CHRPE and Colon Cancer

Another reason to have your eyes checked regularly!

Freckles in Your Eye Can Identify Risk of Colon Cancer

A common pigment spot in the retina can be associated with a hereditary form of intestinal polyps that may become cancerous. Congenital Hypertrophy of the Retinal Pigment Epithelium, referred to as CHRPE (“chirpy”), a form of freckling inside the eye has been associated with a hereditary condition known as Familial Adenomatous Polyposis (FAP) or Gardner’s Syndrome. 80% of patients with FAP have CHRPE.

CHRPE is relatively easily detected during an eye examination, especially if the pupils are dilated or digital imaging/photography is performed. Patients sometimes have just one CHPRE or they can have several, often found together in groups, somewhat like constellations of stars. These groupings of round spots of various sizes can resemble paw prints so they are also called Bear Track Pigment.

Patients with multiple or irregularly shaped CHRPE are the ones most likely to have FAP and are the ones we educate about the importance of preventive colon health care. Unfortunately, the polyps found in patients with FAP have a very high probability of becoming cancerous if left untreated. In 2010 a study in the American Journal of Gastroenterology concluded that patients with such freckles should be referred for colonoscopies.

The guidelines we have developed for our patients with Bear Track Pigment at the EyeCare Center of Leesburg are:

Children and Young Adults (age < 30): We inform the patient (and parent for minors) of the significance of this finding and advise them to never delay a colonoscopy if recommended by a physician or as standard screening as they get older.

Adults without a family history of colon cancer: If under age fifty we advise them that they should have a colonoscopy at age fifty as is commonly recommended. If over the age of fifty we query the patient about if they have ever had a colonoscopy and urge them to stay in compliance with their physician’s colorectal screening schedule.

Adults with a family history of colon cancer: We advise they schedule a colonoscopy or discuss scheduling one with their physician given the ocular finding and their family history.

The information provided is for informational purposes and is not medical advice or a substitute for ocular health or medical consultation with a health care professional.

Leave a comment on this article

*