Wednesday, September 5, 2012

My Daughter's Eyes

My daughter is beautiful. I know you think that I am biased just because I am her mother. While there may be some truth to that, the reality is that she is beautiful. I can claim no magical alignment of genes from my husband and me, as she is adopted. I can only imagine that her Chinese birth parents are both very good looking. I wish they could see their beautiful creation.

She was not a beautiful newborn. Indeed, few newborn babies are. But, now at nearly three years of age, she has grown into a beautiful young girl. She is tall and well-proportioned. She has long dark hair with an auburn hint when the sun shines on it. She has smooth glowing skin. Her lovely round face is accented by the perfect button nose, glossy lips, and dark smiling eyes.

almost 3 years old

Yet beauty is not comprised completely of perfect features. The secret to beauty is in the abnormalities that enhance the perfection and thus create something unique. My daughter is not perfect. She has a scar over her tailbone from the removal of a benign tumor when she was one month old. Her skin is prone to eczema and breaks out in little red bumpy rashes from the heat, the pool, the dry air, you name it. And one of her lovely eyes crosses inward.

I first thought that I noticed something was not quite right with her eyes when we received photos from around eight months of age. It really was barely noticeable and no one else seemed to see it. In the complex mess of paperwork and packing to go to China to meet our daughter, the vague concern about her eyes receded to the back of my mind. In a hotel meeting room in Beijing on the eve of “Gotcha Day,” we were handed a red silk fabric covered notebook with everything the adoption agency considered necessary for us to know before meeting our child. Upon opening the notebook and discovering a packet of new photos of our daughter, the rest of the information was deemed completely irrelevant and quickly ignored. Once again, I noticed her eyes, but thought that I was being paranoid and just searching for any sign of an undisclosed medical issue. I pushed the thought aside and absorbed the beauty of this child who was my daughter and would be in my arms in less than twenty-four hours. And once she was, we spent every moment of the next few months just trying to figure out how to meet her immediate needs. We were new to the whole parenting gig and had a lot to learn.

about 8 months old
11 (almost 12) months old

The first year of parenthood went by like a flash. Our daughter had plenty of doctor appointments during that year, catching up with all the necessary vaccinations and having her blood drawn to test for any signs that the teratoma she was born with would grow back. Thankfully, it did not and her development was right on track. Soon, friends started to comment on her eye. I had noticed it crossing more and more over the course of the year and had resolved that I would ask her pediatrician about it at her next annual appointment. After all, she did not show any signs that she could not see well or that it bothered her. A chance meeting encouraged me to make an earlier appointment with a pediatric opthalmologist.

The opthalmologist’s exams revealed that her left eye was indeed crossing inward, a type of strabismus called esotropia, and that her vision in that eye was weaker than in her right eye. He explained that, for a variety of possible reasons, her brain had selected to primarily use the right eye, especially for near focus, thus causing a “disconnect” between the left eye and the brain, called amblyopia. She was farsighted, not extremely, but more so than the average two year old. He prescribed glasses to correct the farsightedness and physically patching over the right eye a couple of hours daily to force the brain to use the weaker left eye and improve vision in that eye. At the three-month and six-month follow up appointments, the ophthalmologist noted improved vision in her left eye but no improvement in the crossing; although now the right eye was crossing almost as frequently as the left which indicated that the brain was reconnecting with that eye, a positive result from the patching. He discussed the possibility of eye muscle surgery and increased patching to achieve the best possible vision in the left eye beforehand. At the nine-month appointment, surgery was recommended.

A second opinion by another pediatric ophthalmologist at the Elks Children’s Eye Clinic, part of the Casey Eye Clinic at OHSU in Portland, Oregon, confirms the recommendation of eye muscle surgery to correct the crossing. Unfortunately, the type of strabismus my daughter has often requires repeat surgeries over the years. Also unfortunately (and this is the part where I wish I could go back in time and make myself heed my maternal instincts), apparently the brain becomes pretty “hard-wired” to the eyes by the age of two years, so although surgery will correct the crossing of the eyes, it is unlikely to improve her ability to use the eyes together to achieve good depth perception, or binocular vision. The good news is that the brain and eyes adapt to poor depth perception by using other visual and sensory clues; and her beautiful eyes will be straight and should track together more often. Vision tests from this appointment indicate that her vision is actually now better without her glasses and that since both eyes are able to fixate and hold focus on an object equally (but not together), we can back off on the patching to just a couple of days a week. We will miss seeing how cute she is with her glasses, but we will not miss the patching as the adhesive from the patch aggravates her sensitive skin.

I do not like the idea of having my daughter undergo any type of surgery, but I want to do what is right and best for her. I am reassured by the second opinion and by having the surgery done by a surgical team that is dedicated to working just with children. I will update this post in November, pre- and post-surgery.

My daughter is not perfect, but she is perfectly beautiful. I want her to see this too, with her heart and with her eyes.


  1. Save this so you can share it with Ellie a some future, more meaningful, date. It is very, very expressive. I am so very proud of you. Dad.

  2. This is a priceless, heartfelt account, Heather. It makes me want to quote one of my mantras--a sentence at the conclusion of E. M. Forster's novel Howards End: "Nothing has been done wrong." You and Eric are meant to have and care for the beautiful Ellie. The three of you will navigate this bump in the road with grace and love.