Considerations for the Management and Triage of Ocular Oncology Cases during the COVID-19 Pandemic

• Published in: Ocular Oncology and Pathology 2020-04, Vol.6 (3), p.219-222
• Main Authors: Skalet, Alison H., Allen, Richard C., Shields, Carol L., Wilson, Matthew W., Mruthyunjaya, Prithvi, Gombos, Dan S.
• Format: Article
• Language: English
• Subjects: Letter to the Editor
• ISSN: 2296-4681; 2296-4657
• DOI: 10.1159/000507734

[...]risk to patients, physicians and staff, and the community at large, must be balanced with the necessity for urgent care. Intraocular Tumors Examination under anesthesia for children with active retinoblastoma undergoing treatment (intravenous chemotherapy, intra-arterial chemotherapy, intravitreal chemotherapy, plaque radiotherapy, cryotherapy, transpupillary thermotherapy, laser photocoagulation) must continue on necessary schedule to control disease, typically every 3–4 weeks Examination under anesthesia for retinoblastoma evaluation for patients with stable disease, who have received treatment within the past 6 months Examination under anesthesia for children at high risk for retinoblastoma due to family history or known RB1 mutation Intraocular injection of chemotherapy agents for high-grade neoplasia Biopsy of suspected intraocular malignancy (fine-needle aspiration biopsy or other) Excision/drainage of iris cyst with pain or glaucoma Plaque insertion and removal for posterior uveal melanoma (choroidal and ciliary body) Tantalum clip insertion for posterior uveal melanoma (choroidal and ciliary body) Enucleation for uveal melanoma Eyelid Tumors Biopsy of suspected eyelid malignancies including melanoma, sebaceous carcinoma, Merkle cell carcinoma, or others Excision of suspected malignant eyelid tumor or orbital tumor affecting the better eye in a monocular patient (slow-growing eyelid basal cell carcinoma should be excised on a nonurgent basis) Excision of suspected malignant eyelid tumor (particularly squamous cell carcinoma) in an immunosuppressed patient Repair of eyelid defect after tumor removal Conjunctival Tumors Biopsy of suspected conjunctival malignancy including melanoma and squamous cell carcinoma which could not be managed reasonably with outpatient topical chemotherapy Biopsy of suspected conjunctival lymphoma (extended delay may be appropriate under certain circumstances) Orbital Tumor Biopsy of suspected orbital malignancy (case by case – rapidly growing tumor may need urgent biopsy; slowly growing suspected lymphoma is semiurgent) Biopsy of suspected orbital lymphoma (extended delay may be appropriate under certain circumstances) * Exenteration (case by case: rapidly growing tumor may need urgent biopsy; a slowly growing one could be semiurgent) Nonurgent The following procedures are considered nonurgent: Biopsy of suspected benign eyelid tumor Biopsy of suspected basal cell carcinoma, unless monocular patient Biopsy of suspected