February 2023 - Armadale Eye Clinic

squamous cell carcinoma vs basal cell carcinoma melbourne

Squamous Cell Carcinoma vs Basal Cell Carcinoma of the Eye

February 28, 2023/0 Comments/in Oculoplastic Surgery /by armadaleeye

What’s the difference between a squamous cell carcinoma vs a basal cell carcinoma? Skin cancers can affect your eye. Read more about it here.

Cancer can affect many parts of the body, including the eyeball and eyelid. There are a number of different types of cancerous skin lesions that can be found around the eyes. These include squamous cell carcinoma of the eyelid and eyelid basal cell carcinoma. In ophthalmology, these diseases fall under the subspeciality of an oculoplastic surgeon. Keep reading to find out the differences between squamous cell carcinoma vs basal cell carcinoma of the eyelids.

What is Cancer?

Cancer is an abnormal, uncontrolled growth of cells. This resultant mass, if malignant, can then invade and spread through other tissues in a process called metastasis. Invasion of cancerous cells into the various parts of the body causes damage and inhibits its proper functioning.

A carcinoma is a type of cancer arising from epithelial tissue. These cells are found in the skin but also can line our internal organs, such as the kidneys, and also our body cavities, such as the chest cavity. There are also different types of epithelial cells, which can give rise to different types of carcinoma cancers., including sebaceous carcinoma and squamous cell carcinoma of the eyelid, melanoma, and eyelid basal cell carcinoma.

In addition to cancers of the eyelid, the eyeball itself can also develop malignant lesions. Carcinomas and melanomas can be found on the conjunctiva of the eye, which is the translucent membrane covering the whites (sclera). Cancer can also be found inside the eye, such as retinoblastoma in children or choroidal melanomas in adults.

Squamous Cell Carcinoma vs Basal Cell Carcinoma of the Eyelid

At a basic level, squamous cell carcinoma of the eyelid and eyelid basal cell carcinoma differ based on the type of epithelial cell they arise from. As the names suggest, squamous cell carcinomas grow from squamous cells, which are thin, flat cells commonly found on the surface of the skin. Basal cells are small and round, found in the base (the lower layer) of the outermost layer of the skin, the epidermis.

It’s important for an oculoplastic surgeon to differentiate squamous cell carcinoma vs basal cell carcinoma as the management can be different based on the typical behaviours and characteristics of these two different types of cancers.

Squamous Cell Carcinoma

Eyelid basal cell carcinoma is significantly more common compared to squamous cell carcinomas of the eyelid; some research tells us it can be up to 40 times more common. Around the eyelid area, squamous cell carcinoma accounts for only 5% of cancers.

Squamous cell carcinoma has been associated with a number of different causes, including:

Older age
Excessive UV exposure
Skin damage from chemicals such as cigarette smoke or arsenic exposure
Burned skin or chronic ulcers
Viruses, including human papillomavirus (HPV) or human immunodeficiency virus (HIV)
Immunosuppression

This type of eyelid cancer also appears to be more common in males and in those with lighter complexions. Unsurprisingly, people who live in regions with high UV radiation exposure are also at a higher risk of developing squamous cell carcinoma.

In addition to assessing your history and risk factors. your oculoplastic surgeon will perform a thorough physical examination of the eyelid lesion. He or she will be looking for distinguishing characteristics such as:

A painless nodular bump with irregular rolled edges
Chronic scaliness or crustiness of the overlying skin
Any bleeding
Distortion of the surrounding eyelid tissues, such as loss of eyelashes
Ulceration

A definitive diagnosis of squamous cell carcinoma is typically only made after a full-thickness biopsy. This helps your oculoplastic surgeon to rule out other possible diagnoses and also determine how far the cancer has spread if it is a carcinoma. Compared to basal cell carcinomas, squamous cell carcinoma has a tendency to invade other tissues (that is, metastasise).

