Innovative Glasses Help Patients Maintain Vision and Comfort During Eye Cancer Treatment

Our primary goal is to find more effective ways to diagnose and treat eye cancer, but we also try to come up with innovations that make treatment more comfortable and less stressful for our patients.

Consider patients undergoing ophthalmic plaque radiation therapy. This course of treatment involves surgically implanting a radiation source onto the eye to cover the base of lead glassesan intraocular tumor. The radiation sources used for brachytherapy come in the form of small “rice-sized” radioactive seeds. These seeds are attached within a gold or steel bowl called a plaque that is implanted on the eye. This process delivers a highly concentrated radiation dose to the tumor while exposing surrounding healthy tissue to relatively less radiation.

Patients undergoing plaque radiation therapy sometimes have to wear a lead patch over the eye to stop exiting radiation from entering into the environment. These opaque patches obscure vision in the affected eye for the duration of the treatment. This can last four to seven days.

This is particularly problematic for monocular patients with a tumor in their seeing eye. In this case, the lead patch will leave the patient blind during the course of their treatment. The patch can also create an uncomfortable inconvenience for patients who have vision in their untreated eye. They won’t be blind, but they will have to deal with diminished depth perception.

Dr. Paul Finger has come up with a simple yet innovative solution to this problem. He developed leaded glasses that effectively block exiting radiation while allowing patients with only one functioning eye to maintain their full vision throughout the treatment.

In a study funded by The Eye Cancer Foundation and published in the American Journal of Ophthalmology. Dr. Finger and Andrzej Szechter PhD found the blocking glassesleaded glasses improved patients’ quality of life without sacrificing radiation safety.

“Radiation-blocking glasses were remarkably helpful for our patients with only one functional eye. In these cases, use of the patch made them temporarily blind, disoriented, and dependent on others. Use of leaded safety glasses allowed these patients to see and function during ophthalmic plaque radiation therapy.”

This is a concrete example of what we call patient-centered care. The goal is not only to successfully treat the cancer, but to help the patient remain as comfortable as possible throughout the process.


Sunglasses Are a Must in the Winter Too

“Think of Sunglasses as Sunblock for Your Eyes.”

This is a key attitude everybody should develop to help protect themselves from eye cancer and other damage to their eyes.

But who needs sunblock in the winter?

You do.

In fact, you may actually need those sunglasses more in the winter than during the summer.

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In the summertime, most of us instinctively reach for the sunglasses as we walk out the door. But during the winter, it’s easy to leave them sitting on the table. After all, it’s not usually terribly bright out, even on sunny days, and oftentimes it’s gloomy and overcast.

During the winter months, the sun sits lower in the sky, changing the angle. It seems less bright, but this can actually increase your exposure to dangerous UV rays, according to Jessica Lattman, a board-certified ophthalmologist. The risk increases when snow covers the ground. Scientists say snow reflects up to 85 percent of the sun’s UV rays. It’s so intense, it can actually sunburn your corneas.

Skiers need to be especially vigilant.

“UV radiation increases 5% for every 1,000 feet you go above sea level,” Lattman told the Huffington Post. “When you are skiing or outside at higher elevations, the exposure is even greater. At 5,000 feet, you will be exposed to 20% more radiation from the sun.”

That’s why it’s imperative to wear skiing goggles that block UV rays.

Your winter eyewear should meet the same standards as the sunglasses you wear in the summer. It should block all UVA, UVB, and UVC rays. You want to make sure the glasses provide 100% UV protection. Many optical shops have a machine called a photometer that measures UV transmission through glasses. You want to wear sunglasses or goggles that block all UV radiation or light under 400 nm in wavelength.

So, when you run out the door this winter, don’t forget to grab those sunglasses – sunblock for your eyes.


Compassion, Humor and Artificial Eyes Smooth the Road to Recovery

Dealing with the loss of an eye can make patients feel conspicuous and awkward. Darrell Hardin has just the prescription – compassion, humor and beautiful artificial eyes.

