Routine eye exam leads to life-saving cancer diagnosis for West Columbia Doctor of Optometry

What began as a routine eye examination for a Midlands man ultimately led to a life-saving cancer diagnosis after a South Carolina optometrist identified a small abnormality in the back of his eye.

During a comprehensive dilated eye examination, Dr. Katie Davis, Doctor of Optometry at Vision Therapy Institute in West Columbia, discovered a small freckle, medically known as a choroidal nevus, on the patient’s eye. While many eye freckles are harmless, some require careful monitoring because they can develop into ocular melanoma, a rare but potentially life-threatening form of cancer.

Rather than dismissing the finding, Davis began routinely documenting the freckle using Optos ultra-widefield retinal imaging technology, allowing her to monitor the area and compare images over time.

“Years ago, we relied on drawings and manual measurements,” Davis said. “Today’s imaging allows us to compare photographs over time and identify even subtle changes much more accurately.”

Months later, the patient returned after experiencing flashes of light in his vision. Although flashes can have numerous causes, updated retinal images showed that the previously stable freckle had changed.

The changes prompted an immediate referral to a retina specialist, where the patient was diagnosed with ocular melanoma.

“It’s a scary diagnosis for anyone to hear,” Davis said. “Our job is to help patients understand what’s happening and guide them through the next steps. We were going to figure it out together.”

Because the cancer was identified early, specialists were able to treat the tumor without removing the patient’s eye, preserving both his vision and his quality of life. The patient continues to do well and has since entrusted Davis with the eye care of his children.

More Than a Vision Test:
Davis says the case illustrates why comprehensive eye examinations are about much more than determining whether someone needs glasses.

“Our goal is always to protect a patient’s vision, but sometimes we’re protecting much more than that,” Davis said. “A routine eye exam can reveal diabetes, high blood pressure, autoimmune diseases, neurological conditions and, in rare cases like this, cancer before someone even knows it’s there.”

Eye melanoma, also known as uveal melanoma, is the most common primary eye cancer in adults, but it remains exceptionally rare. Nationally, approximately 2,500 to 3,000 people are diagnosed each year, with an incidence of approximately 4.3 to 5.6 cases per million people.

Based on South Carolina’s population, that translates to an estimated 20 to 35 new cases annually in the state.

Unlike many cancers, ocular melanoma can develop without obvious warning signs. Many patients experience no symptoms, with the disease discovered during a routine dilated eye examination. When undetected, the cancer can become significantly more serious, with metastatic disease most commonly affecting the liver.

Early diagnosis provides the best opportunity for treatment before the cancer spreads.

A Reminder for South Carolinians:
Dr. Davis encourages South Carolinians to prioritize annual comprehensive eye health examinations—even when their vision appears perfectly healthy.

“Many serious eye diseases don’t cause symptoms until they’ve progressed,” Davis said. “The best time to find a problem is before you notice one.”

For this Midlands patient, a routine appointment, advanced technology and careful monitoring made all the difference—turning what could have been a devastating diagnosis into a story of early detection, preserved vision and hope.

The case also underscores the importance of access to comprehensive vision care throughout South Carolina. According to information cited by the South Carolina Department of Public Health, nearly 12% of South Carolinians report delaying medical care because of cost, while rural communities continue to face significant health care workforce shortages.

Approximately 85% to 90% of eye melanomas are uveal melanomas, affecting the choroid, ciliary body or iris.

The South Carolina Optometric Physicians Association’s #Sight4SC campaign is working to raise awareness about the importance of comprehensive vision care and the need for greater access to eye health services for South Carolinians.

To learn more about comprehensive eye care and the #Sight4SC campaign, visit sceyedoctors.com.