Luke's Appointment 6-25

Luke was the only one to have an EUA today.  The other boys are in pretty good shape following their enucleations.  Luke's Left Eye has been a concern, as the retina appeared at last visit to have very little blood supply.

First thing this morning, they did a VEP (Visual Evoked Potential) test.  This test measures the electrical activity. When light from an image enters the eye, it is converted into electrical energy at the retina and travels through the optic nerve to the brain which processes vision. The VEP test measures the strength of the signal reaching your brain and how fast it gets there.  This was done by applying some sensory pads to Luke, and then projecting black and white patterns on a screen.  At one point they also turned off all the lights and had a blinking strobe light going.  I assume this was to detect if he had sensitivity to light.

The results from the VEP test are that he doesn't have visual response in his Left Eye.  He does have a little bit of reaction from that eye when lights flash.  Meaning, he can sense a little light, but not process images.



Luke ready for his VEP test.

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Luke was then taken for his EUA.  The concern for today was they noticed some "bubbles" a few weeks ago.  They weren't sure if they were in fact 'bubbles' from the vitrectomy, or if they were cancer seeds.  The good news is it was determined they are in fact bubbles.  There is no immediate cancer threat in this eye today.  This is the great news.

The other things determined today were that Luke's retina is likely dead.  The negative to this is, the vision is gone, but we already knew this.  The positive to this is, with the retina being dead the layer that produces the cancer tumors might also be dead.  This isn't confirmed yet, and they will have to watch Luke very closely in coming weeks/months to make sure tumors don't appear.

In that his Left Eye has no visual response, this eye will begin to turn inwards.  The optic nerve will likely get weaker.  When the eyes aren't aligned, this is called 'strabismus'.  It will mean that Luke will require surgeries to keep his eyes aligned.  In the beginning, the surgery will move his eye out a little.  Later on, the surgery will bring his eye back in as it will start to wander out.  It is common for people with 'strabismus' to patch the good eye, thus strengthening the muscles in the weak eye.  This won't be the case for Luke, because he doesn't have vision in the weak eye.  The patching wouldn't help him.

As Leslie and Richard prepared for this appointment, they knew it was likely they were looking at another enucleation.

After Dr. Gallie looked at everything, her opinion is to keep his eye for now.  Reasons being:
*  There is no immediate cancer concern.
*  If the layer that grows tumors is dead, he may not get more cancer in this eye.
*  The real eye will have better movement later on.
*  The real eye will be less prone to infection than a prosthetic.

Negatives are - it will require surgery.  And, there is a chance later that if cancer does appear in this eye, it would be better to enucleate.  So, it's not as 'final' as an enucleation would be.

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Luke's Right Eye had one small, older tumor that showed a little activity.  Therefore they did the cryo (freezing) treatment on it.  Other than that, no new tumors in either eye for Luke.  !

Sweet Luke