Can Nevus of ota inside the eye be treated similar to brown spots inside the white part of the eye?

[goshHelpMe]

I have an eye condition called blue sclera/nevus of ota since birth (There are too many names for it). My left eye condition is exactly the same as this image:

http://akimichi.homeunix.net/~emile/aki/html/medical/Image/blue-sclera-1.jpeg

My eyes are actually quite healthy and I have 20/20 vision. I don’t have any of the following symptoms
• Pseudoxanthoma elasticum  
• Osteogenesis imperfecta
• Ehlers-danlos syndrome
• Marfan's syndrome

I was wondering can nevus of ota inside the eye be treated similar to brown spot inside the eye eg: under some sort of eye surgery to regain the white part of the eye again, if so how much do they normally cost?  

[Worriedmum818]

Does anyone have an update on surgery to treat Nevus of ota/scleral pigmentation by Dr Ji Won Kwon in Korea? Was it a success?

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

No clue

[Abnbea]

Hi all, I have a 2 years old daughter with dark pigmentation on the sclera of both eyes. No skin pigmentation though (so far). Doctors refered to it as "freckles". I read the entire thread but not sure if anyone went ahead with any of these latest cosmetic procedures. Could you please comment on your latest experiences? I am so worried for her and her schoolages ahead. Cheers

[JohnHaganMD]

There is a huge difference between Nevus of Ota and pigmentation of the conjunctive (the sclera does not usually have the piment).  Such pigment is normal in blacks and darkly pigmented skin individuals.    Surgery is almost never necessary and many of the removal techniques have been discredited and are associated with major complications.

[Abnbea]

Thanks John for taking the time to answer my message. We have no black background but a mix of Mediterranean and Japanese. The pigmentation does not move with the conjunctive hence I am assuming it is based deep in the sclera. She was not born with the marks (or at least were not apparent) but they become very evident once she turned 8 months. It is worthy mentioned she has the darkest set of black eyes I have ever seen and also was born with Mongolian blue spots on her back. Dont understand exactly how but all these things seem to be related to nevus ota.

[JohnHaganMD]

Then what you need is a good pediatrician and Eye MD ophthalmologist.  

[Abnbea]

Thanks John, that is exactly what I am doing. Saw a pediatrician once and a pediatric ophthalmologist twice. The latter confirmed the spots are of no medical concern but a cosmetic issue. Since then I am trying to educate myself about the condition and real options to treat its asthetics. Laser treatments keep being mentioned in the literature but it seems to be still very focused in the Korean market and I am yet to read a single report of someone who actually went through it. Besides, I am curious to know if there is any other modern technique available. Appreciate your time once again.

[JohnHaganMD]

Okay but I would leave it alone and not do anything for 'cosmetic' reasons. By the time the child is old enough to care better techniques will be available.

[JohnHaganMD]

Okay but I would leave it alone and not do anything for 'cosmetic' reasons. By the time the child is old enough to care better techniques will be available.

[Abnbea]

Thanks for your advice John.

[JohnHaganMD]

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[FightNevusofOta]

Sum up from those who post here before and comparing I-Brite and the method from the Korean Doctor....

I-Brite is removing the outer layer of sclera, and placing a frozen solution which will breakdown the dark purple/brown pigments. Then reattaching the flaps of the outer layer together with special bio-glue.

The method of Korean Doctor is to use Donor's sclera to cover/conceal the Nevus of Ota.....and someone said its like painting?

For me...I-Brite surgery sounds more risky...removing the outer layer and stick it back by using a special bio-glue....whether how long the bio-glue lasts and how strong the stickiness is not known. Also, it seems that the results can be vary that the frozen solution may not be satisfactorily break down Nevus of Ota. There must be some left behind.

On the other hand, using Donor's sclera to conceal Nevus of Ota also has the concern of how strong the stickiness is. But the fade off is no harm to our eye(s)....whereas under I-Brite the fade off would be harmful as it is our outer layer of sclera that fades off.....However, whether Nevus of Ota is completely conceal is not known.

One more thing to consider is Nevus of Ota would relapse overtime especially under the exposure of sun light. If it does.....it seems quite risky to remove the bio glue, remove the outer layer of sclera again and stick it back.....

Anyone can share more real experience? No advertisement please

[JohnHaganMD]

This is the deal with these "only one person in the world can do this". If something works legitimate physicians and researchers publish their work in scientific journals where others can see and judge. Then other researchers try it to see if they can duplicate the results. Then larger studies are done. Eventually procedures and medications that are worthwhile become standard therapy. Beware any doctor or scientiest that says I'm the only one with the cure and all the rest of the world is conspiring against me or is not as smart as me.

