Sorting things out...vision issues update

We have completed the testing through the optometrist. While the optometrist believes that the patching will not produce better acuity and that perhaps this is lost and will not be regained, however she believes through therapy his eyes can be trained to compensate in other ways for it. She has recommended extensive therapy for both vision and a host of other issues. Unfortunately, we are not sure how accurate the findings are as much of the test weighs heavily on a concrete understanding of English. It would seem she is relying more heavily on his background and statistics in the recommendation for extensive therapy as she also commented on the English issue to the reliability of the testing. We continue to pray for wisdom and have decided to consult with a second pediatric ophthalmologist who specializes in strabismus and amblyopia...in fact if you do not have strabismus the Dr. will not see you. We have an appointment scheduled for Dec. 9th. We are so grateful for the Lord's provision as each time we "hit a wall" the Lord directs us to the new door of opportunity.

We continue to trust the Lord...believing his Word for all situations. Proverbs 11:14 tells us that "Where there is no counsel, the people fall; But in a multitude of counselors there is safety." This has been our prayer as we have sought Dr. after Dr. and test after test. Perhaps in all of these visits and "feeling" like we are doing something what we needed most was more time.

"You will guide me with Your counsel, and afterward receive me to glory. Whom have I in heaven but You? And there is none upon earth that I desire besides You. My flesh and my heart fail; But God is the strength of my heart and my portion forever. For indeed, those who are far from You shall perish; You have destroyed all those who desert You for harlotry. But it is good for me to draw near to God; I have put my trust in the Lord God, that I may declare all Your works." Psalm 73:24-28

Opthamology Report

Our really cool glasses we got to wear after

having our eyes dilated. Andrew has huge

pupils...I have never seen any so large!



Kathlena with her eyes nearly fully dilated. I think it

made her feel a little funny.


Look at those pupils! I can hardly see anything else except

for that adorable Andrew smile!



Beginning patch therapy right away.


What a trooper...this is hard but Andrew is doing so well.



Well today was like letting out a deep breath for me. We have known from the beginning that Andrew has vision issues, but we have only speculated about Kathlena's multiple issues all being related to vision. Today confirmed what we were thinking. PTL!

We had a great visit with Dr. Coats from Texas Children's. He confirmed what we suspected about Andrew that he has Esotropia (eye drift to the middle and up), mild hyperopia or hypermotropia (same thing) and as a result developed amblyopia in his left eye. The great news is that he has 20/20 vision in his right eye and was reading his letters very well in English. He did so well throughout his exam. He didn't seem nervous at all but interested in how everything in the office worked. His left eye is at 20/50. At this time the Dr. would like for us to do patch therapy where he wears a patch over his "good" eye (right in his case) for 2 months to begin strengthening the left eye. He must wear the patch 6-8hrs a day...he is not liking it but he has been persuaded to wear it. ;) Now, the Dr. thinks that surgery is unavoidable and has asked us to go ahead and schedule it for 3 months from now. We are praying that the patching helps strengthen his vision thus correcting the amblyopia, but in order to straighten the muscle (hypertropia), surgery seems to be the only option-we continue to pray for healing without surgery, Lord willing, and if the Lord chooses to heal him through surgery we will trust Him in this also. We go back in 2 months to see the progress with the possibility of pushing back surgery at that point if patching is making improvements along with his weight gain and overall health improvement.

For Kathlena this was a home run day for us to find out what we have suspected all along. All of her issues were related. No CT scan needed nor neuro follow ups. She did so well in her exam. The Dr. was amazed at how she would sit still and allow him to look into her eyes. We have often attributed this to all of her Dr. visits she has had in Russia, but usually kids who see many Dr.'s and have lots of tests done tend to fight it more. I definitely think we are beginning to see the fruit of lap training. She sat in David's lap the entire time. Even when she and Andrew both had to have their eyes dilated they both did well, no screaming or squirming. While we waited for their eyes to dilate they got to watch Monsters Inc., which was so funny since Andrew has not seen it in quite a while, but still loves it all the same.