Hardin is an ocularist in Willoughby, Ohio. He combines technical skill with a sense of artistry to make eyes for patients who have lost them due to disease or injury. He offers hope for a sense of normalcy for his patients by creating realistic artificial eyes. But he does much more for those who walk into his office, as a recent story in the Cleveland Plain Dealer describes

“Hardin’s irreverent, sometimes corny, sense of humor serves to put patients at ease, and to let them know that it is OK, healing, even, to laugh at the circumstances that caused them to seek his services.”

As the saying goes, sometimes laughter is the best medicine.

Losing an eye is traumatic. Patients can experience a profound sense of loss, depression and self-consciousness about how they look.  Hardin’s demeanor helps lift the gloom.

He has a particular empathy for cancer patients. He battled the disease himself.

“Hodgkins in the ’70’s,” he told the Plain Dealer. “I know . . . I thought, ‘Oh, I’m gonna die.’ But my 87-year-old aunt says ‘God doesn’t want a weed in his garden, and the Devil doesn’t want competition.’”

Hardin can also intimately empathize with patients who have lost an eye. His wife Cindy was born with glaucoma and had an eye removed in her 30s.

“If my wife had both eyes, she probably wouldn’t be with me.” He laughs and then turns more serious. “I finally found a person who understands what I do, and why.”

Hardin calls his work his passion. He paints each eye by hand, creating a prosthetic that is hardly noticeable to the average passerby. It is now possible to produce artificial eyes digitally, but Hardin says they don’t have the depth of hand-painted prosthetics.

“It’s not an ego trip. I try to do my best. My goal is for you not to notice my work.”

Hardin’s work underscores two important points.

First, even if you lose an eye, it’s possible to live a normal life. Most patients can see with their remaining eye and will most likely be able to do all the things they used to do before, even drive a car. With modern eye prosthesis, the loss of the eye is hardly noticeable, as you can see in our enucleation after-image gallery.

Second, a human touch is vital when interacting with people facing adversity such as the loss of an eye, or a diagnosis of eye cancer. At the New York Eye Center, we call this “patient-centered care,” and it’s the foundation of everything we do.

 

Photo Credit: Wellcome Library, London. Used under creative common license


Visionary Newsletter – Winter 2017 Edition

The 2017 issue of The Visionary is now available!visionary-full

The Eye Cancer Foundation publishes The Visionary free-of-charge to keep you informed about the latest news, research, and global efforts focused on improving eye cancer treatment, diagnosis, and cure.

In this edition, you will find articles about:

  • Projects for the second Eye Cancer Working Day
  • The 2020 Campaign to save the lives of 1,000 children by 2020
  • Lost Eye: A networking community for enulceated patients
  • And More

Click Here to Read The Visionary –  Now

Read back issues of The Visionary here

 


Early Retinoblastoma Screening Key to Saving Life and Vision

Early screening for retinoblastoma in infants is key to saving vision and life.

Retinoblastoma is the most common intraocular childhood cancer. It affects approximately 300 children in the United States each year and more than 8,000 worldwide. When detected early, the cure rate is high. But if the diagnosis is delayed, it can result in the loss of an eye and even death.

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In all cases, early screening is important to detect cancer in its beginning stages. Doctors should regularly examine the child’s eyes, and parents should be aware retinoblastoma symptoms. White spots appearing when light shines into the eye is the most common sign. This often shows up in flash photography. Other symptoms include a lazy eye, vision problems, redness in the white part of the eye, bulging eyes, changes in the color of the iris, and unequally reactive pupils.

The importance of screening is magnified in children with a family history of retinoblastoma. They need to be examined by an ophthalmologist immediately after birth. Regular examinations should be continued for the next 5 to 6 years, at least once every 3 to 6 months.

Genetic testing is another option for children with a family history of retinoblastoma.

“Genetic testing is so important in retinoblastoma, the American Joint Committee on Cancer RB-Section headed by Ashwin Mallipatna MD achieved approval for heredity to be included in the 8th edition AJCC RB Cancer Staging System,” notes Dr. Paul T. Finger, Chair of The AJCC Ophthalmic Oncology Task Force.

