NYECC’s How-To for Chemotherapy Eye Drops

Whether treating a dry eye through artificial tears or over-the-counter anti-allergy drops, many people around the word have experienced using eye drops in their every day drops — however, using chemotherapy drops to treat malignant eye tumors may seem daunting. You may be wondering how these eye drops differ from simple artificial tears, what specific instructions, or additional precautions must be made to install them into the eye, and so on. Luckily, the New York Eye Cancer Center has written a comprehensible step-by-step process that can help put your mind at ease when understanding chemotherapy drops.

Before you read the instructions, here are some helpful reminders and tips regarding your drops:

Put one drop in the affect eye 4 times a day, while awake, for the directed amount of time. You may administer the drops to your own affected eye by yourself, or you may have someone else do it for you. Remember to refrigerate your drops at all times! If you plan on being outside for the majority of your day, keep your drops in an insulated bag with ice packs. Do not put your drops in the freezer.

Now, regardless of the drops you are using (for example, interferon A or 5-FU), please take care to follow these instructions.

STEP 1: Sterilization is important — wash your hands! If possible, put on latex gloves.

STEP 2: Lie down flat, or recline in a chair.

STEP 3: Look down, pulling back your upper eyelid.

STEP 4: Put the drop on the top part of your eye.

STEP 5: Slowly close your eye, keeping it closed for 5 minutes.

STEP 6: If there is any excess, gently wipe it away.

STEP 7: Sterilization remains important! If you did not put on gloves, wash your hands again.

And of course, should you be experiencing any eye pain, blurred vision, or flu-like symptoms, do not hesitate to contact NYECC at 212-832-8170.

Want to keep this information on hand at all times? We have put this information into a simple PDF available for download. You can download and print this PDF to keep with you by clicking here.

AAO Newsletter Features Paper Published by ECF Fellow

 

From the summer of 2016 to 2017, Dr. Sonal Chaugule gained a wealth of knowledge as an Eye Cancer Foundation (ECF) fellow under the tutelage of Dr. Paul T. Finger at the NYECC. From shadowing Dr. Finger’s surgeries at the New York Eye and Ear Infirmary, to speaking at the Second Eye Cancer Working Day in March 2017, Dr. Chaugule has since returned to India, using the knowledge she has gained as tools to continue in the footsteps of her mentors. Her efforts manifest in her paper, in collaboration with Dr. J. Park and Dr. Paul Finger, being published by the American Academy of Ophthalmology.

Featured in the headlines of the AAO Newsletter, the paper was first published by the Indian Journal of Ophthalmology in December 2017, and discusses the effectiveness and safety of topical chemotherapy as sole treatment for giant ocular surface squamous neoplasia (OSSN). Ten patients (3 female, 7 male) with biopsy-confirmed giant OSSN were treated with topical chemotherapy drops (interferon alpha 2b and/or 5 flurouracil 1%). Then, patients were monitored for changes in tumor response, vision, recurrence of disease, metastasis, and treatment complications.  

Pictured below are samples from the paper, revealing slit-lamp photographs of patients afflicted with OSSN before treatment (A, C) and after treatment (B, D). Pre-treatment for both patients (A, C) and post-treatment (B, D) reveal complete tumor regression after treatment via topical chemistry therapy drops. You may note that there is no evidence of opacity, or haziness, to the cornea in the after photos.

Results found that there was no evidence of vision-limiting complications due to treatment by chemotherapy drops — no thinning of the sclera (the white of the eye), no cloudiness in the cornea, and no stem cell deficiency. Noteworthily, there were no tumor recurrences, and none of these 10 patients required additional treatment for their giant OSSN such as surgical excision or cryotherapy. For all patients in this study, there was tumor regression, concluding to researchers that topical chemotherapy drops were not only safe, but effective as treatment for giant OSSN. To read the published study in full, click here.

 

The ECF 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. Chaugule has begun oncology services at HV Desai Eye Hospital in Pune, India, a vital center for eye cancer research and patient treatment, serving a wide population of not only Indians, but also those from the neighboring countries of Pakistan, Bangladesh, and Nepal.   

Through its 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 2020 Campaign 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.

When Choosing A Doctor, Results Matter: NYECC Breaks Ground with Clinical Results Available to the Public

Our new Results page began with a question:

how can patients choose the best doctor without knowing their past performance?

