Optometrists are in the best position to detect cancers that are hidden by spectacles…This is one such case.
This man was referred in with a multi-year history of a lump on the side of his nose, which he attributed to his spectacles.
This is a huge noduloulcerative BCC, for which I have arranged Mohs surgical removal then oculoplastic reconstruction by myself.
The key is simple: if a patient says there is a problem on their face, listen. Most patients are quick to detect changes on their face.
I am sure that all our female colleagues out there will agree: I have learnt this rule from my female patients!
Lighting strikes twice.
I will post another patient who I saw just a few hours later with the same problem.
This is the second patient that presented within a few hours of the other patient.
He had a BCC concealed by the nasal foot of his spectacles.
This is a large irregular BCC, morpheaform in appearance which means extensive.
I have arranged Mohs surgical excision and will perform oculoplastic reconstruction.
Pay particular attention to the nasal bridge…. spectacles can hide all sorts of pathology.
Case 3
I have recently posted images of 2 patients with BCC in the nasal region hidden by spectacles.
This is what it looks like with repair. This lady had a large BCC in the left medial canthus, and Mohs excision left a large hole. This region is critical, not just because of the tear drain, but the innervation of blink passes through here, and excision of tumour often leaves impaired blinking, which manifests as dry eye.
I undertook repair under local anaesthetic, and this is the result at 5 weeks.
Get in early, and get out quicker!
Remember to check the nasal bridge, and a slit lamp is better than any dermatoscope.
For more before and after photos of Mohs surgery visit: https://www.mohsreconstruction.com.au/before-and-after-mohs-surger/
Learn more about Dr Anthony Maloof