eye with a needle-like instrument or removes a piece of tumor through a small incision. The cells in the biopsy are then examined under a microscope and by other special techniques.
`Lumbar Puncture` : A lumbar puncture (spinal tap) is a test in which a needle is placed in the lower back to obtain a small sample of cerebrospinal fluid (fluid that surrounds and cushions the brain and spinal cord). This fluid is examined under a microscope to look for lymphoma cells, because eye lymphomas may spread to the brain nerves and damaging the thin veins of the brain.
LINAC : The LINAC is one of the most common standard radiotherapy machines. Cancer specialists use this type of machine to treat many different types of cancer. `Radiotherapies/ Computed tomography scan CT scan/ Magnetic Resonance Imaging scans (MRI), etc are performed with multiple working capacity and capability for many-many hours, have made this sophisticated machine `A Need Of An Hour`! For all those who want to come up with the absolute result in short span of time without wasting a single moment can utilize the efficiency of the machine and could help diagnose the type/kind of disease of a patient. It is one of the most costly scanning machines available to Doctors who analyze it to use for the `Haves and the Have- not`.
`Side effects of Critical operation of surgery of an Eye` :
a) `Temporary(short term) side effects of Critical operation of surgery of an Eye`
• The eyes will feel mild discomfort or pain for the first two or three days and one can experience a tearing in the eye for long.
• One may also notice pink or red spots on the whites of your eyes.
• Another side effect of laser eye surgery is that your vision may seem hazy or blurry.
• Your eyes may feel dry and you may experience glare from lights in the house or outside the house premise
• There can be a halo effect around lights and have difficulty while driving at night for the first month. (Yellow glasses are preferred and prescribed for night driving).
b) `Permanent(long-term) side effects of Critical operation of surgery of an Eye`
• With good vision on the vision chart, some of them may develop permanent debilitating visual symptoms such as glare, halos, and/or double vision that can seriously affect night time vision.
• They may not be able to see clearly in situations of low contrast, such as at night or in fog/Haze. (Long-sightedness and short sightedness)
• Potential long term side effect of laser eye surgery is the development of severe dry eye syndrome. Your eyes may not be able to produce sufficient tears to keep your eyes moist and comfortable.
`Remedy` : (This side effect of laser eye surgery can be resolved through intensive drop therapy).
• `Infection` : it’s the utmost side effect after a `Surgery`! As the largest risk of infection involves special care during the initial stages of healing. The surgeon will give patients a post surgery activity schedule to follow.
• `Under correction` : It is far more common to be under corrected after PRK. Large amounts of under correction require a touch up, which can be performed 90 days after the initial procedure.
• `Overcorrection` : Initial Overcorrection is usually planned as the cornea has a tendency to bounce back towards its original shape while healing. Near predicted results are achieved at 3 month post operatively and should the patient remain overcorrected, a thin pair of glasses or contacts can be worn, or newer laser techniques can be introduced for the patient to consider. The risk of Overcorrection is extremely low.
• `Foreign body sensation`
`Risks of Custom `LASIK revolve around 5 primary areas:
1) Post-operative Side Effects, Adverse Effects and Complications;
2) Refractive Complications;
3) Corneal Flap Complications;
4) Corneal Healing Complications;
5) Other Miscellaneous Complication.
`After the procedure` :
The time you reach home, medical staff will give you personalized after-care instructions and Procedures for taking eye drops. Your vision may be blurred for a few hours; please ensure that there’s somebody accompanying you to the home. After the procedure a short while, you will experience watering of the eyes and feel as if there is something "stuck in your eye". This is quite natural, but on no account must you rub your eyes.
Your follow-up care :
`At the time of surgery, we will see you several times again over the next year, and measure your eyes using the same equipment as before to monitor the success of your treatment`.
` What can you do after the procedure?
Most people can resume their general day to day activities 24 to 48 hours after treatment. However, there are a few other activities that need to be carried out with due care:
Showering
Complete closure of an Eye: The next day!
Driving : When you are comfortable with your new vision, and if it meets driving standards!
Heavy exercise : After one to two weeks depending on how comfortable your eyes feel!