[FightNevusofOta]

Thanks John for your advice! I am quite skeptical on I-Brite tbh. What do you comment on the Korean Doctor? There was a journal they published in Canadian journal of ophthalmology in Oct 2011 "Cosmetic improvement of nevus of Ota by scleral allograft overlay".

[FightNevusofOta]

And is there any way to remove Nevus of Ota in eyes to the extent of your knowledge?

[JohnHaganMD]

That report is 15-16 years old. It basically is just covering the dark lesion with banked sclera. This is a newer paper on using a laser. I have no personal treatment experience it is a relatively uncommon problem:
https://www.ncbi.nlm.nih.gov/pubmed/28398430

[FightNevusofOta]

Thanks Doctor John. What do u think about Argon laser? There are several doctors using argon laser to remove the nevus in eyes and lodged in some medical journals. Is it a relative safe way of doing so? Would it make eyes loss its "Bling"? You said it very right....if something works legitimately and is published in the journal, others will test it and duplicate it and that way would have become a standard.....but none of this happen so far...i am just curious if Argon laser works, why hasn't it become a golden standard

[JohnHaganMD]

I have to say this is outside my area of expertise so can't advise.

[FightNevusofOta]

Thanks John anyway!

[JohnHaganMD]

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[Abnbea]

Hi all, I have a 2 years old daughter with dark pigmentation on the sclera of both eyes. No skin pigmentation though (so far). Doctors refered to it as "freckles". I read the entire thread but not sure if anyone went ahead with any of these latest cosmetic procedures. Could you please comment on your latest experiences? I am so worried for her and her schoolages ahead. Cheers

[FightNevusofOta]

Hi all,

I am from Hong Kong, now 32 years old. I was born with Nevus of Ota around my left eye. The birthmark got darker over time, especially after exposed under the Sun. I have been doing skin laser treatment around the left eye area and the results are very promising, but the birthmark do gets darker again.

When i was young, there wasn't much Nevus of Ota on my eye white, or sclera. During summer time, i like to go to beach and do water sports. That's probably the main reason causing the Nevus of Ota in my eye from pale blue to dark blue. I am not sure what extent of darkness of the mark you guys get on your eye(s), but mine really needs a treatment for removal. I have consulted different
ophthalmologists in Hong Kong but they are not able to do anything on that. After researching from internet, it seems that the only options out there are: 1) I Brites; 2) Dr. Ji Won Kwon.

I wonder is there anyone who has done the surgery before and share some experience?

Is there any update from:
goshHelpMe, Mommy2babygirl, vietnamese1409

Haven't heard from you guys for so long.
Shall we open a chat group or something?
One of the sad thing for us is....we are a minority and therefore there wasn't much research spent on developing advance technology on Nevus of Ota sclera removal. It is also difficult to find relevant information or technology updates or those who can share similar experience. So this forum is amazing and we shall keep in touch!!!

[Jennise88]

Hi can add me in the group chat? do u have whatsapp? my email ***@****.
Hope to hear from you soon

[JohnHaganMD]

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[JohnHaganMD]

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[JohnHaganMD]

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[JohnHaganMD]

Anyone considering I-brite should read this link and also use a search engine and look at "complications from I-brite eye surgery.
http://www.medhelp.org/user_journals/show/930356/Eye-Whitening-Surgery-Iris-Color-Change-Surgery-bling-On-Eye-NOT-RECOMMENDED

[mattlive87]

what treatment did you use? and how do i get into contact with won? please reply.

[mattlive87]

So what happened with you and i-brite?

[JohnHaganMD]

Anyone considering I-brite should read this link and also use a search engine and look at "complications from I-brite eye surgery.
http://www.medhelp.org/user_journals/show/930356/Eye-Whitening-Surgery-Iris-Color-Change-Surgery-bling-On-Eye-NOT-RECOMMENDED

[gigizzz]

Hello  would like to know how your post-op went.
I am considering in doing I-BRITE procedure but I am very skeptical.
Did your nevus fade away completely? Did you had any complications or had
a touch up?

Is there a way to contact you? I would be great I you could share a little bit more with us.

[gigizzz]

Hello how did your post-op went? How are the results.
I am considering in doing this treatment but i'm a little
bit scared.

[revya]

Hi,

Hope you are doing fine.
How are your eyes. Has the nevus faded away post ibrite surgery?
Can you post your eye pics of before & after treatment?

Regards,
Revya

[lkjouygtfedrs]

Have you seen more than to your eye? Have you had any complications? Do you have any before and after photos? Thanks!