If a squamous cell carcinoma is diagnosed, the usual treatment of choice is complete surgical removal. The oculoplastic surgeon will run a test to ensure the entire tumour has been excised and also surgically repair the eyelid area after the lesion has been removed. If the carcinoma has metastasised, further radical surgery or chemotherapy may be required to ensure all malignant cells have been destroyed. In some cases of superficial squamous cell carcinomas, it may be appropriate to use a topical medication.

Basal Cell Carcinoma

Basal carcinomas of the eyelid account for over 90% of malignant eyelid lesions. Fortunately, they are much less likely to metastasise compared to squamous cell carcinoma.

Similar to squamous carcinomas of the eyelid, basal cell carcinomas are associated with lighter-skinned patients with a history of UV damage to the skin. Other risk factors include:

Old scarring
Immunosuppression
Radiation exposure

It can be difficult to distinguish a basal cell carcinoma from a squamous one; sometimes, the clinical features are very similar. Features of basal cell carcinoma can also include ulceration and bleeding, crusting of the skin, eyelash loss, and distortion of the surrounding eyelid tissues. The characteristic appearance of a basal cell carcinoma is a crater-shaped bump with a central ulcer and rolled edges. However, they can also appear as a thickened plaque of skin with no obvious ulcer and indistinct edges.

Prompt treatment of basal cell carcinoma is important to minimise the risk of metastasis to neighbouring tissues. This can be achieved with complete excision through surgery or a topical cream. However, some research has demonstrated that the cream is less effective compared to surgical excision.

A suspect diagnosis of any type of cancer can be frightening. The prognosis for eyelid cancer goes downhill with larger tumours, lesions that have been around for longer, and tumours that are more deeply or widely invasive. For this reason, any new or changing bump around your eye and eyelid should be assessed by an eye care professional without delay.

Call us now on (03) 9070 5753 for a consultation.

Note: Any surgical or invasive procedure carries risks. Before proceeding, you should seek a second opinion from an appropriately qualified health practitioner.

References

Types of cancer.
https://www.cancerresearchuk.org/what-is-cancer/how-cancer-starts/types-of-cancer#carcinomas

Squamous Carcinoma of the Eyelid. https://eyewiki.aao.org/Squamous_Carcinoma_of_the_Eyelid#:~:text=by%20Preeti%20Thyparampil%2C%20MD%20on%20November%203%2C%202022.&text=Squamous%20Cell%20Carcinoma%20(SCC)%20of,times%20more%20common%20than%20SCC.

Basal Cell Carcinoma.
https://eyewiki.aao.org/Basal_Cell_Carcinoma

Management of Eyelid Malignancies.
https://www.reviewofophthalmology.com/article/management-of-eyelid-malignancies

retinal detachment symptoms melbourne

Retinal Detachment Symptoms — How to Identify Them?

February 13, 2023/0 Comments/in Armadale Eye Blogs /by armadaleeye

The retina is a delicate layer of tissue lining the inside of the eyeball at the back. Its function is to detect incoming light, convert the light into neural signals, and forward these signals to the visual processing centres of the brain. It’s a complex piece of anatomy and crucial for vision. This part of the eye can also be subject to a number of retinal eye conditions, many of which can result in permanent sight impairment.

One of these is an ocular emergency known as retinal detachment. Being able to recognise early retinal detachment symptoms is essential to improving the prognosis of your sight. Keep reading to find out what you need to know about retinal detachment.

What is a Retinal Detachment?

As the name suggests, a retinal detachment occurs when the retinal tissue comes away from the wall of the eyeball. Many eyecare practitioners will describe this as wallpaper peeling away from the wall. The retina relies on oxygen, nutrients, and other metabolic support from the underlying tissues of the eye, such as the choroid layer. In addition to no longer being able to receive this crucial support, a retinal detachment also means the retinal cells are unable to transmit their neural signals onward through the visual pathway.

