Thursday, September 29, 2011

First Duke Pediatric Ophthalmologist Visit

Yesterday Alex had his first visit with the Pediatric Ophthalmologist (Ped Op) at Duke.  We really liked the doctor and are looking forward to her treating Alex.  Quite a bit of waiting but it was totally worth it.  Next time I will definitely schedule a morning appointment if possible. 

A big thank you to my parents who were lifesavers and picked up Julia from day care when we realized we would not get to her school before closing. 

So, here is what we found out:

·         Foveal hypoplasia which was pretty much expected.
·         No glaucoma at this time
·         No cataracts at this time
·         No glasses at this time, but with foveal hypoplasia he will have glasses in the future.
·         Sensitivity to light.  Again, this was expected.

Where do we go from here?

·         Monitor for glaucoma or cataracts
·         Formal vision training
·         Wait for results of genetic testing to see if he has WAGR syndrome
·         Frequency of visits will depend a lot on how he progresses in the first 6 months of life or if other conditions arise.  At 18 months he will undergo an exam while sedated to look at the drainage mechanism to monitor for glaucoma. 

I am so glad I brought a note pad and pen with me to take notes and highly recommend doing this.  It is also a great place to write down any questions you have for the doctor.  I plan on making a folder with all his results and reports to keep track of everything in one place. 

I am excited to start the vision training.  I had already researched the Governor Morehead School  and read the Wee Play in the Dark book.  Be on the lookout for a post on vision training (hopefully) soon.

We really appreciate all the prayers and support for Alex.  Thank you!

Thursday, September 8, 2011

First trip to Duke

Yesterday we took our first trip to the Duke Eye Center where we met with a Genetic Counselor to discuss Aniridia and the possibility of WAGR syndrome.   The Genetic Counselor provided a wonderful article on the genetics of Aniridia and WAGR syndrome.  The article is a bit technical, but I thought it provided a lot of information.  Here is the link: http://www.ncbi.nlm.nih.gov/books/nbk1360/

We elected to have genetic testing performed and Alex’s blood was drawn to send to a lab in Maryland.  The results will take 4-8 weeks.    We are praying that Alex does not have WAGR syndrome.  

We look forward to meeting the Pediatric Ophthalmologist at the appointment on September 28.  Everyone we met at Duke yesterday was very nice and helpful.  Alex received a handmade crocheted blanket donated by a woman that makes blankets for babies at the hospital.  It is navy blue with different colors and textures of yarn in each square.

Monday, September 5, 2011

Any excuse to shop...

I did some online shopping on Saturday and I am really excited about my purchases.  These items were recommendations from some moms that have children with Aniridia.  I ordered the sunglasses, hat, and Aniridia book from Amazon.  The sunglasses were definitely cheaper through Amazon.  I ordered the Wee Play in the Dark book from Flaghouse.

Infant sunglasses: With loop to stay on the baby.


Baby play hat: To shield eyes from the sun. I also like that it is SPF 50 and covers the neck.

Book: Wee Play in the Dark by Kristie Smith
For parents! This jargon-free parent’s guide offers early-intervention advice and activities for working at home with infants who are visually impaired.  Smith suggests ways to incorporate activities into the child’s daily routine that will help with color and shape recognition, near and distance vision, logical reasoning, tracking and reaching, and other goals.  The author also provides a list of supplementary resources for parents.

Book: Aniridia and WAGR Syndrome: A Guide for Patients and Their Families (I came across this one on my own)  http://www.amazon.com/gp/product/0195389301

Saturday, September 3, 2011

Our Amazing Little Baby, Alex

This Blog
Please note this blog is not intended to give medical advice.  It is a way for us to keep family and friends updated on Alex and his journey with Aniridia.  We are so blessed to have this little boy and his big sister in our lives.  They bring us so much happiness every day.


Summary of first several days
8/21/2011: Alex is born
8/21/2011: First chest X-ray.  Alex is placed in Special Care Nursery due to rapid breathing and low glucose.  These were not related to Aniridia and most likely due to fluid in the lungs not removed during birth. 

8/22/2011: Oxygen hood removed in the morning and Mom allowed to breastfeed Alex in Special Care Nursery.   That evening Alex is able to “room in” with Mom and Dad.
8/23/2001: Alex survives first earthquake at hospital before we were discharged.  http://earthquake.usgs.gov/earthquakes/recenteqsww/Quakes/se082311a.php
8/23/2011: Mom and Alex discharged from hospital with follow up appointment scheduled with Pediatric Ophthalmologist the next day.
8/24/2011: First visit to family Pediatrician
8/24/2011: First visit to Pediatric Ophthalmologist – diagnosed with Aniridia
8/25/2011: First abdominal ultrasound to check for Wilms tumor.  No tumors found at this time.  Alex will need to have ultrasounds every 3 months to check for Wilms tumor.
8/27/2011: Alex survives first hurricane. http://en.wikipedia.org/wiki/Hurricane_Irene_(2011)

Diagnosis - Aniridia

Alex was born on August 21, 2011.  During the exam to discharge him from the hospital, the Pediatrician noticed that his eyes were fully dilated.  We were referred to a Pediatric Ophthalmologist  (Ped Op) for the following day and Alex was diagnosed with Aniridia at that appointment. 

Aniridia is defined as a congenital absence or partial absence of the iris.  Aniridia is rare. Its incidence is between 1/50,000 and 1/100,000. The genetic defect has been found to be a deletion on chromosome 11.  Approximately, a third of all cases of Aniridia are sporadic (neither parent has Aniridia).

When a child is born without a complete iris, it is usually a symptom of a broader condition. Known as aniridia, this condition can also be a sign other parts of the eye are underdeveloped as well. Moreover, recent research shows that the gene involved can also affect the kidneys, pancreas and forebrain, so aniridia can coincide with a range of symptoms known as WAGR syndrome.

Many aniridics have developmental and ocular abnormalities and may exhibit the presence of one or more of these conditions:
·         cataract
·         lens dislocation
·         foveal dysplasia
·         optic nerve hypoplasia
·         corneal pannus
·         glaucoma
·         nystagmus
·         Wilms Tumor
·         WAGR Syndrome
More information for these conditions can be found at http://www.aniridia.net/whatis.html.

Where do we go from here?
We have scheduled an appointment for September 28 with a Ped Op at Duke that specializes in Glaucoma.  The Ped Op that diagnosed Alex suggested we get a second opinion and we are also hoping the doctor at Duke will be a good fit for us for Alex’s long term care.
We will talk to the Genetic Counselor at Duke over the phone next week to see when we can schedule genetic testing to see if Alex has WAGR Syndrome.  http://www.wagr.org/images/Aniridia_-_The_Genetics.pdf
Alex will need to be tested every 3 months to check for Wilms tumor.  He will also require frequent follow up appointments with a Ped Op to monitor him for the possible ocular conditions he may develop.
He will need to wear sunglasses and a hat while outside due to sensitivity to light.
It is still too early to see what level of vision Alex has.  We will just have to wait and see.  We would appreciate if you can keep Alex and our family in your prayers.
Resources
There is a lot of information on the internet for Aniridia.  I think the most helpful resources have been the United Families of Aniridia group on Facebook and the Vision for Tomorrow website.  If your child is diagnosed with Aniridia, I highly recommend connecting with these groups.