In India, the Orbit and Oculoplasty Clinic of Aravind Eye Hospital recently opened its Ocular Cancer Genetic Centre. India has the highest incidence of retinoblastoma in the developing world. According to an article in the Journal for Human Genetics, about 40% of Indian patients suffer from the hereditary form of RB.

“After providing treatment, prosthetic eye and rehabilitation for patients for years, the question of what we could do to prevent RB kept haunting us. If we are able to see the tumor early, we can save the life of the child. But if we find out the predisposition to RB from gene mutation in either of the parents, we can save both vision and life of the child,” Usha Kim, chief, Orbit, Oculoplasty and Oncology Clinic, told The Hindu.

Mutations in the RB1 gene are responsible for hereditary retinoblastoma. Due to the gene’s large size and complexity, genetic testing can be cumbersome. To overcome the problem, researchers in India developed a rapid screening strategy by prioritizing sections of the DNA.

“Using this strategy for genetic analysis, mutations were identified in 76% of patients in half the actual time and one third of the cost. This reduction in time and cost will allow for better risk prediction for siblings and offspring, thereby facilitating genetic counseling for families, especially in developing countries.”

Advances in genetic testing will make screening more widely available, especially in developing countries. Children with family histories of retinoblastoma should undergo genetic screening when possible. But nothing can replace diligent doctors and parents being aware of the symptoms, and making sure children get regular eye examinations.


Eye Cancer Foundation Joins Union for International Cancer Control

The Eye Cancer Foundation has joined forces with Union for International Cancer Control.

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UICC is the largest and oldest international cancer organization. It has over 1,000 members and 56 partners spanning 162 countries. UICC features the world’s major cancer societies, ministries of health, research and treatment institutions, patient groups, and industry leaders.

Membership in UICC will help expand the reach of The Eye Cancer Foundation’s work by linking it into a worldwide network of individuals and organizations committed to fighting cancer.

“UICC is working with over 130 cancer agencies around the world. The Eye Cancer Foundation is pleased to announce our membership as one of those agencies, and to recieve UICC endorsement of the ECF-sponsored Second Eye Cancer Working Day to be held in in Sydney, Australia, on March 24, 2017. Both the ECF and UICC plan to work toward close cooperation on international initiatives in the future,” ECF Chairman Dr. Paul Finger said.

UICC’s work is guided by nine targets to reduce cancer worldwide, set by the World Cancer Declaration. The goal is to achieve all nine targets by 2025.

  • Strengthen health systems for effective cancer control.
  • Measure cancer burden and impact of cancer plans in all countries.
  • Reduce exposure to cancer risk factors.
  • Universal coverage of HPV and HBV vaccinations.
  • Reduce stigma and dispel myths about cancer.
  • Universal access to screening and early detection of cancer.
  • Improve access to services across the cancer care continuum.
  • Universal availability of pain control and distress management.
  • Improve education of training and health care professionals.

Dr. Finger has already contributed to UICC work. He uthored the eye cancer sections of the UICC Manual of Clinical Oncology – 9th edition.

ECF membership in UICC will create a mutually beneficial relationship. The work of The Eye Cancer Foundation will help UICC achieve its target goals. Membership in this worldwide network will broaden the impact of ECF programs like the 2020 Campaign to strategically train and place eye cancer specialists in underserved regions around the world!

Membership in UICC is an exciting step for The Eye Cancer Foundation, and we look forward to contributing to the organization’s goals.


Successful Eye Cancer Treatment Can Improves Quality for the Extreme Elderly

Treating eye cancer patients in their 80s, 90s, and even older, present a unique set of physical and ethical challenges. A case report written by Dr. Carina Sanvicente and Dr. Paul Finger, and published in the November issue of EyeNet, demonstrates how successful treatment can improve quality of life even for patients of advanced age.

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Demographically, America is getting older, and the fastest growing cohort in the country is the “extreme elderly,” that is patients 85 and older. According to agingstats.gov, the “extreme elderly” patient population will rise from 6.2 million in 2014 to 19 million in 2050.

