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Lifting of the dark cloud
Pediatric cataract surgery restores vision to toddler sisters
  • Shekedra Evans (center) with her cataract-free daughters Amelia (left) and Sasha. PHOTOS: DR. ANTONI GUERRERO

  • Sasha Evans’ eyes prior to surgery.

  • Sasha Evans.

  • Amelia Evans

Chakara Bennett
Guardian Lifestyles Reporter
chakara@nasguard.com

Published: Jun 05, 2012

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Sight — a sense that many people take for granted — that is until they lose it. But for sisters Amelia and Sasha Evans, a sense of sight was something their mother Shekedra Evans thought they would never enjoy. Amelia, 3, and Sasha, 2, were diagnosed with congenital bilateral cataracts and micro-cornea (one eye is larger that the other) within weeks of their respective births.

A cataract is a cloudy obstruction that develops on the lens of the eye. It can be a slight cloudiness to complete opacity, in which a person suffering with it can see shadows, colors, shapes blurrily or, in some cases, not at all. If untreated, it often can lead to blindness. This is particularly true for young children who need proper light stimulation to develop their ability to see according to Dr. Antonio Guerrero, a cataract, glaucoma and opthalmic laser specialist in microsurgery of the eye who has an office at St. Luke’s Medical Centre on Collins Avenue.

The 27-year-old single mother with two older sons was devastated when Amelia was diagnosed.

“It was devastating... and I didn’t know what to do,” said Evans. She was advised to take Amelia to a specialist at a top eye institute in the United States for the eyesight-saving surgery.  She was glad something could be done for her child, but the price tag was pegged at $40,000 per child. Evans could not afford it.

“I was in a tough spot because I didn’t want my daughter to lose her vision at the age of two years old but I didn’t have the money to proceed,” she said.

As Evans struggled to find a way to get treatment for Amelia, she gave birth to Sasha who was also diagnosed with the same eye disease. The mother said she felt as if her world caved in on her, with two toddlers faced with blindness.

“I was distraught and utterly heartbroken with the news. I already couldn’t afford to send Amelia for treatment and Sasha looked like she would need it as well. I didn’t know where the money would come from and every ophthalmologist I spoke to said the operation wasn’t possible locally. I was very depressed in those times and all I could do was pray and hope.”

The mother’s prayers were answered when she met Dr. Guerrero. The doctor opted to treat Amelia first, because her need for medical intervention was greater due her age at that time.

“[Children’s] eyes will need to learn to communicate with the brain. And they longer you wait, the fewer connections there are likely to be between the eye and the brain. This will mean the eye will develop aesthetically, but it will not functionally. This is why operating on Amelia was more important than Sasha who was still younger and could wait another few months before the age I would recommend she undergo the procedure,” he said.

Ideally, according to Dr. Guerrero, pediatric cataracts should be operated on before a child is five years old. He said the preferred age is before the child reaches his/her first birthday, but that the surgery can be done sooner, depending on the severity of the child’s visual condition. He said the procedure is usually not done on newborns, even if the cataracts are present because the chances of them waking up from general anesthesia is cause for concern.

Within weeks after the July 2010 surgery to replace the lens in Amelia’s eyes and clear up the cataract, Amelia was like a new person according to her mother.

Dr. Guerrero operated on Sasha in May 2012.

Evans who said she had put away dreams she had for her daughters said after the successful surgeries, she had revived dreams she had for both of her daughters.

“The best part of all of this not just that the operation was done locally, and for free, but that my girls have endless possibilities now. They are so lively and happy. I still can’t believe how wonderful everything turned out,” she said.

According to Dr. Guerrero, cataracts can develop due to a number of reasons. Some people are born with them — they are then referred to as congenital cataracts, which can be attributed to genetics if there are other members of the family who suffer from visual problems. For others, particularly older people, cataracts are a part of aging or are the result of chronic ailments like diabetes or hypertension. Cataracts can form after an injury as well.

In Amelia and Sasha’s case, the doctor said their grandmother and another relative, suffered from visual problems. He said the girls’ cataracts could be hereditary, but that more studies needed to be done to make that determination. Both little girls also suffered from microcornea, a condition in which one cornea of the eye is larger than the other.

“When you think of cataracts, it may be something that [people think] only old people have, but this is not so, as there are people who develop it at different points in life — or in the case of Sasha and Amelia, they are born with it,” said the doctor.

Dr. Guerrero, who has been practicing in The Bahamas since 1995, said it is an unpredictable operation to remove cataracts from a child and that the surgery is different than that for removing cataracts from an adult.

He said when he operates on an adult it will be done in no time and the results are usually the same — that there is no bleeding or pain associated with the procedure and many patients opt to drive themselves home even. But with pediatric patients he said it’s more difficult due to their still developing vision, and that if the surgery is not done correctly or in time, that it will affect their vision forever.

“In Sasha and Amelia’s cases it was an interesting procedure. Amelia’s cataracts were thick and I was just praying that she would get some vision — if at all, especially due to her age and lack of treatment. There wasn’t an immediate result for her and it took a while to determine that she could see. I knew that all was well when she returned a week later for her checkup and [she] was pushing her stroller around and avoiding people in the crowded waiting room. I was amazed,” said Dr. Guerrero.

The doctor said he had the most trepidation when it came to Sasha’s surgery. Although she and her sister shared a similar visual condition, he said that Sasha’s was a lot worse. Her cataracts were thicker and spread across her eyes like tentacles. The doctor said it was a delicate procedure that he prayed would come out well.

“No matter how much experience you have, the simplest of surgeries can become difficult in a flash — and no matter how much you prepare you still know it is only God who will guide you through what you are doing. But it was all worthwhile and Sasha’s surgery went well. In fact her results were more instantaneous than [Amelia]. After [Sasha’s] surgery she could immediately see and was smiling and laughing for the first time since I had seen her. She was looking around and pointing. It was amazing. Since then I’ve continued to see the sisters and both of their vision seems to be getting stronger and sharper. I am happy about it especially since this is something that was done locally for a family who needed it,” he said.

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