[lkjouygtfedrs]

Have you seen more than to your eye? Have you had any complications? Do you have any before and after photos? Thanks!

[tk413]

So glad I finally  got a name today for my eye.  I'm happy  with my eye besides the outer darkening it causes.  I have lived 36 yrs., with it just the outer is getting  darker the older I get.  Good luck to everyone.

[sss23]

Hi All,

I also have nevus of ota on sclera of my left eye, last month I went and saw Dr Boxer Wachler and he done this surgery known as I-brite on my left eye. It has been a month post-op. The nevus of ota on my left eye has now become alot lighter than what it was. He told further improvements will occur as time goes on. And optimum result will be noticeable after 3 months post op. The operation involved removing the outer layer of sclera, and placing a frozen solution which will breakdown the dark purple/brown pigments. Then reattaching the flaps of the outer layer together with special bio-glue. The op took only 15 min and you are awake the whole time. Cost me $5600 US, but it was all worth it. He is located in California (USA). By the way Dr Boxer Wachler is the only doctor in the world who does this procedure.

Please look at this website: http://www.boxerwachler.com/i-brite-eye-whitening

Scroll down and you will see a picture of before and after of a patient who also had nevus of ota and underwent the same procedure, the post op result is remarkable.
"I-BRITE® Conjunctivoplasty can even improve the appearance from a rare condition called Nevus of Ota."


All his contact details are on the website.

Hope this can help you guys out, having a piece of mind that something can be done for this condition. I am very happy with my results so far and I am looking forward for further improvement in future.

[revya]

Hi Syd2004,

Good to hear about the treatment.
Can you provide some more details about the operation.
Was it a scleral flap surgery or laser ? Cost of the operation.
Duration of stay in the hospital post operation?
Recovery time....

Thanks
Revya

[Syd2004]

Hi all,

I am British Asia male in my mid 30s living in United Kingdom .I had Nevus of ota in my right eye and was searching on Internet all the possible treatments. In the beginning of 2014 I contacted Dr Kwon in South Korea and visited there twice for the operation. Now I can say that the Nevus is nearly gone. I went there alone and had no problem relating to post operation general issues.

I just wanted share my experience that it's treatable now.

[Jennise88]

hi dear can you pls share with me the cost and the procedure?
***@****.

really hope to hear from you soon.

[JohnHaganMD]

Only one post and that was 2014. Not likely you will get a response. Suggest you open a new discussion by posting a new question.

[devinci]

south korea, Dr Ji Woon Kuon
http://www.youtube.com/watch?v=Pfn0XPfFqcs

[Akings7]

Hello everyone I have already sent a message to the person who started this forum but I want to ask you guys if you have found anything new. I had seen this post in 2009 when I was 14 years old doing my research because to be honest this condition we have can really be tough on some of us. Soon I'll be 19 this year of 2014 and back in '09 this had brought me a lot of joy but I had forgotten about it and future research because it was too early to have something for sure. Now 5 years later I am 100% sure that I can now do something about it and specially here in the states now. What have you guys found and if you can please share it with us (:

@revya  @cherish12 @mommy2babygirl

[sadz01]

i too have the same problem. while back i spoke to an opthalmologist who recommened a cosmetic contact lens, which i collected 2 weeks ago after a few consultations and fitting sessions. its not a permanant solution at least its something! not recommended to be used more than 8hrs a day.
if anyone does come across other more permanent treatment avaialbe in the uk please do let me know.

s.darr

[jasjot]

HI
Did you go ahead with Dr. Daljit to get the treatment? My friend needs the same treatment. Should I contact the doctor? Is he good?

[revya]

Hi
I happen to come across Dr Daljit's videos in youtube.
Contacted him for nevus of ota treatment.

Following is his response:
The pigment is under the outer layer of the eye , called conjunctiva. I always turned away the patients (usually young children) saying why worry !But looking at your eye, I can not say that you need no treatment.
I have the knowhow and the tool (Fugo plasma blade) to do the job. This shall be the first ever surgery in the world. I shall do it in stages. The conjunctiva shall be lifted at one place and the pigment/colour shall be ablated (it just disappears where touched with Fugo blade, there is perfect depth control). The conjunctiva shall then be put back. We shall wait for a couple of months, to clear another sector. I shall aim to remove only that part that is normally visible to the observer, not the area that is hidden.
I have over 200 movies in youtube.com, showing the capabilities of Fugo blade, including removal of pigmented spots, which are superficial (not like yours). Write (daljits1) and you shall get all the various films.