Some of the challenges doctors face when treating eye cancer patients over 85 include other chronic illnesses, their mental state, hearing loss, and mobility issues. For older patients with many other health problems, doctors have to weigh the risks and benefits of treatment, and consider carefully how it will impact their overall quality of life.

Dr. Neil Bressler, Chief of the Retina Division at the Wilmer Eye Institute in Baltimore, said “no one is too old to benefit from treatment, and patients in their 90s could live another 5 to 10 years.” This may seem counter-intuitive. It’s easy to look at an extremely old patient and think maybe treating eye cancer isn’t the highest priority. After all, they are near the end of their lives.

While doctors should certainly consider all of the relevant factors, the case study presented by Drs. Finger and Sanvicente reveals just how beneficial eye cancer treatment can be, even for patients of advanced age.

The report focused on Mrs. Gisela Dollinger, a healthy 92-year-old Holocaust survivor who was referred to the New York Eye Cancer Center for treatment of a choroidal melanoma in her left eye. Initially, Dollinger was reluctant to pursue intervention.

“I’m 92, I don’t feel anything; how long do you expect me to live?” she asked.

When Dr. Finger explained she could live another 10 years with good vision in the treated eye, and that forgoing treatment could lead to metastatic melanoma, she relented. She gave consent to undergo palladium-103 plaque brachytherapy .

As Dr. Sanvicente put it, the results surpassed all expectations.

Of course, every patient is different. Not every case involving elderly patients will be as easily resolved. Dr. Finger emphasizes that the key is individualizing care.

“Cases like Mrs. Dollinger’s will likely become more prevalent as our population grows older, and we, as physicians, must be prepared. In this particular case, we had an autonomous, lucid, 92-year-old woman presenting with a life- and sight-threatening condition. She was treated with a safe intervention.”

You can download and read the Mrs. Dollinger’s Full Story Here.


Asking These Seven Questions Will Help You Choose the Best Doctor

It makes a difference where you are treated. Knowing the right questions to ask will help you decide.

7 Questions You Should Ask Your Doctor

Click to Read Now

We have developed a list of 7 key questions that will help you evaluate prospective physicians. Getting answers to these questions will help you be sure the doctor you chose has the experience necessary to provide the most advanced treatments. The answers will also give insight into where you (the patient) rank within the physician’s list of priorities.

When facing the uncertainty that comes with a diagnosis of eye cancer, you want a physician committed to spending all the time necessary to help you understand your condition and concerns. Discussing these 7 questions with your prospective doctors will help you determine their level of commitment. In addition, the answers will give you a peek inside their practice. You will come away with a much better sense of the doctor’s familiarity with the latest diagnostic and treatment options, how the staff views their relationship with their patients, and whether you’re likely to get caught up in bureaucratic red tape.

At The New York Eye Cancer Center, we are committed to providing patient centered care. We will happily answer these seven questions, along with any others you may have.

Click Here to see the seven questions along with more information on why they are important.


Eye Cancer Foundation Fellowship Alum Making a Difference in India

A doctor who recently completed fellowship training supported by The Eye Cancer Foundation (ECF) is providing eye cancer treatment in an area of India currently lacking any trained specialists in ocular oncology.

Dr. Bikramjit Pal worked under Dr. Tero Kivelä at the Helsinki University Eye Hospital during his six-month fellowship from October 2015 through March 2016. In addition to mentoring from Dr. Kivelä, Dr. Pal learned from a wide range of highly trained medical professionals at the hospital. He actively participated in daily patient workups in the Ocular Oncology Service and observed and assisted in the treatment of eye cancer patients.kivelapalimage2

During his training, Dr. Pal was exposed to a wide range of procedures and treatments, including outpatient and intraoperative transpupillary thermotherapy, ruthenium and iodine plaque brachytherapy, conjunctival surgery, and intravitreal chemotherapy. He was involved in the treatment of conjunctival carcinoma, conjunctival melanoma, ocular adnexal and intraocular lymphoma, uveal melanoma, and retinoblastoma. He also had the opportunity to participate in one-on-one teaching in the latest diagnostic techniques related to eye cancer under the supervision of senior consultants.

