Rarer than rare

Warning: this blog entry is long and not about cute things. The cliff notes version is that we had a health scare with the boy but found out today that everything is ok. Feel free to skip the rest; cute pictures will be coming in the next day or so.

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Our boy is fine. Healthy and hale. His doctor assured us of this with 99.999999999999% certainty. Nevertheless, he sent us to a specialist; a pediatric ophthalmologist in a city an hour and a half from here.

You may have noticed that we take pictures of little E on occasion. One or two, anyway. Well, a picture that I took showed an eerie and potentially ominous effect in little E's right eye. You can see for yourself.



You might not think that this could be a big deal---probably just an artifact of the flash or something. I might have thought the same except I'd read an article a couple of weeks ago about a similar white response from a child's eye. The little girl in the article had a tumor on her retina. Cancer.

The red eye effect that often appears in pictures is actually the response of a healthy retina to the camera flash. When there is a problem with the retina the light is reflected differently and this can show up as a white spot in a picture. This phenomenon is called leukocoria.

Though we've taken thousands of pictures of our boy, this white eye thing only showed up in one so I was initially not very concerned. I decided to look it up on the internet assuming I'd find articles that would allay my minor concern. I assumed that this was a common camera effect. Instead I read this: "This is never a normal condition and requires immediate evaluation by trained specialists".

Not a phrase I ever want to read again.

Leukocoria is a symptom of several different problems; none are things I want to contemplate with respect to a loved-one, especially my small, amazing, happy, beautiful baby boy.

It was 10pm. I was alone. Little E was sleeping and the Mav was out of town. I called him, sent him links to the articles. We searched the web; learning about the various conditions, the diagnostic techniques, the prognoses. I kept hoping one of us would find the article saying that nothing was wrong with our little boy. All we found was more to fear.

The Mav was on the road home by 6:30 in the morning having canceled his meetings for the day. I called the doctor's office as soon as it opened and got us an appointment for that afternoon.

The Mav made it home before noon, exhausted from a sleepless night and a long drive. He renewed the search for more info and finally, at last, found the article we'd been longing for. It IS possible to get the white reflection from a completely healthy eye and it's under conditions similar to those in our picture. We may have captured a reflection from his optic nerve.

We might have been saved a sleepless night if our pediatrician had checked the boy's eyes at our appointment just a week earlier. He hadn't. I didn't notice the absence of the check at the time. It was only in retrospect that I realized the omission. He had never turned the lights off to check E's eyes. Do other pediatricians do this routinely?

We saw the specialist and his team today. E's eyes were examined when we arrived then he was given drops to dilate his pupils. Half an hour later we saw the doctor. He checked the small boy's eyes thoroughly and pronounced them completely healthy!

The good doctor (and he is a very good doctor, both in his manner and his expertise) told us that we did indeed take a picture of E's optic nerve. He said that we could have never taken this picture if we had tried; it is nearly impossible to catch the optic nerve through the pupil. The camera has to be a such an angle and the eye at such an angle and so on ... The very rare cancer we feared occurs in about 300 people per year. The study the Mav found had exactly 3 examples (ever, not per year) in which a photograph with a white eye reflex turned out to be the optic nerve. Despite retinoblastoma being extremely rare a white eye in a picture is much much more likely to indicate a tumor than to show the optic nerve and it should always, always be checked out by an ophthalmologist. We did that and, against the odds, received the best imaginable news. We are beyond relieved that our boy is one is a billion instead of one in a million!