In the age of the internet, when HealthGrades and RateMDs are ready to profile a physician with the push of a button, it is now easier than ever to browse for healthcare options. Five-star reviews remarking on wait times and a doctor’s beside manner, while certainly valuable, miss the most important question a patient would like to know: how capable is this doctor of delivering good health outcomes?

For eye cancer patients in particular, understanding where to receive the best possible treatment is paramount. With these patients in mind, The New York Eye Cancer Center is now the first practice of its kind to report patient outcomes on the web in a patient-accessible format. Click here to see our latest Results.

Understanding the Report

We have launched the Results page with reports on three common conditions treated at NYECC: choroidal melanoma, iris-ciliary body melanoma, and squamous conjunctival malignancy. Though Dr. Finger’s clinical practice and peer-reviewed outcomes span his 30 years of practice, this new method of reporting starts with patients treated after December 1, 2017 and will be updated weekly going forward.

For each disease, we report on:

– Patients Entered: The number of patients included in these results.

– Visual Acuity: The median visual acuity, or eye chart test score, after finishing treatment.

– Local Tumor Control: The percentage of patients whose tumors are successfully eliminated through treatment.

– Loss of Eye: The percentage of patients whose cases require enucleation, or the removal of the eye, in order to complete treatment.

– Metastases: The percentage of patients whose tumors spread to other organs after treatment.

– Average Follow Up: Number of years after treatment before additional treatments are required.

The data, located on our Results page and observable through an interactive table, reports on patients treated only by Dr. Finger. Patient data is strictly confidential, HIPPA-compliant and anonymous.

A Piece of the Puzzle

This trailblazing Results page is the next step in a multi-year initiative by Dr. Finger and his colleagues to empower patients and improve outcomes across the ocular oncology specialty.

While medical journals have provided a forum to publish and compare treatment techniques, medicine does not currently have a strong framework to compare overall physician performance in a quantitative, objective manner. In response, a group of eye cancer specialists including Dr. Finger have formed the “International Doctor Reported Outcomes (DRO) Initiative.” This initiative is developing a standardized way for doctors to report their results to the public and each other.

Comparing outcomes is a great way to find areas for improvement in medical practice. More importantly for each individual patient, DRO reporting is a clear way to address that essential question: what are the past results of the doctor who is about to treat me? 

The DRO Initiative has been developed over the course of the last two Eye Cancer Working Day conferences, which gathered ocular oncologists from around the world. But identifying a need and making a plan are but a prelude to the achieving our goal: a world in which all medical centers routinely publish their results for the public.

The launch of our results page is the first step, and we encourage other centers to join us in this effort. The Eye Cancer Foundation will offer assistance to any center or solo practitioner in setting up a page akin to the new NYECC Results page.

Let’s hold ourselves accountable to our outcomes and empower patients to make their life-changing choice of eye cancer specialist based on visible results.

The Eye Cancer Working Day: Our Next Step

 

The Working Day initiative, dedicated to improving the eye cancer field through international cooperation between oncologists, lives on with another successful dinner meeting at the American Academy of Ophthalmology (AAO) 2017. Through various oral and poster presentations, The New York Eye Cancer Center and The Eye Cancer Foundation was actively represented through the Working Day Dinner at AAO 2017 on November 9th at the famous Arnaud’s Restaurant in New Orleans, Louisiana. The dinner, hosted by the ECF, saw continued collaborative efforts of the projects presented at the Working Day meeting on March 2017 in Australia. Here are the ophthalmologists who discussed these tasks at the dinner meeting:

Dr. Brenda Gallie, who specializes in the research and treatment of retinoblastoma, discussed “Big Data registries” that collect both prospective and retrospective information for retinoblastoma, conjunctival melanoma, intraocular lymphoma and radiation side effects.

Dr. Sonal Chaugule, a recent fellow who trained under Dr. Paul Finger at the New York Eye Cancer Center, discussed the open access, eye cancer surgical textbook and video-atlas that will soon become available to the public.

Dr. Bertil Damato discussed doctors outcomes reporting through the Iris Registry.

