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

Norman A. Saffra, Trisha S. Emborgo, Codrin E. Iacob, David S. Kirsch

Research output: Contribution to journalArticlepeer-review

4 Scopus citations


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.

Original languageEnglish
Article number174
JournalJournal of Medical Case Reports
Issue number1
StatePublished - 2 Oct 2020
Externally publishedYes


  • Case report
  • Cost-effective treatment
  • Ocular surface squamous neoplasia
  • Undocumented
  • Uninsured


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