Six-year old Eastyn Huffman knows what glaucoma is, but she’s not afraid of the condition. Her mom, Brooklyn, has a strong family lineage with hereditary glaucoma on both sides . It’s something she grew up with and has lived with her entire life. Her father, grandfather, aunt and cousins in her immediate family have all been diagnosed with and treated for glaucoma. As it happens, childhood glaucoma has an identified gene and can run in families.
Brooklyn knew that her children would have to be tested early and often because they have a 50% chance of developing glaucoma. She was not surprised two years ago on the day their pediatric ophthalmologist announced that Eastyn’s ocular pressure was above 40. Even at four years old, Eastyn knew what a number higher than 40 meant. At that point, Brooklyn set out to find the best doctor she could, and she found Dr. Tosin Smith of Glaucoma Associates of Texas (GAT).
John Lynn MD and Ron Fellman MD, founders of GAT, worked on a methodology to treat congenital glaucoma and popularized it using a suture to cleave open the congenitally malformed drain for 360 degrees instead of only partially opening the drain with the classic metal instrument of the time. The procedure at that time was called trabeculotomy ab externo, and Doctors Lynn and Fellman improved upon the old method during the early 1980’s by opening the drain all the way around with a suture in a safer and more reliable method. This newer version of trabeculotomy, circumferential trabeculotomy ab externo, was performed on the older generation of Eastyn’s family for treatment of childhood glaucoma.
Dr. David Godfrey operated on Eastyn’s aunt, April Skeet, about 20 years ago. Within the last few years, Dr. Smith operated on both Eastyn and her cousin, Eli.
The improved approach glaucoma procedure called a GATT (Gonioscopy Assisted Transluminal Trabeculotomy) performed on Eastyn was an even newer form of the trabeculotomy ab externo that her relatives had at GAT many years ago. The doctors at GAT invented a way to open the defective canal with a suture, again all the way around the eye, but even less invasively with only two small incisions in the cornea (ab interno) compared to the older ab externo which required incisions in the white part of eye (sclera). The GATT is now used to treat patients worldwide, both children and adults, in a very affordable, safe manner.
When Eastyn initially saw Dr. Smith as a patient, the first thing she asked was “Do you know my cousin, Eli?” Indeed, Dr. Smith knew Eli, his mother and his father – all as patients of the practice. Eastyn was thrilled that her new doctor was the same one her cousin saw! She was instructed to be calm and still during the examination so that Dr. Smith could see the butterflies at the back of Eastyn’s eyes. After trying eye drops for about a month, this treatment proved to be unsuccessful in improving her eye pressure. Eastyn underwent surgery for glaucoma at the age of four, with Dr. Smith operating on both eyes at the same time.
Eastyn’s recovery was a little scary because she awoke with patches covering both of her eyes, so she was not able to see anything. She was soon able to transition to a shield with pinholes on one eye and full patches only at night. She stayed home from school for three weeks and was then released to low activity levels for about six weeks. Since then, Eastyn has maintained normal activity levels of a typical six-year-old. She continues to get regular checkups to monitor any changes in her eye health.
Eastyn doesn’t completely understand what takes place with glaucoma, but she knows what normal and abnormal pressures are and what those numbers mean. She is as active as any child and plays softball, basketball and swims. One of Eastyn’s many talents is playing piano. Currently, her favorite piece of music is “When I am Older,” which is performed by the character Olaf in the movie Frozen 2 .
Eastyn understands that Dr. Smith helped save her eyesight. She remembers that Dr. Smith has always helped her feel safe and calm. Eastyn knew that Dr. Smith liked seeing those butterflies, so she presented Dr. Smith with a beautiful butterfly painting that still hangs in her office today.
If Eastyn met another little boy or girl who was facing glaucoma, she would tell them that it’s okay to be scared, but everything will be just fine. Brooklyn would tell another child’s parent that people don’t realize how fast glaucoma can appear and advance and that you must act quickly. Find a place you can trust, where the doctors care deeply for children. Brooklyn is grateful to Glaucoma Associates of Texas and Dr. Smith for such skilled medical care and compassion.