Today was my daughter’s EUA and possible eye surgery. Dr. Trese (pronounced “Tracy”) spent time looking at both her eyes to see what the cause of her reduced vision might be. Bottom line—I’m glad we got in early, because things aren’t looking good. It doesn’t mean we can’t turn around some of what’s happening, but more is happening that needs to be addressed.
The first thing he talked to us about was the pressure in both eyes. Initially when we saw him she had near zero pressure in both eyes. This turned around for a while, which hopefully meant her ciliary bodies were producing fluid and had recovered some. But since two months ago both eyes have dropped dramatically, with one eye at zero and the other at six.
His suggestion was to artificially increase the pressure in both eyes to normal levels by adding Healon, a permeable substance he’s added before. His thought is that perhaps the ciliary bodies didn’t recover, but the Healon didn’t permeate out for a long time, which would make sense given her eye situation. If that’s the case, she will need regular injections of Healon, perhaps every six months or yearly, to keep her eyes at pressure.
The reduction in pressure is concerning, but fixable. Dr. Trese said it was hard to see the retina in the left eye because of her cataract, but it looked like it had some fluid behind it (a serous detachment, remember that?) but his hope was the increase in pressure would help remedy that. The right eye looks good with an attached retina and an optic nerve he could see which looked reasonably healthy.
Next he talked to us about the lenses and what needed to be done. The left lens is clouding rather quickly (becoming a cataract). He said it needed to come out and possibly have an artificial lens added, but he wanted to stabilized the eye pressure first. That would likely be done by Duke as he doesn’t implant lenses. That would also depend on the availability of a lens that would fit her small eyes.
The right eye has another thing going on which is interesting in that “I wish I wasn’t that interesting” kind of way. Her lens was removed last December. Think of the lens as an M&M. The part removed is the chocolate center. The lens capsule remains and holes are opened in the front and back so you can see clearly through the opening.
Sometimes, the remnant parts of the lens, which is a little like an onion with layers, has cell growth occur. This growth is called Elsching Pearls. That’s what’s happening to my daughter’s right eye. So the open area is less open now. The picture below is not my daughter’s eye, but it shows the lens capsule with cellular growth around the opening some time later.
What happens next? Dr. Trese wants to give my daughter’s eyes six weeks to adjust to the normal pressure. The pressure increase should be helpful to her eyes overall. He is meeting with our pediatric ophthalmologist this weekend at a conference and plans to talk with her about next steps.
We will need to have the lens removed in the left and the right lens capsule cleaned out at some point. Hopefully over the next few days things will improve a bit but I don’t expect them to get significantly better until she can see more clearly through the left eye, clouded eye.
She has a follow-up office visit tomorrow with Dr. Trese at which we’ll learn a bit more about his thoughts for a plan going forward.
The Big Boy Update: My son wanted to know why all the cars were at our next door neighbor’s house last night. I told him they were there to watch the debate of our presidential candidates, Hillary Clinton and Donald Trump. He immediately laughed and said, “Donald Trump? That’s crazy funny because trump is like a trumpet and makes funny noises and Donald is like the Duck on Mickey Mouse Club House and he’s crazy.” Folks, I swear, I don’t make these things up.
The Tiny Girl Chronicles: My daughter didn’t recover initially from the anesthesia well, saying her head hurt in the forehead area. Two hours later with her at the mall, throwing her present pennies into the fountain and she was right as rain. She talked to her brother on the phone for a while, telling him she got him the Lego set he wanted as a present.
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