Swimming : After two weeks with goggles, or six weeks without them (Min.)!
Eye make-up : Mascara after four weeks, other make-up after two days (Women)!
`Repeat procedure` :
A repeat procedure for the treatment of an Eye is required so as to ensure that whether the adjustment of the lens is again be demanded with repeated consultation of a doctor. In other words, an enhancement is needed for the `Lens`! The treatment is simpler, as it just involves lifting the flap and re-applying the laser. Please do not wear perfumes, make-up, gels or sprays either, as fine vapors can interfere with the path of the laser beam.
A support staff will always be wholeheartedly happy to assist you. Whatsoever and Whomsoever may demand assistance in a best possible way. Once the laser has been calibrated, your eyelids are held open and your eyes anaesthetized with drops.
` Using a precision device called a micro keratome; the surgeon creates a micro-thin flap on the surface of the cornea. The flap is gently lifted to one side, the bed of the cornea (the stoma) is exposed and the laser reshapes this surface to re-focus the eye. After 30-60 seconds, the flap is repositioned.
The flap holds itself naturally in place, but we do recommend you wear protective glasses during waking hours and the protective shield we provide you with at night to prevent you from rubbing your eyes for a few days.
After resting for a short while in our waiting area, we will examine your eyes again before you leave.
a) `About an Eye` :
There are sections on: -
• The `Eye` itself (globe);
• The `Eyeball`;
• The front of the eye;
• The uvea;
• The tissues surrounding the eyeball (Orbit);
• The accessories structures (eyelids and tear glands).
1) `The globe of an Eye` consists of two main areas: -
The front part;
The part at the back of an eye.
There are 3 layers continuing round from the eyeball, but they make up different structures in the front of the eye to have crystal clear vision of an object
The fibrous sclera becomes clear, instead of white. This part of it is called the cornea and covers your pupil and iris.
The middle choroids layer becomes the iris and the ciliary’s body. The iris is the colored part around your pupil that covers the lens of the eye. It controls how much light enters your eye and checks the contrast spectrum of bright & light lights adjustments.
The ciliary’s body lies just behind the iris. It has two functions. It is the muscle that controls the focusing of the eye. And it makes the clear fluid (aqueous humor) that fills and shapes the front of your eye. It defines the structural beauty of a person with accurate facial tolerance matching at the same time with it. The back part indeed! Itself is the cause of variations of the layers in the beginning to reach to the complete muscle-blood-veins connection for the back portion of an `Eye`! It’s defined as `Posterior part` of an eye which is utmost important for the vision purposes (main site of ‘Eye cancers’).
2) `The Eyeball` :
The eyeball has three layers sandwiched together: -
• The outer white fibrous layer, the sclera;
• The middle blood rich layer, the choroids;
• The inner colored (pigmented) layer, the retina.
The eyeball is filled with a clear jelly like substance called `Vitreous humor`. This and the fibrous white sclera help to keep the shape of your eyeball. The blood vessels that run carry food and oxygen to the cells of the eye. The retina lines the nerve layer of the eye. The cells of the retina react to light. They send messages to the brain through the optic nerve, making it possible for you to see.
3) `The Uvea` : The middle layer of an eye is called `uvea`. The front (or ‘anterior’) uvea includes the iris and ciliary’s body. The back (or ‘posterior’) uvea is the choroids. This layer is the main site of eye cancers.
Melanoma of the eye:
The cells that become cancerous in melanoma are called 'melanocytes'. Melanocytes are cells that make pigment or coloring. There are melanocytes in our skin, lips and the lining of organs such as the eye.
4) `The Tissues surrounding the Eyeball` (orbit) :
It includes.
• Muscles that allow the eyeball to move in different directions;
• Nerves attached to the eye.
5) `The accessory structures` : These include the eyelids and tear glands. They are also called ‘adnexal’ structures. So doctors call cancers that develop in these tissues adnexal cancers.
b) `Risks and Causes of Eye Cancer` :
1) `Ocular Cancer` : Ocular is the medical term for an Eye. Sometimes, it’s called as such in place of Eye Cancer. Cancers that affect the outer or front part are called `Intra ocular` and outside as `Extra ocular`!
