Eye to eye . . .
"He was the one I wanted to see."
Peggy Moloney’s story begins like a classic: “I had gone to an optometrist – a routine eye examination for new glasses. There was nothing wrong, as far as I knew.”
Learning that the clinic had a new machine for taking retinal photos, Moloney agreed to see a sample. “But when I looked at my photo, I could see a growth, sitting on my eye. I was really frightened.”
An Atlantan, Moloney was aware that Emory had a large eye clinic. A little research led her to the Emory Eye Center and Hans Grossniklaus: “I knew he was a specialist, internationally known for his research. He was the one I wanted to see.” From the beginning, Grossniklaus, director of Ocular Oncology and Pathology as well as the L.F. Montgomery Pathology Lab, began to ease her fear.
“I’ve been a nurse and a nurse practitioner for 40 years,” Moloney says. “I’ve done routine eye exams on other people, and I teach nurse practitioner students. But I’d never heard of ocular melanoma.”
Although melanoma of the eye is far less common than skin melanoma, to Grossniklaus it’s a familiar condition: “Yes, it’s pretty rare – unless you’re an at an ocular oncology center. We see 50 to 100 patients with this a year; for us, that makes a melanoma in our practice seem fairly common.”
Members of the Ocular Oncology and Pathology team work collaboratively with oncology specialists at Emory Healthcare, Winship Cancer Institute, and the Cancer Center at Children’s Healthcare of Atlanta. The group includes three clinicians – Chris Bergstrom, Baker Hubbard, Jill Wells – and four research scientists: Shin Kang, Hua Yang, and Qing Zhang. Grossniklaus calls himself “the bridge,” because his work comprises basic science research, clinical care, and clinical trials.
His research currently includes, among other topics, using microtechnology to diagnose and treat a tumor of the eye, and the possibility of using microbubbles – as opposed to biopsy – to image the tumor. With researcher Erwin van Meir of Winship Cancer Institute, Grossniklaus is developing drugs to treat melanoma tumors that travel to the liver. Several presentations of his research findings will take place at major professional meetings in coming months.
Once tests confirmed the diagnosis of ocular melanoma in the choroid of Moloney’s left eye, treatment followed quickly, but not before Grossniklaus, Timothy Olsen, Moloney, and her husband, Frank Casper, had some serious conversations.
“We make decisions with the patient, not for the patient,” Grossniklaus explains. He carefully walked Moloney and Casper through the pros and cons of their two options: a) do nothing, but keep observing the borderline-size tumor; if it grows or changes, it might need treatment to prevent metastasis; or b) treat the tumor with a radioactive plaque, which could possibly cause radiation damage to Moloney’s retina and optic nerve.
Moloney chose the plaque, which Bergstrom surgically applied; one week later, he removed it. In the three years since – with good vision, no evident eye damage, and her tumor almost nonexistent – Moloney has returned for periodic follow-ups.
Grateful for her positive outcome, Moloney warns others to be proactive about vision care: “When you go for your routine eye exam, be sure to get your eyes dilated. Ask the ophthalmologist if you should get retinal photos. You don’t know what could be developing in an area you can’t see. I consider myself very lucky that I got to see the right person,” she continues. “Hans has always treated Frank and me as if he genuinely cares about us. For something like ocular melanoma, you have to have confidence in your provider. And we do.”