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Ask Dr. A.S. Desai Your Own Question

Dr. A.S. Desai
Dr. A.S. Desai, Ophthalmologist
Category: Eye
Satisfied Customers: 2106
Experience:  MS Ophthalmology with 11 years of surgical expereince
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Hello, I was diagnosed with Coloidal Melanoma three years ago.

Resolved Question:

Hello, I was diagnosed with Coloidal Melanoma three years ago. The tumor is measured every 6 months and remains at 1.6. I was advised by my Oncologist to monitor it and wait on radiation therapy. I have episodes of scintillating scotoma which last for 30-40 minutes and I can have up to 3 episodes in a day, sometimes months go by without episodes but in the past 2 months they happen frequently.
My Opthamologist has said the scotoma has nothing to do with the tumor and I am surprised as these flashing zigzag lights are what made me have an eye test in the first place. I assumed the tumor & scotoma were connected. I do not have migraines. What do you think I should do, my opthamologist suggested I see a neurologist? Could i have cancer in my brain now? I am terrified- Marj
Submitted: 1 year ago.
Category: Eye
Expert:  Dr. A.S. Desai replied 1 year ago.

Dr. A.S. Desai :

Hello, Welcome to Pearl.com

Dr. A.S. Desai :

Are you available for chat now?

Dr. A.S. Desai :

You seem to be in safe hands of specialists and it is good to know that you have already been examined and advised by an onchologist and ophthalmologist. They are right regarding the scintillating scotoma and the melanoma being two different conditions with no co-relation to each other.

Dr. A.S. Desai :

The melanoma is a painless condition and goes un-noticed unless it has spread to adjacent structures. In your case it was probably identified incidently while examining the eye during the dilated eye exam for the scintillating scotoma.

Dr. A.S. Desai :

The scintillating scotoma may or may not be associated with headache as such. Please do not fear about the melanoma spreading to the brain just like that . Since you are being followed up by an ochologist , I am sure the tumour is being looked for signs of spread too.

Dr. A.S. Desai :

Scintillating scotoma does not have any specific treatment. Since it can be triggered by various factors like stress, it would help to relax and keep yourself de-stressed.

Dr. A.S. Desai :

I would suggest that you follow the advise of the ophthalmologist and consult a neurologist so as to confirm the above.

Dr. A.S. Desai :

I sthere anything else that I can answer for you in this regard?

Dr. A.S. Desai :

Is there

Customer:

Thank you, XXXXX XXXXX opinion is it wise to leave the tumor and not do radiation plaque therapy, my opthamologist was a little vague and at the last visit stated that she hoped we were doing the right thing "it's a bit like playing Russian roulette" she said. I have only seen the Oncologist once, 3 yrs ago as she lives in Cape Town so rely on my opthamologist who does all the scans etc

Dr. A.S. Desai :

No, It would be better to go ahead with the radiation therapy as suggested by the onchologist rather than just leave it. Once a malignant melanoma is diagnosed, it is better to go ahead with treatment ( if growth is documented.

Dr. A.S. Desai :

Are you there?

Customer:

My apologies, the onchologist suggested to wait on radiation and monitor the tumor which according to my opthamologist hasnt changed since first being diagnosed. Now my opthamologist has suggested I see a neurologist. What in your opinion, apart from stress may have caused the scintillating scotoma. My sister googled and cancer or stroke etc is not ruled out, I know we shouldnt google these things but I am very worried

Dr. A.S. Desai :

You are right about the google thing. Not everything given there is true and only a person with prior knowledge about it would be able to differentiate about what is relevant and what is not. If the onchologist has opined about the wait and watch approach, then I guess there is still a doubt about the tumour being malignant.

Customer:

My line is very slow

Dr. A.S. Desai :

If there has been no growth then it could even be a benign choroidal nevus.

Dr. A.S. Desai :

The best approach at present would be go for a regular follow up to the ophthalmologist who can take all the measurements, scans and dilated eye exams and look for any signs of growth. Apart from this you can consult a neurologist for the scintillating scotoma.

Dr. A.S. Desai :

Migraine is the most common cause for the scintillating scotoma but in some individuals the headache may not be very significant.

Customer:

Wow, that would be a wonderful thing! no-one ever suggested that before so you have given me some hope and insight as to why there has been no growth. I will continue with regular measuring and see the neurologist. Thank you for explaining.

Dr. A.S. Desai :

You are most welcome.

Dr. A.S. Desai :

Have a good day!

Dr. A.S. Desai :

Please feel free to ask follow up questions if any.



Thank you and best wishes.



It was a pleasure to have answered this question.

Experts are credited only if a positive rating is given and not otherwise. So do remember to give your rating. A positive rating is what I aim for and we can continue to interact till you get a satisfactory response. An excellent feedback and /or bonus are most welcome and appreciated.


Views expressed are for information purpose only and cannot substitute a visit to an ophthalmologist


 

Customer:

I dont suffer with headaches, my vision is horribly impaired and it's awful if I am driving. Flourescent lighting seems to trigger it especially in shopping malls.

Dr. A.S. Desai :

Maybe you just found the triggering factor in your case- fluorescent lights.

Dr. A.S. Desai :

Maybe you could wear tinted glasses to overcome that.

Dr. A.S. Desai :

Sunglasses would only work during broad daylight or sunlight but tinted glasses would help even during night or indoors under artificial lighting.

Customer:

Thank you, XXXXX XXXXX that. Have a great day:)

Dr. A.S. Desai, Ophthalmologist
Category: Eye
Satisfied Customers: 2106
Experience: MS Ophthalmology with 11 years of surgical expereince
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