Routine eye examination reveals life-threatening tumour

Forty-five minutes after walking in to his optician for a routine eye examination Terry Arber (62) was sitting feeling completely “stunned” as his optometrist, Gordon Ilett, explained that what Terry describes as a “grass stain” on his retina was in fact a tumour.

Terry had only just joked to Gordon that he felt “as fit as a fiddle” and that he “had never had a day off sick” and now he was sitting looking at an image of the inside of his eye and fearing the worst.

He was immediately referred to a consultant at Queen Mary’s hospital for more tests and confirmation of Gordon’s diagnosis before being sent to see Mr John Hungerford, Oncology Consultant at Moorfields Eye Hospital.

Melanoma diagnosis

Terry was swiftly diagnosed as having a melanoma the size of a pea (6mm) inside his left eye, and, despite having read some “horror stories” on the internet, Terry was reassured by Mr Hungerford that his chances of survival and retaining his vision were extremely good.

The tumour was treated using internal radiotherapy an experience that Terry describes as “surreal”. “I felt I could see perfectly well”, Terry explains, “despite having a radio active plaque sewn onto the sclera (the white of the eye) over the tumour! It felt strange knowing that the plaque was there and not being able to see or feel it.”

Terry continues: “I had to wear a protective patch over my eye whenever anyone came to to see me during my four day stay in hospital to protect them against any chance of being exposed to radioactive waves.”

After the plaque was removed, Terry underwent a course of transpupillary thermotherapy. This involved using a laser beam to destroy any lingering cancerous cells.

Following treatment, Terry, who works in the graphic design industry, was left with slightly impaired peripheral vision in his left eye – although this doesn’t affect his work and he is still able to drive.

Clean bill of health

He has now been given a clean bill of health but will continue to have six monthly blood tests to check the tumour has not spread.

Reflecting on his experience Terry says: “I’m so grateful to my optician, Gordon, for picking up the tumour during my routine sight test. I had no symptoms and no reason to suspect that my health, or my life, were at risk. Without his diligence I would not be leading the fit and healthy life that I am today.”

About ocular melanoma

Ocular melanoma are rare – approximately 500 new cases are diagnosed in the UK every year. The incidence on ocular melanoma increases with age.

The exact cause of ocular melanoma is unknown. However, some practitioners believe there may be a link with excessive exposure to UV.

Symptoms can include blurred vision, flashing lights, shadows and misting of the lens of the eye. Although, as in Terry’s case, the patient may not notice any symptoms at all.

A number of tests may be done to diagnose ocular melanoma, these include: ophthalmoscope, an ultrasound scan, retinal imaging or a CT scan. Occasionally a small tissue sample (biopsy) may be required to confirm a diagnosis.

Treatment will depend on the size, type and position of the tumour. Factors such as the patient’s age, general health and visual acuity will also be taken into consideration. Types of treatment include: internal and external radiotherapy, laser treatment and surgery.

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