Dr. Paul Finger remarked on The Eye Cancer Foundation’s ongoing work with the International Council of Ophthalmology in helping train eye cancer specialists to work in unserved and underserved countries. He invited all who are willing to participate in this fellowship program to contact the speakers directly, thereby extending the efforts of the 2020 Campaign, which is close to reaching its goal of training 20 eye cancer specialists in these unserved countries by the year 2020.

To stay updated on the continued, exciting efforts of all Working Day participants, please keep our website in your bookmarks!

The Global Effort

 

The Eye Cancer Foundation 2020 Campaign continues to make tremendous strides in the advancement of eye cancer care through the exciting completion of Dr. Milly Shakoor’s 6-month fellowship in retinoblastoma training. This news arrives unitedly with the announcement of another ECF Fellow’s completed training, Dr. Veronica Molleda, from Bolivia. With every fellowship thus offered and completed, The Eye Cancer Foundation and its supporters come closer to fully realizing the goal of training 20 specialists in 20 countries to treat childhood eye cancer.

Eye Cancer Foundation fellowships offer doctors to be trained in the specialized treatment of retinoblastoma, training that they cannot otherwise receive in their home country. These ECF fellowships, partnered with the International Council of Ophthalmology (ICO), are available to candidates from unserved or underserved countries. After doctors complete their six months of training, they agree to return to their home country to start or participate in eye cancer treatment for the unserved.

But what is retinoblastoma? Retinoblastoma is the most common eye cancer in children and affects approximately 8,200 children each year. In developed countries like the United Sates,  the survival rate reaches beyond an astounding 96%, with early diagnosis and treatment being key to saving patients’ lives and sight. However, the incidence rate is higher in developing countries, where most of the children succumb to metastatic retinoblastoma. In areas where children and families have no means of traveling to treatment centers far away from them, these afflicted children often endure their untreated disease untreated, which eventually leads to death. Because no child or family should have to suffer these losses, especially due to inability to simply reach a treatment center, the ECF has launched the 2020 Campaign.

Dr. Milly Shakoor comes from Dhaka, the capital of the highly densely-populated country of Bangladesh, where availability of retinoblastoma care is certainly low. She trained at The Centre for Sight in Hyderabad, India with the renown Director of Medical Services, Dr. Santosh G. Honavar (pictured above), who specializes both in oculoplasty and ocular oncology. Since her return to Dhaka, she has been met with several retinoblastoma cases and continues her treatment of them.

As always, The Eye Cancer Foundation these fellowships could not have been completed without the support of readers and donors — and so, the ECF thanks you for helping to provide hope for eye cancer patients around the world. To our audiences, we hope that you will continue to support these projects through your continued readership, word of mouth, and well wishes!

ECF Fellow Brings Hope to Bolivia

 

It is with the deepest pride that The Eye Cancer Foundation announces the successful completion of Dr. Veronica Molleda’s first 3-month fellowship in retinoblastoma care at the Hospital Infantil de Mexico. Under the tutelage of Dr. Marco Ramirez (pictured right), Head of Ophthalmological Services at the Hospital Infantil and the support of the ECF, Dr. Molleda is now well-equipped with valuable training that will aid eye cancer patients in her native home of Bolivia.

In 2016, The ECF launched the 2020 Campaign with the goal of training 20 Specialists in 20 countries to treat childhood eye cancer. In partnership with the International Council of Ophthalmology, ECF fellowships are available to candidates from unserved or underserved countries. Once the doctors complete their six months of training, they agree to return to their home country to start or participate in eye cancer treatment for the unserved. Dr. Molleda was offered this fellowship by the ECF, which supported her research and stay in Mexico before her return to Bolivia.

Eye Cancer Foundation fellowships offer doctors specialized training in the treatment of retinoblastoma they cannot otherwise receive in their home country. Retinoblastoma is the most common eye cancer in children and affects approximately 8,200 children each year. The incidence rate is somewhat higher in developing countries, where most of the children eventually succumb to metastatic retinoblastoma. In contrast, there exists a better than 96% survival rate in developed countries like the USA. Early diagnosis and treatment is key to saving retinoblastoma patients’ lives and their sight.

