Tuesday, March 15, 2011

Presley's beautiful eyes

Last July I started noticing that Presley's eyes were slightly misaligned when she looked at me sometimes. In the beginning, it was so subtle that Aaron thought I was crazy. By the end of the summer he was noticing too. We took her to the eye doctor at the end of August and she was diagnosed as having strabismus. According to Duke Eye Center, "strabismus is the medical term for misalignment of the eyes. It refers to the problem of the eyes not working together and one eye turning in, out, up or down. Approximately four percent of children in the United States are affected by strabismus. There are various reasons for this condition, ranging from a need for glasses to eye or neurological abnormalities. When a vision problem is suspected, a complete eye examination should be arranged as soon as possible. Early detection and management are important for best results."
During Presley's eye exam the doctor determined her vision was not being affected by the condition, therefore glasses would not help her and eye muscle surgery was recommended. Over the next several months, her eyes seemed to get worse as far as the degree to which the misalignment was visible to us. Now it seemed that friends in the neighborhood and at church could easily recognize that there was a problem. The picture above was taken at the end of November when we took our family pictures. In January when we took her to have another exam, the doctor did in fact say there was a significant difference from her first one. So, we scheduled her surgery for the end of February.
What exactly happens during surgery? Well, according to the numerous measurements taken during the eye exam and the expertise of the doctor, the surgery is all about weakening or strengthening the muscles in the eyes to get them into the ideal position. Incisions are made in both corners of the eyes in the white part. The muscles are located under this tissue. The muscles are either detached and reattached at a different spot on the eye, or sometimes even part of the muscle is removed and then reattached at the same spot, depending on what outcome is desired. All the stitches used to reattach the muscles just dissolve on their own.

On the day of the surgery we didn't have to be there until 11:00 am, which was tricky because Presley could only have apple juice in the morning and then absolutely nothing two hours before surgery. I thought it would be worse than it turned out to be; the toughest thing was making Avery wait and wait to have a snack so her sister wouldn't see it and get sad! By the time we got into the little room where Presley changed her clothes, it was 12:30 pm and she was all out of energy. They gave her some medicine to drink that made her sleepy and Aaron put some scrubs on so he could take her back to the operating room. She said goodbye to Avery and I gave her a kiss and told her I'd see her soon. When Aaron came back just a few minutes later he said they had put the mask over her nose and mouth and she struggled for about three seconds and then she was out.
About 90 minutes later they called me to go back to the post-op space to be with her when she woke up. I waited for almost 30 anxious minutes and when she finally stirred, she was confused and frightened. She cried and cried and I was heartbroken because one of the things I had promised her before the surgery was that it wouldn't hurt or sting (she vividly remembered her first exam when they had put stinging eye drops in her eyes). And of course the reason I told her there would be no pain was because I knew she would be under anesthesia. I didn't think about how it might feel when she woke up and her eyes felt like sandpaper! Oh, I was so sad! She cried and slept on and off as we drove home and then did the same thing that evening. She had a banana and cheerios before going to bed and then slept pretty well all night long.
In the morning she was still very upset and wouldn't open her eyes at all. Aaron took her to see the doctor and came back with good news. Everything looked exactly how it should (she actually opened her eyes for a few minutes so the doctor could take a look.) The rest of the day at home was rough. She refused to open her eyes even for a second, so Avery and I attempted to find things to do with her...we listened to music, listened to stories, she even watched Dora with her eyes closed! I had to carry her around, hold her hand or guide her in the right direction all day. I'm not sure if her eyes were sore or if she was just apprehensive about what would happen when she opened them. But, the next morning they must have either felt much better or she decided she didn't want to spend the day bored and helpless again... we all made a big deal about seeing her beautiful eyes again!

We are grateful for:

a doctor who is an expert when it comes to these surgeries
the short 30 minute drive to Duke Eye Center and Hospital
a patient and well-behaved twin sister who accompanied us on the day of surgery and endured the day after surgery with mom
Sushi for Aaron and I (yes, Sushi!) and chicken fingers and fries for Avery at Duke Hospital's cafeteria
health insurance
anesthesia and anti-nausea medicine for the anesthesia
a neighbor who helped me put Presley's eye drops in the day after surgery while Aaron was at work
a healthy three year old who recovered quickly



This is a picture of Presley that Aaron took the other day with the reward she picked out at the toy store after she finished her eye drops (THREE times a day for a week) - she named her "Allie the elephant". I know you can't see her eyes very well-I'll have to take a close-up so you can see how beautiful they are now!