On Nov. 4, 2019, Brianne Carpenter rested in her hospital bed at Spectrum Health Butterworth Hospital.
She felt exhausted.
She had labored 30 hours to bring her baby into the world, and now she looked on as her newborn son underwent the usual tests for infants.
Slowly, her anxiety inched up.
“I was in a postpartum haze,” Carpenter, 36, said. “Sam was a healthy 8 pounds, 6 ounces at birth. I ended up having a C-section. But when they did all the tests, something was wrong with Sam’s right eye.”
Dr. Geddie trained the light onto the baby’s left eye, eliciting a red glow, a healthy reflection of the retina.
In the right eye, nothing.
“Sam had a congenital cataract of the right eye, blocking the light reflex and also his vision,” Dr. Geddie said. “He would need to undergo an outpatient procedure to remove the lens of his eye to improve his sight.”
Cataracts and their management are different in children compared to adults, Dr. Geddie said. The eye is still growing, the lens substance isn’t as solidified, and visual development is still occurring.
“He will need to wear a contact lens until he is old enough for a lens implant, and an eye patch over his good eye for a period every day, so that his right eye vision can develop,” Dr. Geddie said.
A different view
Carpenter, a new mother, remembers bursting into tears at the news.
“At first, when I heard Dr. Geddie say he would need to wear a special contact lens and eye patch until he was 8 or 10, I thought 8 or 10 months. Not years, months,” she said.
Carpenter felt overwhelmed. There would be much to handle, even as her own body healed.
“I couldn’t imagine how we were to keep a baby from pulling off a patch for years,” she said.
On Dec. 19, at 6 weeks old, Sam underwent his first surgery.
“A procedure like this is more involved with an infant than with an adult,” Dr. Geddie said. “It requires general anesthesia and specialized equipment and skill.”
The surgery is done through two 1-millimeter incisions using tiny instruments under a microscope, carefully removing the lens of the eye while leaving the necessary support for the planned lens implant when the infant is older.
Sam’s procedure was a success.
After surgery, parents play a big role in the outcome.
Carpenter and her husband, Adam Pepper, were wholly committed to meeting the challenges. They wanted to ensure their baby boy would someday see with both eyes.
“But it was really scary,” Carpenter said. “The thought of putting our fingers in a baby’s eye was really daunting. Everyone was so patient and kind with us, showing us how to do things and showing us videos.”
Sam’s parents quickly mastered the contact lens insertion and removal, the required postoperative drops and, next, the patch.
The eye patch became a normal part of Sam’s life.
“He didn’t mess with it,” Carpenter said. “Actually, this whole process became fascinating to me.
“If at first I wondered how could doctors possibly test a non-verbal child who couldn’t read an eye chart, I would soon learn all the tools, tricks and toys they would use to test his vision. They would wiggle a puppet to see if he would focus on it. They would use lights.”
A favorite doctor
Sam underwent regular eye appointments, in the beginning visiting Dr. Geddie’s office weekly for a test.
As he grew, he came to look forward to those meetings.
“Sam is a very smart little guy,” Dr. Geddie said. “At first, we were matching pictures and symbols to test his vision. But it soon became apparent that he was ahead of the game. By the time he was 13 months old, he knew all his letters.”
His first few years coincided with the COVID-19 pandemic, which meant Sam saw few adults other than his mom and dad, and his grandma who babysat him while his mom went to work as a health tech writer.
But Dr. Geddie, too, became a big part of his life.
“He loves Dr. Geddie,” Carpenter laughed. “When someone else came into the doctor’s office first, he would look up and say, ‘That’s not Dr. Geddie!’ She was his main event.”
Dr. Geddie smiled at the thought of little Sam.
“Sam will be my next recruit,” she said. “When he comes in, he likes to name all the equipment. And he knows all of them.”
There’s the retinoscope. The indirect ophthalmoscope. The slit lamp. The tonometer.
“One day, this kid is going to be an ophthalmologist,” she said.
“When will you use the indirect ophthalmoscope, Dr. Geddie?” Sam asked during a recent visit, his face bright with anticipation.
His excitement for his eye exams makes for such a fun interaction.
And now, with his glasses, along with the contact lens on his right eye—and thanks to the dedication of his parents with patching—he has 20/20 vision. His prognosis is excellent.
On Jan. 20, 2022, Sam had another outpatient procedure on his eye.
“Even with the eye patch on for four hours each day, it seemed Sam’s brain was still focusing too much on his good eye and using that one,” Carpenter said. “His other eye began turning in, so this surgery corrected that.”
Eye misalignment is very common for children with cataracts as infants.
Carpenter thought for a moment, recalling the experience of her son’s surgery.
“I worried over that last surgery that he might get scared,” she said. “The Child Life specialist at Helen DeVos (Children’s Hospital) came in first to prepare him, then Dr. Geddie.”
On the day of the procedure, Sam looked ready, but Carpenter felt nervous as the team whisked him away.
“But Dr. Geddie later told me he was chatting the whole time, counting the lights down the hall, talking about the equipment, until he went to sleep,” Carpenter said. “This hasn’t meant suffering for Sam. He thinks it’s fun to come to the hospital. The care here has been incredible. Trust has diminished our anxiety.”
Sam is now learning a new set of words: baby, crib, bottle, diaper.
That’s because he’s now focusing his happy gaze on something quite exciting.
A brand-new sister, born in April.
There will be so many words to teach her—and so many things to see.