During her rotation in Mexico, Dr. Molleda accomplished a great deal of activities. She engaged in bi-weekly meetings with fellow residents to discuss the most recent and relevant issues on retinoblastoma treatment and how to tackle them, as well as presenting difficult cases in retinoblastoma with several oncologists and radiotherapy specialists. She has learned critical information on retinoblastoma, from clinical and differential diagnosis, to Rb genetics. She has developed skills in RetCam operation for outpatient clinics as well as B-scan eye ultrasound for patients with suspicious intraocular tumors. In addition to this, she’s learned critical surgical skills with indirect ophthalmoscope lasers and enucleation with orbital implants. 

“Dr. Molleda will give a superb ophthalmological service to Bolivian patients with retinoblastoma,” says her mentor, Dr. Marco Ramirez, who looks forward to receiving her for another three-months rotation later this year.

The Eye Cancer Foundation humbly thanks its supporters and donors, without whom these fellowships could not have been completed. Every new fellowship awarded and completed provides hope for children whose lives and visions are at risk simply due to their inability to access proper medical care. Your support has always and will continue to make tremendous strides in the field of eye cancer.

 

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

 

Oblique (Angled) Injection Technique Improves the Delivery of Avastin Treatment

Intravitreal (IVT) injections are the most common surgical procedure in ophthalmology practice today. In fact, it is projected that millions of these injections are given each year in the United States. Ocular oncologists use intravitreal injections to treat such conditions as cystoid macular edema (CME), radiation retinopathy, and neovascularization. But did you know that the technique of delivering the injection can influence the effectiveness and safety of treatment?

Following IVT injection, some medication can actually egress or leave the eye through the port of entry, thus delivering less medication than what the physician intended. This can lead to under-treatment of the disease. The perfect IVT injection delivers an exact amount of medication with the least risk to vision and the eye.

Mehta and Finger used a technique of oblique (or angled) IVT injection in an effort to minimize the amount of medication leaving the eye. IVT injection was delivered at a 30-45 degree angle and compared to the standard technique of using a perpendicular (orthogonal) angle.

The researchers found that the angled IVT injection technique had a significantly higher mean intraocular pressure immediately after the injection. This finding suggests that angled injections are self-sealing and more of the drug is staying in the eye. Thus, the angled technique delivers a more accurate dose as well as prevents intraocular infection by closing a potential entry for pathogens.

The Figure below shows how the angled technique may allow for better retention of the drug within the eye following injection:

Through PubMed, you are able to read the published scientific article that explains this in detail here. To stay tuned on all the latest in eye cancer research, please keep our website, eyecancer.com, in your bookmarks!

Fighting for Hope: One Retinoblastoma World 2017

“The One Retinoblastoma World mission is to ensure that every caregiver has access to appropriate knowledge, skills, resources and collaborative opportunity to enable high quality evidence based care for each affected child, survivor and family.”

Every day, new strides are being made towards developing the field of eye cancer. Whether through published papers, international gatherings for ophthalmologists, or patient support group therapy, efficient communication remains a crucial contributor to progress. It was precisely the communication — in fact — between eye cancer patients and ocular oncologists that spearheaded The One Retinoblastoma World Conference that was held October 9-11, 2017 in Washington DC.

At this meeting, families, survivors, and doctors came together to inspire, share, educate, and learn concerning all matters of childhood retinoblastoma. But what, you may be wondering, is childhood retinoblastoma anyway? When born and throughout early stages of life, in areas like the United States where proper medical care is available, children are routinely screened for a childhood eye cancer called retinoblastoma. If diagnosed early, this disease is curable. However, as many as 7,000 children die each year due to improper diagnoses or in-access to proper medical care. No child should die, or suffer avoidable blindness because of that. One Retinoblastoma World is dedicated to breaking down the obstacles that prevent proper treatment for these children.

Ten questions asked by parents and survivors served as a basis for the meeting’s evolution. Because doctors and patients can sometimes be separated by the scope of complicated medical language, these questions better familiarized researchers with the common concerns of patients.

Here were some of the questions:

  • Can we screen for retinoblastoma, and if not, what are the best ways to improve early diagnosis?
  • What do my / my child’s genetics results mean for risk and screening, -current treatment, EUAs after treatment, and for adult life? What do we do if we can’t access genetic testing?
  • How do doctors know when trying to save an eye is dangerous, and removing it is the only option? How do we best care for the socket throughout life?
  • How do doctors and parents make the decision about adjuvant chemotherapy?
  • What is the status of Rb in developing countries? I’ve been contacted by a family in a developing country whose child has Rb. What can I do to help them?
  • What recommendations do you have for long term follow up care and screening in RB1 mutation carriers and children treated with chemotherapy / radiotherapy? How can you help us educate our primary doctors so they take us seriously, and what can we do if we have no access to a survivor / follow-up program?