`Cancers of the Eyeball`
Intraocular cancers include
• Melanoma of the Eye
• Lymphoma of the Eye
• Rare cancers found in children including (Infant Eye disease).
Melanoma of the eye
`Melanoma cells` are called upon as `Cancerous cells. They make pigment or coloring of an Eye. Melanocytes are found in our skin, lips and the lining of organs.
Most melanomas can start in the skin but they also develop in other parts of the body organs including the eye.
`Places of the Eye effect by `Melanoma`:
• Eyeball Globe
• Conjunctiva (covering of the front of the eyeball)
• Eyelid
Your specialist may call it `uvea` or choroids melanoma because it grows in the tissues in the middle layer of the eyeball, the choroids. This layer is sometimes called the uvea and includes the iris and ciliary’s body.
The melanoma starts in the choroids or the ciliary’s body in almost 95 out of every 100 cases (95%) of eyeball melanoma. The other 5% begin in the iris.
Lymphoma of an Eye
As Lymphoma of an Eye is an extremely lower contingency of Eye problems it usually affects the entire immune system of the body rather than experienced in the rare cases affecting an Eye? If it does it only affects the inner parts of an Eye.
Intraocular Eye cancers in children
There are 2 main types of cancers of the eyeball that develop in children. These are
• Retinoblastoma
• Medulloepithelioma
`Retinoblastoma` is the rare disease of an eye as well that happens/occur in the tiny-totters of age 5. This may turn out to be as a `Tumor` in sexagenarians or octogenarians (40-60) of age in particular. The surgery done can cure 90% of the disease in the children so far. One or both eyes can be affected by it. This is called as `Unilateral or Bilateral` retinoblastoma. Children with one eye affected are usually diagnosed in the first year of life. But those with both eyes affected tend to be diagnosed a bit later - between 24 and 30 months. Less than 1 out of every 100 children diagnosed is over 5. Some children are born with a faulty retinoblastoma gene that they inherited from one of their parents. This gene is known as the `Rb` gene.
`Medulloepithelioma` is a surgery to remove an Eye.
`Cancers` that develop in parts of the eye are cancers of muscle, nerve and skin tissue. ‘Rhabdomyosarcoma’ is a rare type of cancer that can start in the muscles that move the eye, usually in children.
`Secondary Eye Cancers` can spread from one part of the body organ towards the areas of the Eye and are called Secondary as in ‘women` they are found in the form of `Breast Cancers` and in men the disease/cancer of ‘Lungs’!
`Symptoms of Eye Cancer` :
There are several symptoms for eye cancer. Other eye conditions that aren’t eye cancer can cause many of these symptoms. But it is important that you report any of them to your doctor. People with eye cancer may have as follows: -
• Bulging of one eye; itch; blinking; Photophobia; Infection; Numbness
• Complete or partial loss of sight; Dark circles; Optic nerve damage;
• Pain in or around the eye (rare with eye cancer); Bleeding; Squint;
• Watery eyes; Bloodshot eyes; Cataract/Myopia; Paralysis; Raccoon;
• Blurred vision(seeing abnormal lights/flashes); Tears; Puffy; Wide-set eyes;
• Eye Discharge; Swelling; Blueness; Eyelid coldness; Twitch; Eyelashes loss;
• Yellow eyes; Cotton wool spots; Corneal ulcer; Lens dislocation; Pupil Dilation;
`Eye cancer` can also cause :
• Seeing spots, flashes of light or wiggly lines in front of your eyes. These are called floaters. They are also a natural part of getting old and for wrinkles.
• Blinkered vision (loss of peripheral vision) – you can see what is straight ahead clearly, but not what is to the sides; an object
• A dark spot on the colored part of the Eye- ‘The Iris’ i.e. getting bigger & bigger.
Note: (Pain is quite rare unless the cancer has spread to the outside of the eye).
`Screening for Eye Cancer` :
Screening means testing people for early signs of cancer before they have any symptoms of Eye cancer. If no accurate screening test is available, it is not possible to screen for a cancer. The test must be reliable at picking up cancers. It must not give false results in people who do not have cancer. Screening is a very costly test performed over and over with multiplicity of payments considered together and it would cost a lot of money to screen everyone for a disease only a few people get. So any screening test must be simple and cheap to do. With uncommon diseases, it is most cost effective to screen people who are at higher risk of the disease. But first we must be sure we know:
`Who is at the Higher Eye Cancer Risk and how the treatment be made possible`?
