Cancer-Free and Seeing Clearly After Eye Cancer Surgery at Duke Health

Less than three years ago, Daryl Johnson was diagnosed with eye cancer that threatened not just his eyesight, but potentially his life. Thanks to the expertise of Jason Liss, MD, his oculofacial plastic surgeon at Duke Health, today Johnson enjoys spending peaceful afternoons on his back porch in La Grange, NC. He credits the care he received at Duke for allowing him to see the world clearly, cancer-free. 

A Referral to Duke

In spring of 2021, Daryl Johnson, now age 83, noticed a growth in the corner of his left eye. While it did not interfere with his vision, his eye was irritated and uncomfortable, so he made an appointment with a local ophthalmologist. After examining Johnson’s eye, the doctor referred him to a larger practice in Greenville, NC. By that time, the growth had spread to his lower eyelid. The doctor in Greenville knew that Mr. Johnson needed specialized care. “He took one look and said that I needed to go to Duke,” recalled Johnson.

A Cancer Diagnosis and Initial Eye Surgery

In March, he met with Jason Liss, MD, an oculofacial plastic surgeon -- an ophthalmologist with specialized training in the treatment of eyelid, eye socket, and tear duct diseases -- at the Duke Eye Center. Dr. Liss was immediately concerned with Johnson’s condition. “The mass was unusual, and right away I was afraid for his ability to keep his eye, and depending on what type of tumor it was, his life could be at risk too.” Dr. Liss recommended surgery to remove as much of it as possible. A biopsy would also be performed to identify the tumor type.

During Johnson’s surgery, Dr. Liss took out most of the mass, which was identified as squamous cell carcinoma, a type of skin cancer, while leaving Johnson’s eye intact. “The good news was that we were able to separate it from the eye. The bad news was we had not removed all of it,” Dr. Liss said. That meant a second eye surgery was needed. 

In a follow-up visit, Dr. Liss noticed another growth in front of Johnson’s left ear. It’s not uncommon for cancer in or near the eye socket to spread to lymph nodes in front of the ear, he explained. Dr. Liss referred Johnson to Russel Kahmke, MD, a head and neck surgeon at Duke Health, to have the mass in front of the ear removed. 

Two Options for a Second Eye Surgery

Then, Dr. Liss presented Johnson with two options for his final eye surgery. The first was to take out the rest of the tumor without disrupting the eye. Dr. Liss explained that this approach might mean that some of the cancer would be left behind, and that due to scarring, the eye might not function properly after surgery. The second choice was to remove the eye and surrounding tissues to better ensure that that the entire tumor was eliminated. This would mean the loss of Johnson’s left eye. Johnson did not want to sacrifice his eye and chose the first option. “Thankfully, the surgery went really, really well,” Dr. Liss said.

Johnson, who is now in remission, agrees. His vision was unaffected by the cancer and the surgeries. Today he relishes spending time with his three grown children, who live nearby, and is grateful to Dr. Liss for his compassionate care and expertise. “Dr. Liss is on my list of some of the greatest people on earth,” said Johnson. “He is the man.”