Definition and Overview

Patients who are receiving treatment for eye cancer are scheduled for regular ocular oncology follow-ups so the doctor can monitor the treatment progress and minimise associated risks and possible complications.

Who Should Undergo and Expected Results

An ocular oncology follow-up is part of an ophthalmologic treatment for patients who are diagnosed with or are suspected to have cancerous eye tumors, some examples of which are:

  • Eyelid or iris tumours
  • Anterior segment tumours
  • Melanocytoma
  • Hemangioma
  • Osteoma
  • Granuloma and xanthogranuloma
  • Lymphoma or melanoma of the eye
  • Ocular surface squamous neoplasia
  • Nevus
  • Disciform degeneration
  • Congenital hypertrophy of retinal pigment epithelium
  • Metastatic lesions
  • Optic nerve lesions
  • Orbital nerve lesions
  • Vascular eye lesions
    An ocular oncologist may request for a follow-up appointment in the following situations:

  • When the results of diagnostic tests are released – It is very common for doctors to request for various tests during an initial consultation in order to come up with a diagnosis. The results of these tests are discussed during the follow-up consultation together with possible treatment options.

  • When the patient has decided on a form of treatment – Patients are not forced to agree on a specific treatment plan presented during their consultation. In fact, they are encouraged to weigh all their options so they can make a well-informed decision. They are free to go back for a follow-up once they make a decision.

  • During the treatment process – Once treatment begins, the patient will be asked to come back several times during the entire process. This will allow the doctor to closely monitor the patient’s condition and the progress of treatment. If the treatment is not working as expected or is causing some negative side effects, it can be adjusted accordingly and promptly.

  • After a treatment procedure – Some treatment options require the patient to undergo certain procedures such as chemotherapy or surgical excision. Once these are completed, patients will be asked to make a follow-up to check the wound, ensure that there’s no infection on the surgical site, and assess if all the cancer cells have been removed, among others.
    Regular ocular oncology follow-up visits are very important part of post-treatment care. Keeping in close contact with an ophthalmologist can help protect the patient from possible risks and complications of various ocular oncology treatments.

How the Procedure Works

The process and scheduling of an ocular oncology follow-up may differ depending on the purpose of the visit. For example, a doctor may call for a follow-up when there are new findings regarding the case that need to be discussed with the patient or when the patient has recently undergone a procedure.

A follow-up checkup after a treatment is usually scheduled two to three weeks following surgery or therapy. However, some procedures require a more specific schedule. For example, if a patient chooses to undergo proton beam therapy or stereotactic radiosurgery, he will need to come back after 8 to 10 weeks while patients who undergo treatment for conjunctival tumors are recommended to undergo MRI scans once every six months for preventative screening.

In most cases, an eye cancer patient will require long-term care and follow-up appointments are usually scheduled once every 4 to 6 months.

During the follow-up visit, the doctor will check the patient’s condition and ask about any symptoms or side effects he may be experiencing. This is typically followed by an external physical examination. To do so, the doctor may perform the following:

  • Use dilating eye drops
  • Perform imaging scans, such as an ultrasound or MRI
  • Take photographs of the eye

Possible Risks and Complications

Patients who have eye cancer and undergoing treatment for the condition may be at risk of some complications, such as:

  • Dry eyes
  • Inflammation and swelling of ocular tissue
  • Infection
  • Bleeding
  • Cataracts
  • Vision fluctuations
    Going to the doctor’s office for follow-up checkups on a regular basis can help prevent these complications from occurring, as doctors can adjust or change the treatment method at the first sign of a problem.

To assess the patient’s current condition and take note of any changes, doctors may perform several tests and scans during the visit. These tests and scans are guaranteed safe.

The radiation levels used in imaging scans are very minimal, so they pose very little risk of radiation exposure and are generally safe for all patients, except pregnant women.

Meanwhile, the use of dilating eye drops can cause some side effects. For example, the pupils may stay dilated for up to 4 or even 8 hours, and the drops may cause blurry vision and sensitivity to light and glare. It may also trigger an allergic reaction in some people, although this is quite rare. Given these potential side effects, the patient can refuse to have dilating eye drops during his ocular oncology follow-up, in which case the doctor will use alternative techniques to examine the affected eye.


Reference:

  • American Academy of Ophthalmology Preferred Practice Patterns Committee. Preferred Practice Pattern Guidelines. Comprehensive Adult Medical Eye Evaluation - 2010. Available at one.aao.org/preferred-practice-pattern/comprehensive-adult-medical-eye-evaluation--octobe. Accessed February 27, 2015.
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