`Screening requires a `Routine Eye Examination and Tests` of an Eye`!
`Question and Answers to Doctor/ophthalmologist (Eye Cancer) `
• Am I more likely to contract an eye cancer than other people?
• How would I know if I have an acute eye cancer?
• How many different types of eye cancers are there?
• Can I be screened for eye cancers easily?
• Do eye cancers run in the family (congenital disease)?
• What can I do to reduce my risk of having eye cancers?
• What kind of unwanted changes could appear after an `Eye Surgery`?
Q. Can I use `Laser Treatment` for Eye melanoma?
Q: Can you surgically remove the tumor and leave along my Eye?
Q: How long shall I be treated as a patient for an Eye disease?
Q: What are the standards treatment options for the disease?
Q: What are the forms of researches being conducted with expertise?
Q: What usually happens to an individual’s eye? (After care)
Q: Will the tumor of an Eye spread to other parts of my body.
Q: If I must lose my eye forever, will it really hurt for a very longer period?
Q: When will I get a prosthetic Eye?
Q: How are most large sized Tumors be treated after removal of an Eye?
Q: What sort of soft and subtle care is required for an eye after I go home?
Q: When can I get back to normal `Daily activities` of my schedule?
Q: Can I volunteer to help those patients who’re going under the operation?
Q: What is an `Eye Care Foundation`?
`Ophthalmic Radiation Therapy` :
Q: Am I radioactive after the plaque is removed from an Eye?
Q: How quickly my `Tumor` go away after plaque radiation?
Q: What is a `Radioactive Eye Plaque and Therapy`?
Q: What is `Proton beam Radiation Therapy`?
Q: Why does the Radiation Plaque stays up till 7 days tenure?
Q: Until what age a child can develop a symptom of a `Retinoblastoma`?
Q: What are the most common symptoms related to it in the first stand?
Q: Who contracts the effect of `Retinoblastoma in early/ later age of life?
Q: What are stereo tactic radio surgery and stereo tactic radiotherapy?
Q: What are low-LET and high-LET radiations?
Q: What are the sources of energy for external radiation therapy? Alfa; Beta & Gamma radiation Therapy for sophisticated `Eye Cancer Surgical` procedures?
`Artificial Eye`
Q: Will other people be able to tell I have an artificial eye?
Q: Can I drive with an artificial eye?
Q: Can I play sport with an artificial eye?
Q: How do I look after my artificial eye?
Q: How does the doctor measure the dose of radiation? Etc..
`How is Eye Cancer Diagnosed`?
`Diagnosis of Melanoma of the Eye` : Patients with eye cancer may have:
`Eye cancer tests at reputed ophthalmologists clinic`!
• decreased ability to see;
• floaters (spots or squiggles drifting in the field of vision) or flashes of light;
• visual field loss (losing part of your field of sight so that instead of seeing all around, you only see part of what is around you)
• a growing dark spot on the iris;
• a change in position of the eyeball within its socket;
• bulging of the eye;
• A change in the way the eye moves within the socket.
• Floaters, for example, may occur as a normal part of the aging process.
Note: (Pain is quite rare except in cases of massive spread outside the eye).
`Tests for Diagnosing the Eye`
`Eye Exam` : `Examination` of an Eye by a re-known ‘Ophthalmologist’ is the important step in diagnosing an Eye. The doctor will look for enlarged blood vessels on the outside of the eye, which can indicate a tumor inside the eye. Using an ophthalmoscope, the ophthalmologist can get a very good look inside the eye and detect a tumor or other abnormalities inside a naked `Eye`. To confirm the diagnosis, imaging tests such as ultrasound may be required. Very rarely will a biopsy also be needed. Sometimes these tumors are missed or grow so fast that they weren’t there when you were examined by an `ophthalmologist`. Examination of the eye and detection of tumors has been improving because of better technology. Also, the ability to take photographs of any abnormality is helpful.
