The 'wait and see' diagnosis: Is it a freckle or cancer in my eye?: Column
I have worn glasses a long time, ever since sixth grade art, when Debbie Sisson asked me why I was squinting so hard at her figure drawing on the chalkboard. Which just serves as a reminder that teachers don’t just teach your kids, they also are usually the ones who recognize when kids don’t see or hear well. Not that any strength of glasses would have improved my figure drawings, but still.
So for all these years, I’ve gone to exactly one eye doctor, a super nice guy in Charleston. His office staff is really helpful, and he has an extremely calming manner, which is dead useful when someone is coming at your eyeball with a glaucoma pressure gauge. I think I could happily nap in one of the exam rooms, but they’ve never kept me waiting long enough for that. And until now, it's been all routine: Better one; better two; read these letters/numbers; okay, nothing's changed; see you next year. It's one of the few doctors appointments I enjoy because I pretty much know what to expect.
And I guess 20-plus years of no surprises was a good run. Because this time, instead of “See you next year,” I got “So there’s a freckle.”
“Freckle” is an adorable word. Just saying “freckle” makes you smile. Thinking about little kids with gap-teeth and freckles makes you smile. Freckles are so cute, they’re trending right now in the make-up world. That’s right: People are paying money for tools they can use to put fake freckles on their face. Good money. When they could just buy a brown Crayola marker and be done.
But a freckle in your eye is not cute, as I found out. It's so not cute that when your very calm eye doctor says you have one, he also immediately makes you an appointment with a retina specialist, and they think eye freckles are so un-cute they insist you come in immediately for an appointment. So after getting a referral, I and my very dilated eyes hauled butt across Charleston for an impromptu specialist appointment. I didn’t even have time to Google how serious eye freckles were.
So I and my dilated eyes got the quick-in treatment at the retina specialists, where the intake tech put more dilation drops into my eyes, then sent me in for eye x-rays. And I guess I never thought about what it takes to x-ray an eye, because I’d never done it. It somehow manages to be much less annoying and invasive than a typical x-ray (since you get to keep your clothes on), and at the same time, if you have the really cool digital one, pretty ego-busting. You ever get your head pressed right up against a screen, while a very knowledgeable tech behind tries to gently push you into the correct position until a green light flashes so brightly in your eyeball, you think you’ve just seen the Death Star blow up? Well I have, and I had the crazy hair to prove it.
And then I waited in a room, with those digital pictures on the screen. For something so important to me, I have never considered much about my eyes. I know I have terrible vision (putting on my glasses is like seeing underwater). I know I have green eyes (that’s actually just been within the last five years or so — before that, I’d have sworn they were hazel). I know that I can’t wear contacts because they constantly roll up inside my eyes, then come back out at the worst times. But sitting there, waiting to talk to a doctor, looking at those pictures, I realized what I know about my eyes could fit on the head of a pin. And now I was going to find out if those sons of britches had betrayed all the money I’d spent on them (because I pay my vision bills out of pocket) by getting cancered.
The retina specialist came in and proceeded to put another round of dilation drops and pressure drops in my eyes (at this point, I swear my eyes were so dilated I could see into the back of my own skull), and he took a look. Yep, definitely a freckle, or in eye-doctor terms, a nevus. They aren’t super common; anywhere from 2-10 percent of the population has them. I certainly had never given any thought to the idea that eyes could get freckles before this day. And eye freckles, he told me, go one of two ways: They stay flat and small and you never have to do anything about them, or they get bumpier and irregular and you have to treat them like cancer. So we needed to see if my freckle had a bump, or was nice and flat.
I have had ultrasounds on me before, and have certainly seen them done on television, so I don’t know what I was expecting an eye ultrasound to be like; I think I had this vague notion that it would be like a laser pointer held a few inches above my eye and just moved around; you know, the very thing they tell you never to do with laser pointers. I don’t think I was expecting the basic ultrasound procedure you use to see babies in the womb to happen on my eye, but that is exactly what happened.
The technology behind an eye ultrasound is amazing; the actual ultrasound is not. First, more drops to anesthetize my eye. Then came the ultrasound jelly. Yeah, you read that right: the same jelly that goes on a pregnant woman’s stomach WENT DIRECTLY ON MY EYEBALL. Just right on it, and then the doc came in with the little ultrasound wand about the size of a cigar and started swirling it around ON MY EYE. It was a dang good thing my eye was numbed up to high heaven and the doc moved fast, because if I had had 10 minutes to think about what was coming, I think I would have said “Changed my mind. I’ll just take my chances with Freda Freckle rather than jelly and a wand in my eyeball.”
But I’m a big girl, and I moved my eyeball when he said and held still when he asked, and we finished up in just a few minutes. And he told me it was flat, which is great news. We’d check it again in three months, then six months, then nine, and as long as Freda stays flat and my vision stays the same, we’ll get back on my yearly check-up schedule. But he also laid the alternate outcome out: If Freda grows like a mushroom, getting taller and bumpier, if my vision changes, then my freckle has become a potential melanoma and that means cancer-type treatment. Which can mean anything from lasering it down to taking out the eyeball. And I know enough about melanomas and cancers to know if it gets in one place, it can get in others.
That’s a scary thought, y’all. And good news today doesn’t mean good news in three months or six months or nine months. I’m going to have be vigilant about my vision, and go to the doctor way more than I ever do. I’m going to have to become good friends with the ultrasound jelly in my eye and the half-hour of eye pain that follows as the anesthesia wears off (I was surprised at how much that half-hour burned, and I shouldn’t have been because you know, wand and jelly directly in my eye). And I just have to hope Freda stays a freckle. Statistics are on my side — most eye freckles never become a problem. Mine is also not anywhere near my iris — honestly, it's so far in the upper edge of my eye that I’d have never noticed it, except I have a really good, thorough eye doctor, who in turn got me right in with another good, thorough specialist.
So even though in the back of my mind for the next two years I’ll be wondering if a mushroom is taking root in my eye (I’m a visual worrier. When I was a kid and they told me I had caught a stomach bug, I sincerely thought a two-foot, ant-like creature had made my body its home and couldn’t figure out how it would ever escape me.), and even though I do not care for “wait and see” diagnoses on parts of my body I use a lot (I’d be perfectly fine “waiting and seeing” if it involved the part of my brain that houses my geometry knowledge), I am grateful that we caught Freda early so she can be monitored. Chances are, she’ll just live peacefully on my body like all the other freckles I’ve got.
And if she doesn’t? Well we’ll cross that bridge when we come to it. Until then, be vigilant about your eyes, readers. If you don’t have vision insurance, it's worth paying out of pocket for a yearly check-up with a good eye doctor, so you can find any freckles early, and it's worth every penny when you have one who is vigilant about following up on things that don’t look right.
Now, all y’all go Google “eye ultrasound” and then tell me if that's not the creepiest thing you’ll see all this Halloween season. I and my jelly-filled eye will wait.