Nevus on the sclera

[tcase]

I have a few questions regarding my 5 year old son. He has just recently, in the past 2 months, developed a nevus on the corner of his left eye on the sclera. At first I thought it was a broken blood vessel because it just kind of popped up. It wasn't going away though so I made an eye appointment. We saw our eye doctor and he said it was brown pigment that had developed. He was a little concerned with the fact that it just showed up and that he is white. He said that it is usually more common in darker skin decents. So he referred us to a pediatric opthalmologist to make sure it wasn't anything more than what he was seeing. We went to her and she is the one who told me that it was a nevus. She was not concerned by it at all. She said everything looked well, but I am still a little shaken by the fact that she had mentioned that it had to be watched to make sure that it does not turn malignant.

So my questions are:
1. What are the chances of it being malignant?
2. Can it be removed?
3. What if it grows?
4. Is this normal to have it just "pop up"?
5. How often does it need to be checked?
6. Should he be wearing sunglasses when playing outside?

I would just really appreciate any other information you have to offer. I just need my mind put at ease and know that everything will be ok for him.

Thank you for your time.

[vk1999]

Hi,

My 3 and half year old son has a developed a nevus in his left eye. It just 'popped out' of nowhere. The ophthalmologist is recommending we have it removed, they call it 'excision'.

I am writing to know what happened to your son's nevus? Did you have it removed? Was it tested after removal? How is he now?

Thank you so much for your help.

[NS2012]

I'm a lady in my late 30s and I have 2 brown spots in my left eye. One in the bottom of my eye since birth and a newly formed freckle in the left hand side of my eye. My doctor says they're harmless but they're causing me grief, people constantly tell me I look tired when I'm fine or ask what's wrong with me eye! To be honest my left eye looks a horrible blotchy brown mess. I'd like to remove the spots cosmetically at my own expense.
What procedures like Eye Brite are available in the UK? Is this procedure safe?

Can I get an eye doctor to remove them via surgery in the UK?

Thanks alot!

[maale]

dear DR. John,
                      My daughter who is going to turn 4 has nevus in her left eye and a little blue area on the eyelid too,she had this ever since she was born and now i think it has increased.Firstly plz tell me that can this effect her vision and secondly i want to get it removed but as I'm living in Pakistan there r hardlt ne surgeons who can do the job.Plx tell me exactly which feild of doctor can remove it.I have a plan to go to U.K and get it removed.Could u pls refer me to a doctor who specialises in removing it with his details give along with the hospital name?and does it only get removed by a surgery or it can be removed with low frequency lasers and what r the side effects and a surgery or a laser treatment be done in a 4 year old child.Plz reply me doc as i desperatly need help,thank u!

[roy602]

the sclera of my eyes is turning kinda yellow because of too much exposure to the summer days. the oculist say is was kinda common on dark people and hispacis, however it doesn hurt at all.my self-steem drops when people tells me i have a liver dissease. as far as i know it could be treated with a cosmetic eye surgery ...can a kind doctor informe me about the prices of the cosmetic eye surgery?

[wendytoni]

I was born with a brown birth mark on the cornea of my eye. It was located to the left side of the pupil of my right eye. From a  distance it gave my eyes an irregular shape. When I was born my mother spent almost an entire week trying to remove it thinking that something had fallen into my eyes. Later it was discovered that the birthmark was growing and if I did not have it removed I would eventually go blind. So I did surgery to remove the same and I have not looked back since.

[John C Hagan III, MD, FACS, FAAO]

1. Most lasik surgeons would likely NOT remove it at the same as lasik. I would agree with them.
2. If your corneal surgeons doesn't think it needs removed there is no reason not to respect what he/she says.
3. If you absolutely insist either do the lasik or the nevus first. Let it fully heal then do the other procedure at a later date

JCH MD

[Marlen261]

Hi, I'm getting Lasik surgery this week. My doctor doesn't want to remove a nevus I have on my sclera in the same surgery. It has grown a lot this year, it was a 3 mm circle, and now it's around 7 mm in just one year. Now it touches my iris. I want to remove it for cosmetical reasons:
1. Is it save to remove it the same day of my lasik surgery without any sides effects? Or after?

Thank you for your time

[John C Hagan III, MD, FACS, FAAO]

This was answered elsewhere.
JCH MD

[CarolinaMom504]

Hello:  My 14-year-old daughter was seen today for a routine eye exam by her pediatric ophthalmologist.  He noticed what he thinks is a nevus in her right eye.  It has invaded the cornea.  She has a history of Langerhans cell histiocytosis, diagnosed at age 6 months, that involved her temporal bone on the same side.  She was treated with chemotherapy and later with a recurrence of the skull lesion, received low-dose radiation for 4 days.  

Have you heard of nevus in the setting of LCH and/or a history of radiation treatments?

Thanks so much.  I am a worried mom.  

Sandra

[John C Hagan III, MD, FACS, FAAO]

1. Usually its local anesthetic injection, pick up with forceps, cut off with scissors, cautherize and that's it.
2. You may end up paying for everything as a cosmetic operation.
3. risks infection, bleeding, scar formation, double vision, reoccurence of the nevus..
4. Will have no effect of lasik

JCH MD

[pc272]

Hi
i do have a nevus on my sclera as well, was told by my ophthalmologist there's no issue with it. I'm considering cosmetics removal, i would like to know the
1. methods used to remove it
2. are there any risks/side effects invloved eg. vision affected when ones get older
3. is it still possible to do lasik surgery in future after the removal?

Thank you for your precious time.

[John C Hagan III, MD, FACS, FAAO]

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[dbuono]

Hello my son was 7 when I noticed the same thing to him to a childrens optamoligist that told me just to remove it but I was scared and made a second opinon to anothe doctor that was very well knows at the Will Eye center in Philly I saw an oncologist of the eye and they told me just to come back every year to check on it. They also told me not to remove it till he was old enough to do a local and remove it.

D Buono

[tcase]

Thank you so much for answering all of my questions. I feel like I can put my mind to rest now, which is something I haven't been able to do for the past two months!

[John C Hagan III, MD, FACS, FAAO]

1. very small chance of becoming malignant.
2. Yes, but unless it grows or exhibits abnormal appearance it generally is not worth the expense, pain and discomfort and risks of removal.
3. See above.
4. Yes, it is not an unsual problem.
5. You are getting excellent care, go by what your ophthalmologists tell you.
6. Again, ask your Eye MDs. As a generalization, I wouldn't make a big deal out of it. On the other hand a hat with a bill (worn forward) is great sun protection.

The odds are with you that this isn't a big deal.

JCH III MD Eye Physician and Surgeon