A retinal detachment is one of those retinal eye conditions that constitute an emergency. The success of retinal detachment surgery and restoration of sight depends, in part, on how long the retina has been detached for. This is why being able to recognise when you’re experiencing retinal detachment symptoms is important for seeking urgent medical attention.

What are the Retinal Detachment Symptoms?

Retinal detachment symptoms can vary. Not everyone will experience all the symptoms, and in fact, some patients may have an asymptomatic retinal detachment that’s only incidentally detected on a routine eye check-up. However, more often than not, you will notice that something is unusual if you are experiencing detachment.

These are the common symptoms of retinal detachment:

Flashing lights. The medical term for this is photopsia. You may see what looks like a lightning flash out of the corner of your eye, or it may feel like the sudden flash of a reflection from a surface. Many people report this as being the most apparent when they move their eyes or shake their heads, and it may be more noticeable when the environment is dark. Photopsia during a retinal detachment occurs because as the retina is pulling away from the wall of the eyeball, it mechanically stimulates the neurons to fire, inducing the perception of light.
Floaters. Floaters are dark or translucent specks, lines, squiggles, or cobwebs-like shapes that you see in your vision. Sometimes people may think they’re seeing actual spiderwebs or a cloud of flies in front of them. During a retinal detachment, floaters can arise from blood released from broken retinal blood vessels or from fragments of retinal tissue floating around the vitreous gel inside the eyeball. The onset of floaters can also be a sign of one of the retinal eye conditions that are a normal part of ageing, known as a posterior vitreous detachment. However, you can’t know for certain whether you’re experiencing a retinal detachment or a posterior vitreous detachment until you have an examination with an eye care professional.
Blurred sight. As the retina comes away, it is no longer able to perform its job in enabling sight. This means in the area of detachment, you may realise you can’t see as clearly. This will be especially noticeable if your macula is involved in the detachment, as this part of the retina is responsible for your central vision, which we’re most attentive to.
Dark, missing areas of your visual field. During a retinal detachment, you may feel like a dark curtain or shadow is coming across your field of sight. This represents the area of the retinal detachment where the retinal tissue is no longer able to perceive light.

A detached retina will most likely need retinal detachment surgery by a retinal specialist.

What to Do if You Think You’re Having a Retinal Detachment?

If you experience any of the symptoms of a retinal detachment, it’s important to see an eye care professional on the same day. GPs don’t have the necessary equipment to investigate a retinal detachment and will have to refer you to an eye care professional.

You can contact your local optometrist, who can discuss your symptoms with you. If they think the likelihood of a retinal detachment is high, they may suggest you go straight to your city’s eye and ear hospital or a hospital emergency department. Depending on your optometrist and their experience, they may alternatively recommend you come in to see them for an examination to see whether you need a referral for retinal detachment surgery.

If you are already under the care of an ophthalmologist, you can contact their rooms for advice. Only an ophthalmologist is able to perform retinal detachment surgery, typically one who has undergone specialist training in managing retinal conditions.

When you attend an eyecare appointment to investigate a retinal detachment, you should avoid driving. This is because your eyecare practitioner will need to perform a dilated eye exam to thoroughly assess the retina. You will have eyedrops instilled that will widen the pupil. The effect of a dilated pupil is that your clinician can see further out to the periphery of the retina, but it also means you will be quite glare-sensitive, and it may be difficult to see clearly for the duration of the eye drops. For most people, the eyedrops wear off after about an hour or two. For this period of time, your near sight may also be quite blurred.

Call us on (03) 9070 5753 today.

Note: Any surgical or invasive procedure carries risks. Before proceeding, you should seek a second opinion from an appropriately qualified health practitioner.

References

Retinal detachment.
https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/retinal-detachment#long-term-outlook-for-retinal-detachment

Asymptomatic Rhegmatogenous Retinal Detachments.
https://www.ophthalmologyretina.org/article/S2468-6530(22)00474-2/fulltext