Eye exams can reveal a range of health problems

07/21/2014 1:01 PM

07/26/2014 10:23 PM

Eyes have long been poetically described as the window to the soul, but they are also capable of revealing serious health concerns.

Two Dania Beach parents credit a routine eye exam with saving their child’s life.

Grace Carr, 6, had been experiencing frequent migraines and vomiting when her parents brought her to see a pediatrician, who couldn’t determine the cause.

It was not until they noticed their daughter’s eyes were misaligned that they brought her in April to Dr. Mark Dorfman, senior pediatric ophthalmologist at Joe DiMaggio Memorial Children’s Hospital in Broward County.

Right away, Dorfman grew concerned.

“We dilated her eyes to look at the optic nerve,” Dorfman said. “It was significantly swollen and her intracranial pressure was elevated.”

The symptoms can result from a number of causes, including a brain tumor.

Dorfman referred Grace to Dr. Dean Hertzler, a pediatric neurosurgeon at Joe DiMaggio Children’s Hospital. He scheduled an MRI.

“I didn’t let them leave the office until I knew she would be getting an MRI that day,” Dorfman said. “You need to follow your own intuition in treating every child like they’re your own.”

Grace’s MRI results revealed what Dorfman had feared — she had a large benign tumor in her cerebellum. The tumor had blocked the normal flow of spinal fluid, which was reflected in her optic nerve.

“After the MRI, when the doctor said they found the mass in the back of the head, that part blew me away,” her mother, Mary Carr, said. “I never would have imagined something being that serious.”

The following morning, Hertzler performed a nine-hour surgery to remove the 7-centimeter-wide tumor growing on her brain stem.

“The tumor had gotten so large to the point where if we hadn’t caught it soon, she would likely have died,” Hertzler said.

Hertzler was able to remove most of the tumor, and Grace is now in physical therapy to rehabilitate her balance, coordination and vocalization.

Grace’s case is not the only health concern that can be unearthed by an eye exam. Eye exams can also reveal that a person is suffering from issues such as diabetes, allergies and eye cancer.

“There are many similar stories to this that I see almost every day in the clinic, where the eyes reveal a more serious problem,” said Dr. J. William Harbour, professor of ophthalmology at the Miller School of Medicine at the University of Miami.

For Habour’s patient Keira Hoffman, it took a specialist to recognize that her health was at risk.

Keira’s parents had noticed that her left eye had started drifting when she was 6 months old, but her pediatrician thought she would eventually grow out of it.

When Keira was 23 months old, her eye had not improved.

“Her perception was starting to be way off and way worse than it was,” said mother Kristina Reichert. “It was getting to the point where she was tripping and falling and became clumsy.”

Reichert took her daughter to see an ophthalmologist near their home in Williamsburg, near Orlando, last August. The specialist dilated Keira’s eyes for examination, prompting him to run more tests.

The results indicated that Keira was suffering from retinoblastoma, a cancerous tumor of the retina found mostly in children 5 and under. About 300 children are diagnosed each year.

Keira was referred to Harbour; the next day the family traveled four hours to his Miami office. He started her with chemotherapy treatment, and nearly six months later the 2-year-old was declared cancer-free.

Harbour says it is often outside the pediatrician’s office that eye issues are first noticed.

“It is usually the family of a child, not the pediatrician who notices something is wrong,” Harbour said. “When you are in a brightly lit doctor’s office, because the eyes constrict, it is difficult to see something with the pupil. When you are home the lights are a little lower and any issues are easier to notice.”

With cases like Keira’s, flash photography may also indicate there is something wrong. In photos, the child’s pupil will appear white instead of red.

Harbour says parents need to be the ones to act on anything unusual they may notice with their children’s eyes.

“Kids don’t know that anything is abnormal,” Harbour said. “They don’t know to complain so they won’t complain. Even if the eye turns red or is misaligned, they often will not complain about it so it is really the parents more than anyone [who need to look for signs].”

Grace’s parents have started a grassroots effort to encourage other parents to take charge of their children’s eye health. They created the Facebook page, Amazing Grace, to spread their message.

“We don’t want this to happen to other children so we use Grace as an example of how with proactive parenting you can stop something,” Mary Carr said. “We just want to bring awareness to take your children to get their eyes checked. If there is the slightest issue, don’t ignore it.”

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