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QUOTE="KiwiNZ, post: 16921397, member: 236815"]I don't know if she actually had a melanoma but my point was more that her sister believed she did and I would have thought that would have been quite concerning to a "normal" person and that she would have been mentioned to Sally at some point in the last 20 odd years[/QUOTE]
Yes, your meaning was clear and understood. Good point and no criticism intended! I wholeheartedly agree! Apologies that it came across as throwing disagreement on your comment. No shade intended.
My point was simply that melanosis could be described as a "freckle" of the eye, which Sally did know. When I heard Sally mention the eye "freckle"-- I assumed it was a melanosis based on my experience currently working as a clinical coordinator for an eye clinic. The melanoma diagnosis was surprising.
Melanoma and melanosis sound very similar, although the prognosis and treatment is vastly different. I wondered if there was clarification available for the more serious diagnosis. Is it possible that this information was misunderstood or misremembered?
Melanosis is reasonably common in fair skinned middle aged people. Follow ups would be yearly checks to observe for changes. An optometrist (not a medical doctor, a lower acuity level provider) would be appropriate for a yearly check on melanosis. If the "freckle" or lesion appeared with changes or a nodular appearance, typically an optometrist would refer a patient for follow up with an ophthalmologist (MD) and other medical doctors (MDs) to confirm melanoma and screen for systemic disease. It would be unusual, particularly in the 90's to have an optometrist (not an MD) treat melanoma of the eye. I question (but not rule out) if an optometrist in the 90's would be able to diagnose melanoma of the eye. Typically, an optometrist would not do a biopsy. The optometrist's diagnosis would be something along the lines of "nodular eye lesion suspicious for melanoma...further testing and referral recommended." That's how it works in the United States. Currently, it is is possible that an optometrist with special training would diagnose, an eye melanoma--but seriously doubtful if in the 90's this would be the case. I don't know the Australian protocol for melanosis versus melanoma in the 90's. We need an Australian eye professional.
Marion would be typically a decade young to present with melanoma of the eye. Certainly not impossible, but less likely. It also seems like the optometrist would have memory of a "younger than average" patient with melanoma of the eye, which would be serious. Melanosis of the eye would not be serious and hence not memorable at all. Patients with vision threatening or serious illness would have a higher likelihood of remembrance by medical personnel such as an optometrist since optometrists typically treat routine eye care. The non-routine patients stand out. With ophthalmologists or other eye specialists they might not remember melanoma since they treat a higher number of very serious problems. However, it's not surprising that the optometrist wouldn't necessarily remember anything at all (even an unusual occurrence) without notes. Just another piece of the puzzle to consider about this case.
As with all the facts in this case, time clouds the issues. As another member mentioned, that if it was melanoma, surely there would have been a higher usage of healthcare.
It's great hearing other's opinions, insights, and perspectives, and questions. Everyone brings a different skill set to the discussion. The variety of backgrounds and skills adds much more depth to the discussions.
Disclaimer: All MOO.
Yes, your meaning was clear and understood. Good point and no criticism intended! I wholeheartedly agree! Apologies that it came across as throwing disagreement on your comment. No shade intended.
My point was simply that melanosis could be described as a "freckle" of the eye, which Sally did know. When I heard Sally mention the eye "freckle"-- I assumed it was a melanosis based on my experience currently working as a clinical coordinator for an eye clinic. The melanoma diagnosis was surprising.
Melanoma and melanosis sound very similar, although the prognosis and treatment is vastly different. I wondered if there was clarification available for the more serious diagnosis. Is it possible that this information was misunderstood or misremembered?
Melanosis is reasonably common in fair skinned middle aged people. Follow ups would be yearly checks to observe for changes. An optometrist (not a medical doctor, a lower acuity level provider) would be appropriate for a yearly check on melanosis. If the "freckle" or lesion appeared with changes or a nodular appearance, typically an optometrist would refer a patient for follow up with an ophthalmologist (MD) and other medical doctors (MDs) to confirm melanoma and screen for systemic disease. It would be unusual, particularly in the 90's to have an optometrist (not an MD) treat melanoma of the eye. I question (but not rule out) if an optometrist in the 90's would be able to diagnose melanoma of the eye. Typically, an optometrist would not do a biopsy. The optometrist's diagnosis would be something along the lines of "nodular eye lesion suspicious for melanoma...further testing and referral recommended." That's how it works in the United States. Currently, it is is possible that an optometrist with special training would diagnose, an eye melanoma--but seriously doubtful if in the 90's this would be the case. I don't know the Australian protocol for melanosis versus melanoma in the 90's. We need an Australian eye professional.
Marion would be typically a decade young to present with melanoma of the eye. Certainly not impossible, but less likely. It also seems like the optometrist would have memory of a "younger than average" patient with melanoma of the eye, which would be serious. Melanosis of the eye would not be serious and hence not memorable at all. Patients with vision threatening or serious illness would have a higher likelihood of remembrance by medical personnel such as an optometrist since optometrists typically treat routine eye care. The non-routine patients stand out. With ophthalmologists or other eye specialists they might not remember melanoma since they treat a higher number of very serious problems. However, it's not surprising that the optometrist wouldn't necessarily remember anything at all (even an unusual occurrence) without notes. Just another piece of the puzzle to consider about this case.
As with all the facts in this case, time clouds the issues. As another member mentioned, that if it was melanoma, surely there would have been a higher usage of healthcare.
It's great hearing other's opinions, insights, and perspectives, and questions. Everyone brings a different skill set to the discussion. The variety of backgrounds and skills adds much more depth to the discussions.
Disclaimer: All MOO.