Each of these questions were answered in a specific panel addressed by researchers, doctors, and clinicians to families and survivors. This proved greatly beneficial to those in attendance. But the collaborative effort did not stop there! The education these sessions provided were not restricted to those able to physically attend. Indeed, the meeting was live streamed to achieve global access for all. As the DC team explains:

“We wanted to make One Rb World 2017 truly a global event. We wanted parents, survivors and medical professionals to join us from across the USA and around the world, even if they couldn’t travel to Washington DC. Live stream viewers were able to interact with speakers and participate in discussions by sending written comments and questions via the live stream system. Their comments were received and shared by several dedicated volunteers in the conference room.”

The DC team is currently working with an editor to publish the livestream for future public viewing. Stay tuned to our blog posts to keep updated on when that will be! Additional information concerning One Rb World 2017 can be found here, including a full list of their program and the subjects of each panel.

One Retinoblastoma World 2017 marks a great advancement in the fight to defeat retinoblastoma. Through the efforts of specialists and advocates combined can we hope to ensure that all children have access to high quality care. We urge you to join us in the fight; have your voice be heard, and be a part of the cure.

To stay updated on all the latest in eye cancer research, please keep our website in your bookmarks!

Visionary Newsletter — Fall 2017

The Fall 2017 issue of The Visionary is now available!

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:

  • Details regarding the highly anticipated Second Eye Cancer Working Day and its success
  • A study by ECF fellow Dr. Bikramjit Pal on chemotherapy side effects for eye cancer patients
  • And more!

Click here to read The Visionary now!

Read back issues of The Visionary here.

The Eye Cancer Foundation can send The Visionary directly to your inbox. If you’d like to receive a personal email notification when new editions of The Visionary are released, please click here and fill out your contact information in order to subscribe. Your information will not be shared with third parties.

The NYECC Support Group’s Next Meeting! Attend In-Person or via Phone!

After two successful meetings where eye cancer patients and survivors shared their feelings in a welcoming, comfortable environment, The New York Eye Cancer Center Support Group, sponsored by The Eye Cancer Foundation, will meet for a third time on November 17, 2017 at 1:30 PM, Eastern Standard Time. This meeting, like its previous ones, will be held at The New York Eye Cancer Center’s conference room located at 115 East 61st Street, New York City, 100065.

Are you halfway across the country? In Texas, California? Are you unable to make it due to working hours, or even that dreaded New York City traffic? Because many potential visitors have expressed their desire to attend but are unable to make it due to any travel inconveniences, we would gladly like to inform anyone that these meetings may be attended via phone call! Regardless of where you are located, the NYECC Support Group wants your voice to be heard! Simply call Karen Campbell, a Licensed Clinical Social Worker who helps facilitate these meetings, and mention that you would like to attend via phone.

You can find Karen’s biography below:

“I am a Licensed Clinical Social Worker (LCSW) and have been practicing in the field for 24 years. In addition to my private psychotherapy practice, most recently, I was in the Director of Vision Rehabilitation Services at the Lighthouse Guild. I started up the Social Work Department at Lighthouse International in 2010 and, as part of that, developed and faciliated the Department’s Support Group program. I also have a background in medical social work, including oncology, having worked at NYU/Langone. I have found support groups to be a valuable way for people to manage their medical challenges and address issues such as family adjustment, depression, anxiety and loss. Although I work primarily with individuals and couples in my private practice, I really enjoy working with groups!”

As we’ve mentioned previously in our regular updates regarding this support group, stress and anxiety are normal experiences for anyone enduring an eye cancer diagnosis. And although it is normal, there are ways to combat these feelings by having a solid support system. For some, these support systems are crucial in order to find one’s bearings and coming to terms with “a new normal”, both of which are important in overall quality of life.

 

Please consider downloading our flyer for November’s meeting here. We hope to meet you there! And to stay updated on all upcoming sessions, please keep our website, eyecancer.com in your bookmarks!

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