Many people have a benign tumor called a choroidal nevus. These can sometimes be mistaken for eye melanomas and about 1 in 5000 will turn into melanomas. If your ophthalmologist spots one of these, the best approach is watching it to see if it grows and does it consists of `Perennial nature` altogether.
`Ultrasound/X-ray` : Ultrasound is a very common test that is often used in pregnant women to look at the fetus. It can be applied anywhere in the body. This test works by "bouncing" high frequency sound waves off the tumor and reading their pattern. It is especially useful for diagnosing eye melanomas because they have a specific appearance on ultrasound. Using this test, doctors can confirm a diagnosis of melanoma of the eye in more than 80% of cases.
`Angiography`: It’s yet another technique where fluorescent dye is injected into the bloodstream through a vein in the arm. Pictures of the back of the eye are taken with light that causes the dye to fluoresce (glow). Although melanomas do not have a special appearance with this test, some other eye problems do. `Doctors` can trace out whether there’re any symptoms of ‘Melanoma’!
`Computed tomography scan (CT or CAT scan) : The `CT scan` is an x-ray procedure that produces detailed cross-sectional images of your body. It is used to look for spread of your melanoma. Instead of taking one picture, like a conventional x-ray, a CT scanner takes many pictures as it rotates around you. A computer then combines these pictures into an image of a slice of your body (think of a loaf of sliced bread). The machine takes pictures of multiple slices of the part of your body being studied thoroughly and examining to trace the minutest of the cause of any such viral disease. Some people are allergic to `scanning`, a flushed feeling, or rarely, more serious reactions like trouble breathing and low blood pressure can occur. If you have ever had a reaction to any contrast material used for x-rays or demands some `Medications` prescribed by any doctor please! Do comply with the norms and tell the expert immediately to avoid contingencies. `Magnetic Resonance Imaging scans` works just like CT scans itself as MRI scans use radio waves and strong magnets instead of x-rays. A computer translates the pattern of radio waves given off by the tissues into a very detailed image of parts of the body. Radio waves are absorbed and then are been released in a pattern of easily readable text format only to the concerned `Radiologist`! MRI scans take longer -- often up to an hour. Fear of enclosed spaces is felt & a thumping noise emits out of the machine. It’s used for examining `Eye Tumor` and checks the spread of a cancer to detect it efficiently.
`Biopsy` : Biopsy procedure includes a small needle deeply pricked into the skin or passed away into an eye, and cells from the tumor are sucked up into a small syringe. After processing it the expert magnifies and examines it into a `Microscope`. It’s however not recommended for Eye procedures because the slightest mistake could spread the Tumor to the complete eye further risking the Eye Sight! New sophisticated technology has been introduced that may make biopsy safe in situations where the diagnosis is uncertain with the help of a procedure called a vitrectomy can be done by an ophthalmologist, who takes a sample of the vitreous fluid from inside the eye with a needle-like instrument or removes a piece of tumor through a small incision. The cells in the biopsy are then examined under a microscope and by other special techniques.
`Lumbar Puncture` : A lumbar puncture (spinal tap) is a test in which a needle is placed in the lower back to obtain a small sample of cerebrospinal fluid (fluid that surrounds and cushions the brain and spinal cord). This fluid is examined under a microscope to look for lymphoma cells, because eye lymphomas may spread to the brain nerves and damaging the thin veins of the brain.
LINAC : The LINAC is one of the most common standard radiotherapy machines. Cancer specialists use this type of machine to treat many different types of cancer. `Radiotherapies/ Computed tomography scan CT scan/ Magnetic Resonance Imaging scans (MRI), etc are performed with multiple working capacity and capability for many-many hours, have made this sophisticated machine `A Need Of An Hour`! For all those who want to come up with the absolute result in short span of time without wasting a single moment can utilize the efficiency of the machine and could help diagnose the type/kind of disease of a patient. It is one of the most costly scanning machines available to Doctors who analyze it to use for the `Haves and the Have- not`.
`Side effects of Critical operation of surgery of an Eye` :
a) `Temporary(short term) side effects of Critical operation of surgery of an Eye`
• The eyes will feel mild discomfort or pain for the first two or three days and one can experience a tearing in the eye for long.
