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April 16, 2009

Misericordia Saves Vision

By Judy Owen

Our eyes are our windows to the world.

When Janice Christie was diagnosed with lymphoma in the tissue of her lower right eyelid and eye socket, she feared she would lose her sight. But with a quick diagnosis and the skilled hands of a Manitoba surgeon, Christie is enjoying the view around her.

"I feel very reassured that we have such excellent medical practitioners and we have access to them," the 65-year-old retired home care case co-ordinator and social worker said.

Christie's experience began in May, 2008, when she felt a lump on the inside of the lower lid of her right eye. When she went to her optometrist to see about new glasses, she pointed it out to him.

He told her it might be a blocked tear duct and to put hot compresses on it. After a month and a half, the lump was still there but she didn't feel any pain.

When she went to her family doctor for a regular appointment, she told him about it and he referred her to an ophthalmologist.

The ophthalmologist took a look in November and referred Christie to Dr. Lorne Bellan, an oculoplastic surgeon at Misericordia Health Centre's Eye Care Centre of Excellence.

When Bellan examined her on Jan. 21 and looked at a CT scan that had been done, he told her the lump might be lymphoma, but he wanted to do a biopsy to confirm the diagnosis.

One week later, Christie was at Misericordia having the biopsy done and the soft-tissue mass was cancerous.

"I just went into shock," she said. "I really did not have any warning or any idea at all that this is what it could be.

"I had no symptoms, no pain, no nothing. It was very frightening."

Bellan immediately took action, carefully removing as much of the lump as he could. It was reduced to less than two millimetres from 2.5 centimetres.

"I can remember saying during the biopsy, 'This is actually more than I expected. I did not come prepared for this today,'" Christie said.

"He said, 'Well, sometimes this happens.' He kind of played it down."

Christie was referred to CancerCare Manitoba and had follow-up CT scans, but because the lump was now so small she didn't need chemotherapy. And the decision whether or not to have radiation treatment was up to her.

She decided to do a wait-and-watch approach after specialists told her it wasn't an aggressive lymphoma.

"It was just absolutely amazing," she said. "It was due to Dr. Bellan's accurate assessment of the lymphoma and his surgical biopsy that it has not required active, aggressive treatment at this time."

Christie's surgery was one of 139 oculo plastics surgeries performed in January at MHC. The average is about 100-140 per month, said Jane Singh, the eye clinic's senior nurse.

Oculoplastics is a subspecialty of ophthalmology that deals with reconstructive and cosmetic surgery of the eyelids, bony orbit around the eye, tumours and the tear duct system.

Misericordia's Eye Care Centre of Excellence has 20 ophthalmologists. Bellan is one of two oculoplastics specialists and has been an eye surgeon since 1991. The other, Dr. Matthew Lee-Wing, has more than 15 years of experience.

The skills required to perform surgeries such as Christie's are highly developed, Singh said.

For example, when a biopsy is performed, the surgeon may remove small sections of the targeted area and those sections are immediately analyzed by a pathologist.

Depending on the findings, more specimens may have to be carefully sliced off until a cancerous tumour is removed. That can leave a large defect.

"Sometimes (Bellan will) have to take grafting from the lid or another part of the face to close up that defect so that it's functional and cosmetically pleasing," Singh said.

"They do some excellent reconstruction here, he and Dr. Lee-Wing. They just make it look so easy."

The gratitude of patients is heartwarming and inspiring for staff.

"Of all your senses, sight is No. 1," Singh said. "Patients are so
thankful . . . when you get the report that it's clear and then we reconstruct it.

"It's just such a rewarding, motivating feeling - just psychologically very fulfilling."

Since 1898, Misericordia Health Centre has been providing compassionate high quality health care to those most in need in accordance with our core values: caring, respect and trust. Misericordia provides an array of specialized programs including our Eye Care Centre of Excellence, pediatric dental surgery, Sleep Disorder Centre, long-term and interim care, urgent care, ambulatory clinics, diagnostic imaging and laboratory services. Misericordia also operates the internationally-recognized Provincial Health Contact Centre, including Health Links-Info Santé. For more information, please visit www.misericordia.mb.ca.

Judy Owen is a Winnipeg-based freelance writer.

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