In addition to his practical training, Dr. Pal also participated in research studies during his fellowship. He took part in an ocular oncology journal club and undertook three scientific projects, including one case report and two observational case series. Dr. Kivelä praised Dr. Pals work during his fellowship training:

“Dr Pal has shown keen interest in his studies, an excellent working knowledge of fundamentals of ophthalmology, and he has been a most avid observer.”

The Eye Cancer Foundation offers fellowships to doctors from unserved and underserved countries, providing specialized training in the treatment of retinoblastoma and other eye cancers. Once they complete their training, ECF fellows commit to return home to create eye cancer treatment programs.

Dr. Pal plans to begin oncology services at a tertiary eye care facility in Kolkata. This center serves a huge population, not only in eastern India, but also in the neighboring countries of Nepal and Bangladesh. Dr. Pal said he was eager to apply his training in his home country.

“In India, we deal with retinoblastoma so often; hence my aim is to start with a fully equipped clinic which will provide services to patients having intraocular tumors.”

With Dr. Kivelä’s ECF-sponsored fellowship training, Dr. Pal will be able to provide high-quality care to eye cancer patients who would otherwise have little to no access to treatment. This translates to saved vision and lives. Dr. Kivelä will continue to mentor Dr. Pal, providing long-distance consultative support and will soon visit Dr. Pal’s center.

Through the recently launched 2020 Campaign, The Eye Cancer Foundation plans to multiply this success story across the world. With your help, we can train 20 eye cancer specialists to work in 20 countries by 2020.

Our immediate goal with the 2020 Campaign is to save the lives of 1,000 children by 2020. But that’s only the beginning. Our ability to train doctors and supply them with the equipment they need to properly diagnose and treat retinoblastoma is only limited by the generosity of our donors.

You can become part of the cure with a one-time or recurring donation to The Eye Cancer Foundation. Click HERE to donate today.

For more information on The Eye Cancer Foundation Fellowships, including how to apply, click HERE.


The 2020 Campaign: Train 20 Specialists in 20 Countries to Treat Childhood Eye Cancer

Every year, retinoblastoma afflicts some 10,000 children around the world. This eye cancer has a 98% cure rate with proper diagnosis and treatment, but many children in less developed countries lose their vision and even their lives because of lack of access to proper care.

Through the recently launched 2020 Campaign, The Eye Cancer Foundation plans to change that. With your help, we can train 20 eye cancer specialists to work in 20 countries by 2020. This will save thousands of children’s lives.

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Retinoblastoma is the most common eye cancer in children. It typically develops before the age of three. The incidence rate is somewhat higher in developing countries, where most of these children eventually succumb to metastatic retinoblastoma. In contrast, in developed countries like the US where there is access to specialized treatment, most patients survive to lead normal lives.

Screening, early diagnosis, and prompt treatment will save lives. In countries without eye cancer specialists, children with retinoblastoma typically go undiagnosed and untreated until it’s too late. Many less developed countries don’t even have a single doctor specializing in eye cancer treatment, and local general ophthalmologists are not familiar with modern eye cancer medicine. With a relatively small investment, we can provide doctors with specialized training in retinoblastoma treatment and strategically place them in underserved regions around the world.

Earlier this fall, The Eye Cancer Foundation launched a partnership with the International Council of Ophthalmology to support and promote eye cancer fellowship education for doctors from unserved and underserved countries. This partnership will greatly expand the ECF fellowship program already in place.

But we still need your help!

Through the 2020 Campaign our immediate goal is to save the lives of 1,000 children by 2020. But that’s only the beginning. Our ability to train doctors and supply them with the equipment they need to properly diagnose and treat retinoblastoma is only limited by the generosity of our donors.

You can become part of the cure with a one-time or recurring donation to The Eye Cancer Foundation. Click HERE to donate today.

Note: You are welcome to use the graphics in this post to promote the 2020 Campaign on social media or your own website. Please link to: https://www.eyecancercure.com/2020/

 

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