• One may also notice pink or red spots on the whites of your eyes.
• Another side effect of laser eye surgery is that your vision may seem hazy or blurry.
• Your eyes may feel dry and you may experience glare from lights in the house or outside the house premise
• There can be a halo effect around lights and have difficulty while driving at night for the first month. (Yellow glasses are preferred and prescribed for night driving).
b) `Permanent(long-term) side effects of Critical operation of surgery of an Eye`
• With good vision on the vision chart, some of them may develop permanent debilitating visual symptoms such as glare, halos, and/or double vision that can seriously affect night time vision.
• They may not be able to see clearly in situations of low contrast, such as at night or in fog/Haze. (Long-sightedness and short sightedness)
• Potential long term side effect of laser eye surgery is the development of severe dry eye syndrome. Your eyes may not be able to produce sufficient tears to keep your eyes moist and comfortable.
`Remedy` : (This side effect of laser eye surgery can be resolved through intensive drop therapy).
• `Infection` : it’s the utmost side effect after a `Surgery`! As the largest risk of infection involves special care during the initial stages of healing. The surgeon will give patients a post surgery activity schedule to follow.
• `Under correction` : It is far more common to be under corrected after PRK. Large amounts of under correction require a touch up, which can be performed 90 days after the initial procedure.
• `Overcorrection` : Initial Overcorrection is usually planned as the cornea has a tendency to bounce back towards its original shape while healing. Near predicted results are achieved at 3 month post operatively and should the patient remain overcorrected, a thin pair of glasses or contacts can be worn, or newer laser techniques can be introduced for the patient to consider. The risk of Overcorrection is extremely low.
• `Foreign body sensation`
`Risks of Custom `LASIK revolve around 5 primary areas:
1) Post-operative Side Effects, Adverse Effects and Complications;
2) Refractive Complications;
3) Corneal Flap Complications;
4) Corneal Healing Complications;
5) Other Miscellaneous Complication.
`After the procedure` :
The time you reach home, medical staff will give you personalized after-care instructions and Procedures for taking eye drops. Your vision may be blurred for a few hours; please ensure that there’s somebody accompanying you to the home. After the procedure a short while, you will experience watering of the eyes and feel as if there is something "stuck in your eye". This is quite natural, but on no account must you rub your eyes.
Your follow-up care :
`At the time of surgery, we will see you several times again over the next year, and measure your eyes using the same equipment as before to monitor the success of your treatment`.
` What can you do after the procedure?
Most people can resume their general day to day activities 24 to 48 hours after treatment. However, there are a few other activities that need to be carried out with due care:
Showering
Complete closure of an Eye: The next day!
Driving : When you are comfortable with your new vision, and if it meets driving standards!
Heavy exercise : After one to two weeks depending on how comfortable your eyes feel!
Swimming : After two weeks with goggles, or six weeks without them (Min.)!
Eye make-up : Mascara after four weeks, other make-up after two days (Women)!
`Repeat procedure` :
A repeat procedure for the treatment of an Eye is required so as to ensure that whether the adjustment of the lens is again be demanded with repeated consultation of a doctor. In other words, an enhancement is needed for the `Lens`! The treatment is simpler, as it just involves lifting the flap and re-applying the laser. Please do not wear perfumes, make-up, gels or sprays either, as fine vapors can interfere with the path of the laser beam.
A support staff will always be wholeheartedly happy to assist you. Whatsoever and Whomsoever may demand assistance in a best possible way. Once the laser has been calibrated, your eyelids are held open and your eyes anaesthetized with drops.
` Using a precision device called a micro keratome; the surgeon creates a micro-thin flap on the surface of the cornea. The flap is gently lifted to one side, the bed of the cornea (the stoma) is exposed and the laser reshapes this surface to re-focus the eye. After 30-60 seconds, the flap is repositioned.
The flap holds itself naturally in place, but we do recommend you wear protective glasses during waking hours and the protective shield we provide you with at night to prevent you from rubbing your eyes for a few days.
After resting for a short while in our waiting area, we will examine your eyes again before you leave.
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