Download Cancers of the Eye Group Study

Cancers of the Eye Group Study: V. Brady, R. Johnson, A. Marchbanks, S. Miller
Case Study
Mark Edwards
Date of Birth: 1-13-1963
Etiology: Choroidal Melanoma
Mr. Edwards, with no previous visual impairment, began to experience a small blind spot in his
central vision at the age of 45. The blind spot gradually grew bigger and at age 46, Mr. Edwards
went to his local optometrist to determine the cause of his change in vision. During examination,
the optometrist noted a pigmented lesion in the back of the left eye. The doctor sent Mr. Edwards
to Dallas for further testing. On February 25, 2009, Mr. Edwards was diagnosed with choroidal
melanoma in his left eye. CT scans showed no evidence of cancer elsewhere and it was
determined that Mr. Edwards was otherwise in good health. Without correction the vision in the
right eye was 20/20 and the left was 20/80. Vision in his left eye improved to 20/40 with pinhole
testing. Mr. Edwards was advised at this point to begin radioactive plaque treatment. He was
informed that there was an extremely high likelihood that he would later have further loss of the
central vision, although gradual and delayed.
On March 20, 2009, Mr. Edwards underwent ocular surgery. An 18mm radioactive plaque was
implanted into the eye covering the tumor. During this time, Mr. Edwards was to limit close
contact with others to protect them from receiving unnecessary radiation. The plaque remained in
the eye for the time necessary and then was removed on March 23, 2009. The tumor responded
to the radiation plaque therapy showing significant shrinkage over the next year. Mr. Edwards
continued to have follow-up eye exams to monitor any changes.
On January 25, 2012, Mr. Edwards was sent to MD Anderson after his regular eye exam showed
changes in the edges of the tumor. It was determined that the best course of action from this
point would be adjuvant laser hyperthermia to the areas of concern. The patient was informed of
the risks to this procedure. On February 22, 2012, Mr. Edwards received his first transpupillary
thermotherapy (TTT) in his left eye. He returned three months later to receive laser treatment
again. Mr. Edwards has since received two more transpupillary thermotherapy treatments in
2012 and will return in August of 2013 for his next treatment.
Mr. Edwards is a financial advisor and reliant on his vision in his field of work. He has many
concerns about losing his vision completely in his left eye and how that will affect his job
performance. Mr. Edwards also shared his concern over the cost of the procedures. Every three
to four months he must have a scan done. Each scan costs approximately $9000. Laser
treatments and travel costs to MD Anderson are only two of many additional costs. Even with
insurance, the additional costs can be quite stressful.
At this time, Mr. Edwards is able to function normally in his daily routine. He does not require
any accommodations or extra services. He has found the Ocular Melanoma Foundation to be
helpful in finding answers and support. As a last result, the removal of Mr. Edward’s eye may be
necessary. There would be many difficult adjustments to his work and daily living if this were to
happen. However, Mr. Edward remains hopeful that the treatments will continue to be beneficial.