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APHA Scientific Session and Event Listing

Robert C. Capone, OD, FAAP, Department of Clinical Services, The New England College of Optometry, 424 Beacon Street, Boston, MA 02115 and Richard M. Frankel, MD, MPH, Biosciences and Disease, The New England College of Optometry, 424 Beacon Street, Boston, MA 02115, 6172366223, marich620@aol.com.

A seven minute ophthalmoscopic exam can extend the life of a child by seven decades. The well trained practitioner can, with this non- invasive test, identify lesions of the fundus which can predict, 90 percent of the time, the development of colon cancer by midlife. This hereditary form of colon cancer generally occurs in an autosomal dominant pattern. Having elicited a family history of colon cancer, the clinican, using ophthalmoscopy, screens for familial adenomatous polyposis(FAP), where thousands of polyps will soon carpet the colon. FAP is caused by mutations in the gene APC (adenomatous polyposis coli). Eventually, the polyps will transform into cancer early in life, barring screening by ophthalmoscopy followed by colectomy. About 2 percent all colon cancers occur as FAP, but FAP makes up for its uncommon occurrence by its inexorable development into malignancy by age 40, decades before the more common, sporadic form of colon cancer. The characteristic ophthalmoscopic findings of pigmented lesions predict at birth the development of cancer long before it occurs, allowing time for intervention. These easily, observable lesions, the only signs of FAP evident at birth, can be detected by those well trained in the use of the ophthalmoscope. Counseling siblings and offspring to seek ophthalmoscopy and genetic testing may avert multiple deaths in young families. In Conclusion, ophthalmoscopy can anticipate, decades in advance, the development of a significant form of colon cancer, making routine early screening by ophthalmoscopy an imperative for preventative public health.

Learning Objectives:

• Identify a hereditary form of colon cancer, often overlooked, which is 100% lethal.
• Using an ophthalmoscope, detect those lesions which herald the inexorable development of colon cancer.
• Describe the multifocal and bilateral, retinal, pigmented lesions of the retina, which characterize the specific ocular lesions.

Keywords: Child Health Promotion, Screening Instruments

Presenting author's disclosure statement:

Any relevant financial relationships? No