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

Abstract

Background New 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 presentation A 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. Conclusions Our 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.

Racial and Socioeconomic Differences in Eye Care Utilization among Medicare Beneficiaries with Glaucoma

“…One study published in 1996 demonstrated that laws designed to bar undocumented immigrants from medical care can lead to reductions in utilization of ophthalmic care. 39,40 To date, there is limited ophthalmologic research focusing on care for undocumented immigrants in the United States. Further research is needed to improve healthcare, and specifically eye care services for undocumented immigrants.…”

Novel automated non-invasive detection of ocular surface squamous neoplasia using artificial intelligence

“…In the elderly, they are the third most common type of oculo-orbital tumours, being exceeded in frequency only by melanoma and lymphoma[ 1 ]. OSSN poses a considerable economic burden, given the potentially high out-of-pocket costs for topical chemotherapy, lost work time for follow-up visits, the cost of the office visits, and even transportation costs to the visits[ 10 ].…”