Kathlena was diagnosed with nystagmus (her eyes bounce, difficulty tracking). Dr. C ruled out the Spasmus Nutans even though she has the head bobbing. His best explanation of how this could be related to the "birth trauma" we were told at the orphanage is that oxygen was restricted during birth to a particular area in the brain that effects vision, including the pigment for the eye color. He also ruled her out as having albinism (ocular or otherwise) even though her eyes are very light. He did not see the other characteristics that usually mark this. He did say that she could be on the spectrum of it though due to the birth trauma. For now, we wait and see how much good food and activity improve her situation. It is expected that eventually she will also have to have surgery, and providentially it would be the same surgery that Andrew will have. Is that not amazing! Two biologically unrelated children placed in the same home who will have the same surgery...the Lord knew and placed together for His glory. It may sound strange, but I am thankful that I have already gone through surgery with J.Michael when he was young (again, providentially when he was 6yrs old just like Andrew will be if we do have surgery). I know it will not be any easier to have Andrew wheeled out to surgery, but the Lord is so good to prepare us and strengthen us through these times. Here is what to expect from the surgery and recovery stage. I have lots of reading up to do and will post more soon. Thank you for your continued prayers.

Strabismis

We have known from the beginning that Andrew would have some vision issues. We also found out that Kathlena has them too after being seen by our pediatrician (we suspected this in Russia too). Both children were diagnosed as strabismis in Russia but Kathlena's was not noticeable.


What is strabismus? Well here is what I have been researching and have come up with.


Strabismis-Symptoms Typically it is when the eyes move in different directions (crossing) but can also be less noticeable...eyes are straight but the child will tilt his head to see and likely run in to things because of depth perception problems.


Strabismus-treatment Simple explanation of possible treatments available. We will know more after our visit to the Pediatric Opthamologist next Mon. for both Andrew and Kathlena.


Amblyopia This is what is sometimes called lazy-eye, wandering eye and characterized by loss of vision due to the brain compensating through the other eye that is straight or stronger. Thus making it more of a neurological issue than muscular although usually they go hand in hand. Another good article explaining Amblyopia also has some great pictures of corrective surgery. Possibly to a degree what Andrew has...we are waiting for our Pediatric Opthamologist visit on July 21st to know for sure. Amblyopia-Exams and Tests what to expect. Hypertropia is a verticle drift which we see in Andrew's left eye mainly when he is looking up at you.



Nystagmus Uncontrolled movement of the eye usually from side to side. Also, characterized by a head tilt to compensate for the "null zone" This is generally thought to be genetic. Nystagmus Spasmus Nutans is a form that occurs generally between 6 mos. and 3 yrs. but resolves itself from age 2 to 8. Possibly what Kathlena has...would explain the head tilt issue that has been with her since birth. Albinism, "Albinism is the name given to a group of inherited conditions in which there is a lack of pigmentation (colour) in the eyes (ocular albinism) and often in the skin and hair as well. This causes most people with albinism to have a very fair, almost white, appearance, although in some people albinism affects the eyes only. People with albinism find their greatest problems arise on sunny days and in brightly lit environments. Virtually everyone with albinism has nystagmus", Understanding Nystagmus Again, only my limited knowledge of surfing the net and connecting some vague dots...we hope to know more specifics after our P.O. Dr. visit.


An interesting article on Vision and Learning. He even references poor nutrition(over consumption of processed foods and sugary sweets, sodas etc.) as one of the causes of visual problems in children. Hmmm...quite interesting info.

We are praying for a clear diagnosis and that the Lord would direct our steps(Psalm 37:23) to the best solutions to help Andrew and Kathlena function the best visually. We appreciate your continued prayers as we continue to grow their trust with us, developing good communication skills and seek to do what is best for them. I will update next week what we find out and give more specifics for prayer...thank you for lifting us up.

"Now faith is the substance of things hoped for the evidence of things not seen." Hebrews 11:1