The Cascading Eye Effect

Tonight’s post is an attempt to explain the series of events that have led my daughter to her current state of ocular affairs—otherwise known as “she can’t see crap.”   And just so we’re all on the same page here, the only way I’m dealing with this without becoming a completely depressive, blubbering mess is to treat it with humor, positive attitude and an immense amount of thankfulness and gratitude to those around me who are helping my daughter, and by extension my husband and me in our understanding of what’s going on.

So now, based on a commitment in last night’s blog post when I was too tired to finish writing up my thoughts, I committed to explaining what’s going on in my daughter’s eyes.   I thought I knew last week, but I was wrong (well, many of us were at that point.)   My understanding has evolved now, but I have the most menial sense of confidence that I’m getting it all right.   So if I spell medical words wrong or put components of the eye in an entirely different area of the body, it’s me getting up to speed on the whole medical eye realm.

The prevailing thought in what’s happening to my daughter’s eyes is that everything started with inflammation.   The cause for that inflammation is the problem no one’s been able to solve.   Rheumatology is driving her case at this point, but as test after test come back normal or negative for inflammatory and autoimmune causes, we’re still at a big zero on the inciting event/cause front.

Inflammation can be a bitch.   Here’s what the doctors speculate happened (but not necessarily in this order):
1) Inflammation —> low blood flow —> aberrant vessels growth anterior to the eye

• Some inciting event or agent caused the vessels in the eye to be inflamed. 
• The inflammation constricted or restricted blood flow to the eyes.
• The nerves in the eyes sent messages to have new vessel growth to combat the low perfusion
• New blood vessels are grown in the anterior portion of the eyes, near and around the drainage region

2) Inflammation —> low blood flow —> serous retinal detachment

• Inflammation and lack of blood flow cause fluid to build up behind the retina, causing serous retinal detachment

3) Retinal Detachment —> aberrant vessel growth anterior to the eye

• Low blood flow causes retinal detachment which in turn sends messages to grow additional vessels in the eye

I said in last night’s post I was going to put up a picture of an eye and point to things with my virtual finger, letting you know where all these things were happening.   Here’s a diagram of an eye:  

The fluid buildup is behind the very large “retina” which covers the right two-thirds of this picture.   Is the fluid in only one place?  Is it moving around as my daughter changes positions?   We’re not altogether sure.   The fluid buildup from a serous retinal detachment drains to the Choriod layer, but for some reason isn’t being pumped out like it normally is.   The current suspect: inflammation.  

The aberrant vessels have grown not in the back of the eye, but in the anterior portion of the eye, close to the drainage region which is a three-dimensional area close to the Schlemm’s canal.   This isn’t one or two or three vessels, but a large network of itty bitty, teeny tiny blood vessels she doesn’t need.   Hopefully the Avastin they injected into her eyes yesterday to combat the growth of the vessels will be helpful.

So for now, inflammation is the enemy.   We will know more in two weeks.   Hopefully prior to that the fluid will reduce some behind her retinas, but to be fair, healing from this type of retinal detachment commonly takes weeks or longer to recover from.

The Big Boy Update:  My son wore his rain boots to school today.  He insisted on doing so because our weather station (which is notoriously inaccurate) said rain.    For dinner in the eighty-four degree weather, he wore his rain boots again and this time wore his warm rain jacket.   He has utmost faith in our weather station it would appear.  Funny enough, a brief bit of rain happened while we were at dinner, although it was so quick, we only knew because cars were wet when we left the restaurant.

The Tiny Girl Chronicles:  My daughter decided to wear her rain boots to school.   Her old ones were too small so I had her pick some new ones out online.   She wore them today and told me when she got home about her friends who told her they liked her new boots.   My son told us that, “everyone likes her new rain boots.”

Fitness Update:  I went to the fitness room today and tried out just doing some free weights, being mindful of form and careful of injury.   I have no aspirations for big muscles, only toned ones.  Therefore, I don’t mind one bit if I use the lowest weights on the rack, as long as they work for me.