A New Vision

A year before they adopted their son, Andrew, from Poland in October 2015, Dana and Michael Parsons learned he had drooping eyelids and strabismus, an eye condition sometimes known as lazy eye where an individual’s eyes do not align correctly. Knowing both conditions were treatable, the Parsons made an appointment to meet with a physician soon after then 4-year-old Andrew came to his Henrico County home.

Much to the Parsons’ surprise, the physician recommended a surgical procedure that had a three-week recovery period and required 24-hour-a-day care. They sought a second opinion from Evan Silverstein, MD, Assistant Professor, Department of Ophthalmology, Children’s Hospital of Richmond at VCU (CHoR), who suggested a less invasive plan to lift Andrew’s drooping eyelids followed by careful observation to determine if his strabismus, which affects two to five percent of children, would correct itself.

“It was a great relief,” recalled Dana of Dr. Silverstein’s recommendations. While she said he did not rule out the possibility of a second surgery, the Parsons appreciated his more conservative approach.

Watching and Waiting

“I consider myself a conservative surgeon,” said Dr. Silverstein. “For patients with strabismus, sometimes glasses can treat the problem while other times an eye patch or careful observation are necessary. When surgery is indicated, however, I recommend it.”

When Dr. Silverstein met Andrew in November 2015, he said, “Andrew’s eyelid droop was pretty severe. He had to tilt his head back to see.”

The Parsons, including their then 6-year-old daughter, Alexandra, gave Andrew some time to settle into his new home before scheduling surgery. On December 14, 2015, Andrew underwent eyelid lift surgery, a same-day procedure that involved making five tiny incisions on each side of his eye to implant small silicone rods in his eyelids and connect them to his forehead muscles. The surgery was successful, and even though Andrew was scared as his anesthesia wore off, a common problem in children, Michael said Andrew felt great the next day.

“The next day was a miracle,” recalled Dana. “He bounced back quickly, and you could instantly see his eyes.”

Soon after surgery, Andrew told his parents he could see better and liked seeing pictures of his eyes. Although Dana was concerned about scarring on his face, within two weeks, and with regular use of anti-scarring cream, she said Andrew was almost healed.

A New Outlook

“Andrew’s control of his strabismus improved significantly after his eyelid surgery,” said Dr. Silverstein, who continues to check Andrew’s progress every six months. “The majority of time his eyes are straight.”

Although strabismus is not life-threatening, if left untreated it can lead to decreased vision in one eye as the body naturally overcompensates to use the other eye. Before the Parsons met Andrew, he wore glasses, but at this point, Dr. Silverstein said he doesn’t need glasses or additional surgeries.

“Andrew’s eye condition is something that was a part of him his whole life,” said Michael. “It didn’t keep him from doing anything he wanted to do.”

Andrew is an energetic kindergartener who loves soccer, baseball, jumping on trampolines and playing school with his sister. Although he was more interested in playing on his iPad than talking with me during a pre-Christmas visit, when I asked him about Dr. Silverstein and his visits to CHoR, his smile and sparkling blue eyes said it all.

“From the first time we met him, Dr. Silverstein made Andrew feel comfortable,” said Dana, who used translation services on her phone during Andrew’s early days with the family. “The hospital staff were very welcoming and always made sure we were comfortable.”

A year after surgery, Andrew continues to have some eyelid drooping and eye wandering, especially when he is tired. However, a reminder from his parents to open his eyes quickly fixes the problem. Michael said the family will continue to follow Dr. Silverstein’s lead regarding next steps for Andrew.

“For a little boy who came from another country, he has acclimated so well,” Dana said. “Dr. Silverstein took our circumstances into play, and the outcome worked out well.”

Photos by Doug Buerlein

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