Learn about why not all eye plaques used for treatment of choroidal melanoma and other intraocular tumors are not equal. Dr. Finger started using palladium-103 seed sources in eye plaques back in 1991.  He recognized that palladium-103 would provide more radiation to choroidal melanomas while reaching fewer normal vital intraocular structures compared to iodine-125 seeds. This difference has translated into better local cancer destruction and better vision retention for his patients. Paul T. Finger, MD, FACS The New York Eye Cancer Center 115 East 61st Street New York City, New York, USA ..read more

Normal plaque position was defined by the American Brachytherapy Society (ABS) as covering the entire tumor and a 2-3 mm margin of normal-appearing tissue. However, the optic nerve in its sheath behind the eye is 5-6 mm wide. In order to achieve normal plaque position for any tumors that are near the 1.8 mm wide optic disc, an 8-mm slot was required to accommodate for the optic nerve sheath diameter, incorporate it into part of the plaque and thus move the plaque into ABS normal position. Paul T. Finger, MD, FACS The New York Eye Cancer Center 115 East 61st Street New York City, New York, USA ..read more

Dr. Finger believes that patients should know each doctor's track record. They are interested in surgical success rates and what happens to patients with similar or equivalent tumors. Dr. Finger agrees, so he started averaging together the outcomes of patients that returned to his office for follow up. Plus, his fellows add this data in near real-time to his web site where it can be viewed. Just go to http://eyecancer.com and on the upper right corner click, “Dr. Finger’s Success Rates. There you will be directed to information about choroidal melanoma, iris melanoma, and squamous carcinoma pa ..read more

Tumors and cancers commonly occur on the conjunctiva and often grow onto the corneal surface. Both conjunctival melanoma and squamous carcinoma have been associated with sun (ultraviolet UV-ray) exposure, so Dr. Finger says, "Think of Sunglasses as Sunblock for your Eyes.®" Commonly treated with observation for growth, surgical removal or a combination of surgery and freezing "cryotherapy," over the last 10 years more and more patients are treated with immunotherapy or chemotherapy eye drops. Of course, your doctor may need to biopsy first, but at The New York Eye Cancer Center, most patients ..read more

This Podcast takes a closer look at what I do to maximize eye radiation outcomes and minimize patient risk. Until we have a treatment for metastatic ocular melanoma, destruction of the intraocular tumor will be the best way to prevent and thus "treat" metastasis.  Across the world, each eye cancer center has its own radiation methods to destroy choroidal melanomas. However, a closer look at the methods of plaque selection and implementation reveals significant differences. This Podcast discusses basic plaque design, construction, and dose calculations. I explain why certain methods/plaque ..read more

This Podcase discusses a technique I introduced to ophthalmic oncology. Sometimes, when eye cancer specialists have to remove a large tumor from the surface of the eye, we created a large tissue-defect on its surface. The surgeon cannot leave it grow on its own because the eyelid can scar and stick to the eyeball (called symblepharon). This scarring can hamper the movement of the eye and doesn't look normal. So, decades ago, I used to borrow some mucus membrane tissue from the inside of the cheek (mouth). This was a second surgery that left the patient's mouth sore and swollen for a week or tw ..read more

Iris tumors are visible. Patients see them in the mirror and eye care specialists view them through the clear cornea. We use specialized ultrasound (UBM) and anterior segment OCT tests to reveal the contents, distribution, and size of these tumors. Most are benign and thus can be observed for growth prior to intervention. Others are either clinically diagnosed and treated or undergo biopsy. We review the differences between biopsy methods. In this Podcast, we will explore iris tumors, their diagnosis, and treatment. Paul T. Finger, MD, FACS The New York Eye Cancer Center 115 East 61st Street N ..read more

Cancer textbooks tell us to remove or destroy primary cancers to prevent spread (metastasis) to other parts of the body. In the 1950s, most eyes with choroidal melanoma were removed. Some small anterior choroidal, ciliary body and iris melanomas were locally resected. However, The multicenter, international, Collaborative Ocular Melanoma Study taught us that removal of the eye was not necessary for moderately sized choroidal melanomas. That eye and vision sparing plaque radiation therapy was statistically equivalent for the prevention of metastatic disease. However, surgical removal, including ..read more

There are many different types of vascular tumors within the eye. In the uvea or vascular layer beneath the retina, there occur both circumscribed and diffuse hemangiomas. The latter or diffuse variant is commonly associated with the congenital neurologic disorder Sturge-Weber Syndrome (encephalotrigeminal angiomatosis). It is associated with Port-Wine skin coloration, glaucoma, seizures, intellectual disability, and ipsilateral leptomeningeal angiomas. Within the eye, both circumscribed and diffuse hemangiomas may leak causing secondary retinal detachments. Vision changes can also be due to p ..read more

Tumors and cancers commonly occur on the eyelids. Once the clinical or pathologic diagnosis is established it is time to consider treatment. Eye cancer specialists will recommend either removal or destruction of the eyelid cancer. Depending on the type, size, and location of the tumor, different surgical or treatment strategies will be used. These treatments can range from simple surgical excision of the tumor and margins or Moh's microsurgical resection, typically followed by oculoplastic surgical repair. When tumors invade around the eye, into the orbit, brain, or sinuses, treatment becomes ..read more