An Eye on Melanoma

What is melanoma?

Melanoma occurs when Melanocytes- the pigment-producing cells that give colour to the skin become cancerous. Melanomas can occur anywhere on the body, with the eye being the second most common site after the skin.

Signs may include a new, unusual growth or a change in an existing mole or naevus. Treatment may involve surgery, radiation, medication or in some cases, chemotherapy.

Ocular melanoma

As an optometrist, I frequently note pigmented spots and lesions in eyes of my patient’s. These can range from benign iris freckles (small pigmented spots on the surface of the coloured part of the eye), through to large choroidal naevi (large moles situated beneath the retina at the back of the eye).

Posterior uveal melanoma- choroid and ciliary body

Being the most common site for ocular melanoma and occuring inside the eye, they are only detected during an eye examination. Symptoms may include blurred vision or blind spots, new floaters or flashes- however, these usually occur when the melanoma is well advanced.

Conjunctival melanoma

The conjunctiva is the delicate, vascularised tissue that overlays the sclera (white of the eye). Accounting for 10 percent of eye melanomas, treatment outcomes are favourable. However, recurrence is high so regular reviews are important.

Iris melanoma

Generally found during routine eye examinations and often occurring from pre-existing iris naevi- New Zealand has the highest known incidence in the world. If caught early, treatment options are favourable.

Risk factors

·        Fair skin- although 4% of Uveal Melanoma in an Auckland Clinic occurred in Maori patients

·        Light coloured eyes

·        Having a pre-existing mole within the eye

·        Ultraviolet light exposure

·        Older age

Recommendations

Wear sunglasses, ensuring they provide 100 percent UV protection. A hat is also beneficial to further shield ambient light exposure around the eye.

My strongest recommendation would be to those who have never had an eye examination to book one! This enables the Optometrist to screen you for any risk factors of eye cancers and advise a time frame for any further reviews. As mentioned, as many of these lesions are not visible to the naked eye, it is only during a routine eye exam that they may be detected.  

Migraine

What is migraine?

It is a neurovascular headache, meaning it manifests as a result of complex events and interactions between both the central and peripheral nervous system and blood supply to the brain.

Migraine is often inherited and is considered the 3rd most common disabling event for those under the age of 50 years.

Symptoms of migraine

Warning stage – You may experience subtle clues that you will develop a migraine which may include neck stiffness, mood changes, constipation, fatigue, thirst or craving of sweet foods

Aura- Visual disturbance which may include light flashes, zig-zags, spots or tunnel vision. But may also cause numbness or tingling on one side of the face or body, hearing or speech disturbance, memory loss, confusion, dizziness or even fainting. The Aura usually occurs before the headache and most commonly persists for 5-20 minutes. Some people will experience the aura only; without the headache developing.

The Headache- throbbing pain, usually on one side of the head. This may be accompanied by nausea, vomiting, and sensitivity to light, sound or head movement.

Resolution & Hangover- Symptoms usually gradually fade but a ‘hangover ‘effect can persist for hours to several days. Symptoms may be similar to the early warning stage or can be the opposite, ie. If appetite was initially lost you may be incredibly hungry.

What causes migraine?

Genetics- sufferers often have a first degree relative with migraine

Sensory overload- sensitivity to light, patterns, sound and even smells

Foods and food additives- certain foods may trigger a migraine such as cheese and chocolate. MSG and some artificial sweeteners may also be implicated.

Sleep disturbance- either too much or not enough

Hormonal fluctuations

Stress or Anxiety

Physical Exertion

What you should do

First of all, if you experience regular headaches, or any significant headache event it is paramount you visit your family doctor for a thorough general health assessment and diagnosis.

A headache diary can be useful to help pinpoint any trigger to your headache.

What can help?

Medication can be prescribed to reduce the pain and even prevent events from occurring. Some patients require referral to a neurologist to help manage their symptoms.

Lifestyle changes including regular sleep, exercise and a healthy diet. Limit alcohol.

Consider an eye examination. In my experience, those with migraine, benefit from correction of even small vision imperfections. We often recommend lenses to reduce light intensity, blue-light exposure, reflection and glare indoors. Prescription sunglasses are helpful in brighter light conditions. I have also recently experienced success with a migraine patient who has found relief from light sensitivity with the new Acuvue Transition Contact Lenses. These lenses, incredibly incorporate the adaptive tint technology of traditional Transitions spectacle lenses but within a contact lens. They can even be helpful to reduce glare when night driving.

Feel free to contact us if you have any queries about your vision or light sensitivity.

Protect your eyes in style with Transitions GEN 8

Recent survey data tells us that 9 out of 10 people are light sensitive, yet only 8 out of 10 people wear sunglasses. In a world where we are constantly exposed to necessary light; visible, ultraviolet or high energy blue light, it is nice to know there is lens technology available which adapts to our constantly changing lighting environment.

Having recently attended industry training on the new GEN 8 Transitions, I am excited how this technology works faster than ever before!

Transitions lenses are a clear lenses which respond to ultraviolet light exposure, darkening to sunglass levels when outdoors. Features of the new Transitions GEN 8 lenses;

• Activate up to 30% faster

• Darker outdoors, reaching a category 3 sunglass level

• Return to a clear state, 3 minutes faster than before

• Longer lasting performance - providing increased value for money over the lifetime of your prescription

• Provide 100% UV protection

• Filter blue light both indoors and from sunlight

The lenses are available in the iconic grey, a new aesthetically pleasing brown and the popular graphite green. In addition to the new Style colours; Amber- which provides a more vintage look to a brown lens – very popular with younger wearers, along with Emerald, Sapphire and Amethyst.

With the Style colours we have definitely seen an increase in popularity among younger wearers, with many celebrities choosing to wear their eyewear in style on the red carpet!

As a Transitions wearer, I can attest to their convenience and the fact that they are ‘right in any light’. Therefore, I have less eye fatigue and light sensitivity with the one pair, no matter what the conditions.

From an Optometrist perspective, I recommend Transitions for my patients as a way to have seamless eye protection but also to ease adaption when going from one light condition to another.

As we get older, it can take longer for our eyes to adjust, for instance if we are coming from the bright outdoors to a darker environment indoors. With Transitions lenses the eyes have less difficulty as the retina is not disabled by the blinding glare while outdoors and therefore your indoor vision is immediately more comfortable, clearer and therefore safer.

We know that 8 out of 10 Transitions wearers would happily recommend these lenses to others and with our ‘Love them or exchange them ‘guarantee, there is simply no reason not to give the latest in lens technology a go in your next pair!