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.

[John C Hagan III, MD, FACS]

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

[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!

[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

[John C Hagan III, MD, FACS]

-----

[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]

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

[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]

This was answered elsewhere.
JCH MD