Cost-effective treatment of ocular surface squamous neoplasia for an undocumented and uninsured New York City patient: a case report

Journal of Medical Case Reports

Trisha S. Emborgo¹  David S. Kirsch¹  Norman A. Saffra²  Codrin E. Iacob³ 

[1] Department of Ophthalmology, St. John’s Episcopal Hospital, Far Rockaway, NY, USA;Department of Ophthalmology, St. John’s Episcopal Hospital, Far Rockaway, NY, USA;Department of Ophthalmology, New York Eye and Ear Infirmary of Mount Sinai, New York, NY, USA;Department of Pathology, New York Eye and Ear Infirmary of Mount Sinai, New York, NY, USA;

关键词: Ocular surface squamous neoplasia;    Undocumented;    Uninsured;    Cost-effective treatment;    Case report;   

DOI  :  10.1186/s13256-020-02510-w

来源: Springer

【 摘 要 】

BackgroundNew York City has a heterogeneous population with many undocumented and uninsured immigrants from equatorial areas who have a higher incidence of ocular surface squamous neoplasia. To the best of our knowledge, this is the first documented selection of this cost-effective treatment of ocular surface squamous neoplasia (the use of absolute ethanol along the corneal margin, primary excision, double freeze-thaw cryopexy, and primary conjunctival closure) for an undocumented and uninsured New York City patient.Case presentationA 35-year-old man from Ecuador presented to a New York City emergency department due to worsening discomfort of a long-standing left eye pterygium. A slit-lamp examination of the left eye demonstrated a nasally located conjunctival mass measuring 6 × 8 mm extending onto the cornea (3 mm superiorly and 6 mm inferiorly on the cornea). Histological diagnosis confirmed squamous cell carcinoma in situ arising from the pterygium. Surgical excision with adjunctive absolute alcohol with additive double freeze-thaw cryopexy was performed. Our patient has remained free of tumor recurrence at year 2 postoperative visit.ConclusionsOur case highlights the need to choose a cost-effective treatment for ocular surface squamous neoplasia in an at-risk population among undocumented and uninsured patients. Areas in the world with similar types of populations or treatment challenges may need to consider this approach as a primary treatment option.

【 授权许可】

CC BY