Ocular melanoma survivor warns others as UV levels reach seasonal highs
18th January 2023
The Australian Society of Ophthalmologists (ASO) is calling on the community to ‘slide’ on their shades as the country braces for seasonal high temperatures and conditions.
Sun protection measures are recommended when the Ultraviolet (UV) Index is 3 and above, but most of mainland Australia is currently experiencing seasonal indexes within the ‘extreme’ range of 11–15.
ASO Chief Executive Officer Kerry Gallagher said it comes as no surprise that Australia has some of the highest UV ratings in the world.
“It’s an Australian childhood rite of passage to learn to ‘Slip, Slop, Slap, Seek and Slide’, especially when the call of summer arrives,” Mr Gallagher said.
“A very important part of the message often gets overlooked, and that concerns our eye health.”
As an eye surgeon, Dr Bill Glasson sees and treats patients whose repeated or excessive sun exposure has led to serious conditions such as pinguecula and pterygium, and cataracts, among others.
Although less common, he said Australians should be wary of not only developing melanoma on their skin this summer, but the risks associated with ocular melanoma — the most common form of eye cancer.
“Each year 125–150 people[1] will be diagnosed with ocular melanoma around the country,” Dr Glasson said.
“As the symptoms and common areas for growths can be difficult for the naked eye to see, patients often receive a diagnosis following an eye test with either an ophthalmologist or optometrist.”
This was the case when then 37-year-old mother of two, Susan Vine, booked in to see an optometrist for an assessment for glasses after experiencing frequent headaches.
Susan was immediately referred to Dr Glasson, who has a special interest and expertise in ocular oncology.
Within two weeks of an initial eye test, she had been diagnosed with a form of ocular melanoma and had undergone enucleation surgery — the complete removal of her affected eye.
Seventeen years on from her diagnosis, Susan has become an advocate for others by establishing an online support group for Australian and New Zealand patients, family, and carers — OcuMel Australia and New Zealand.
“The journey and challenges are unique, especially when it comes to treatment and related vision loss, so we find many of our members are looking for understanding, guidance and support,” she said.
Susan said there is an alarming lack of awareness about eye health and wants every Australian to know to ‘slide’ on their sunglasses and make a healthy habit of booking an annual eye test.
“Every day I live with the reminder of my diagnosis and the challenges that come with being vision impaired and wearing a prosthetic eye, such as thinking about how I sit or even cross the road.
“I rarely wore sunglasses when outdoors, and despite having a freckle on my eye from childhood, did not realise the importance of monitoring it for changes.
“We need to teach children the value of protecting their eyes from a young age and encourage healthy habits early of getting regular health checks,” she said.
Dr Glasson reinforced that in addition to ocular melanoma, skin cancers such as basal cell carcinomas (BCCs) and squamous cell carcinomas (SCCs) can be found in and around the eyes, strengthening the cause to protect not only our eyes, but the areas around them.
The ASO said risk factors to be aware of include having pale or fair complexion, light eye colour, family history of melanoma, growths on or in the eye, increasing age, and skin conditions which cause abnormal moles to grow.
It also noted that individuals with pterygium are at a greater risk of developing skin cancer, including melanoma, as the condition is a marker for previous exposure to high levels of UV light.
Mr Gallagher said the best method of eye health protection from the effects of UV exposure is to ensure you and the ones you love ‘slide’ on UV-blocking eyewear this summer and ‘slap’ on broad-brimmed headwear.
“Always check the label when buying eyewear to confirm the level of UV protection,” he said.
“At the ASO, we recommend wearing close-fitting and wraparound style sunglasses that meet the Australian and New Zealand Standard for sunglasses with a lens category of 2, 3 or 4 — which will ensure they’re practical for wear in Australian conditions.
“And don’t forget — for best practice when selecting headwear — a broad-brimmed hat will provide the optimum eye protection against reflected radiated rays.”
You can be summer eye safe by checking UV indexes on the Bureau of Meteorology website at www.bom.gov.au/uv/ and always doing the five: ‘Slip, Slop, Slap, Seek and Slide’.
Categories of sunglasses and fashion spectacles according to the Australian/New Zealand Standard AS/NZS 1067.1:2016
Lens category |
Description |
Lens category 0: Light tint sunglasses or fashion spectacles |
These provide very limited reduction of sun glare and some UV protection. |
Lens category 1: Light tint sunglasses or fashion spectacles |
These provide limited protection against sun glare and some UV protection; they are not suitable for driving in at night or under dull light conditions. |
Lens category 2: General purpose sunglasses |
These provide good protection against sun glare and good UV protection; they suitable for driving in at night or under dull light conditions. |
Lens category 3: General purpose sunglasses |
These provide high protection against sun glare and good UV protection; they are not suitable for driving at night or under dull light conditions. |
Lens category 4: Very dark special sunglasses – very high sun glare reduction |
These are special purpose sunglasses that provide a very high protection against extreme sun glare and good UV protection, they are not suitable for road use and driving. |
Source: Australian/New Zealand Standard AS/NZS 1067.1:2016
Cataract
Cataract is a condition that causes clouding of the eye lens and progresses gradually over time. When left untreated, it can result in vision loss. More than 500,000 cases are diagnosed each year in Australia.
Ocular melanoma
Ocular melanoma — also known as uveal melanoma, intraocular melanoma or eye melanoma — is a type of eye cancer that develops in the cells of the body that produce melanin, which is the pigment that gives skin its colour. Ocular melanoma is rare with around 125–150 Australians diagnosed each year.
Pinguecula and pterygium
Pinguecula and pterygium are growths that occur on the white part of the eye, known as the conjunctiva. Both conditions are caused by exposure to ultraviolet radiation and worsened by chronic dryness or irritation — unavoidable challenges in our Australian summer.
A pinguecula can only be found on the conjunctiva and is often a small raised white- or yellow-coloured growth. Generally, it does not affect vision but can cause dryness, redness and inflammation.
A pterygium grows from the conjunctiva and extends onto the cornea, known as the surface of the eye, and can occur on either side of the eye. It is commonly referred to as ‘surfer’s eye’. These growths can cause decreased or distorted vision, but more commonly present with irritation, redness or the sensation of something in the eye.