More than 1 million new cases of non-melanotic skin cancer are diagnosed in the United States each year, making it the most prevalent malignant disease in light-skinned people in this country.1 In addition, melanomas are diagnosed in anywhere from 1.3% to 8% of patients, depending on the criteria used and the population studied.2-4
Most cancerous lesions in and around the eye are related to ultra-violet light exposure. This means that patients who live near the equator, who have light skin and eyes, or who are older (a lifetime of UV light accumulation makes these patients more vulnerable) are more susceptible to forms of skin cancer.5
While most of the “lumps and bumps” we see on the ocular surface and eyelids are completely benign—examples include nevi, papillomas, pingueculae and pterygia—the alarming incidence of skin cancer indicates that we will inevitably be caring for patients who have potentially deadly lesions in and around their eye(s).
But differentiating between what’s safe and what’s “scary” can be challenging due to the sheer number of possible diagnoses. Also, no one can claim to definitively and correctly diagnose lumps and bumps every time; that’s what biopsies are for.6
This seven-step ABC strategy can help you determine if a lump, bump or “funny spot” is suspicious. This is not a checklist in which you count the number of “bad” indicators vs. “safe” indicators and make your referral based on that ratio. Rather, this strategy is merely a tool to help you determine your own level of suspicion when looking at different growths and lesions and to guide your management plan accordingly.
Kimberly K. Reed, OD
Company: Review of Optometry
Expire Date: 01/31/2007
CE Credits: 2
CE Format: Online text/photos
COPE ID: 15301-AS