Article Date: 12/1/2000

It's not uncommon to find ourselves feeling sorry for people who have very little. However, do we really know what "very little" is? Often, we look at a person's financial situation to make this assessment. However, I had a patient recently who had more than most children his age, despite his family's financial woes. A patient like A.J. is a reminder to us all of how valuable determination and family support can be.

Family support

When A.J. first came into my office for an exam, he was 12 years old. His school had referred him to me because his teachers were concerned that he couldn't see the blackboard. His clothes were worn, and the knees on his jeans had been patched more than a few times. A.J. was small for his age, almost fragile looking, which made him seem younger than he was. He and his family lived in the neighboring town; however, getting A.J. to my office for his eye exam was still a difficult task. His parents had no transportation, so A.J. had to take the bus. The trip took him about 2 hours because he needed to catch several different buses.

Because his parents needed to save money for A.J. to take the bus, it was usually several weeks between follow-up exams. Sometimes his brother escorted him; sometimes his parents did. Either way, it meant they had to take time off from work � a hard hit for a family already struggling financially. No one ever seemed to mind though.

From the first time I met A.J.'s family, I could see that they truly loved and supported him. I think they were as excited about correcting his vision as A.J. and I were.

Making it work

During A.J.'s first exam, I could tell right away that he had severe microphthalmia in his left eye. The aperture size was 5 mm � so small you could barely see his eye � while his right eye aperture was normal. Also, he had scar tissue in his left eye, which he was probably born with. The parents indicated he'd always had this problem and couldn't recall a childhood injury.

A.J.'s right eye was a low correction at -0.25D, but his left eye had a high correction at -4.00D with cylinder of -3.25D. He had to use contact lenses of some kind because he'd have no binocular vision with glasses because of his left eye's condition.

I started him off with soft contact lenses. However, they didn't work because of the problem with his left eye. So, I tried rigid gas permeable lenses next. I started with an 8.8 diameter for both eyes, but then lowered the diameter for the left eye to 8.4. The smaller diameter for the left eye would help A.J. insert the lens.

Determination wins

It took a while for A.J. to adjust to his lenses, but his determination to make them work was an inspiration to us all. So many times, he left my office crying with the frustration of not being able to get them in. But instead of giving up or lashing out, he was always very appreciative of everyone's help. After every visit, he always made a point of giving me a hug before leaving.

A.J. finally became a real pro at putting his lenses in. He's still wearing them. Most importantly, his vision is corrected so that he can see the blackboard and has useable binocular vision. His family still brings him to me for his exams, and I can't help but think of how fortunate he is to have the greatest gift of all � his family's love and a determination that just won't quit.

DO YOU HAVE A MEMORABLE EXPERIENCE YOU'D LIKE TO SHARE? Contact Tobin E. Sharp at (215) 643-8127 or, so we can talk about getting your story published.

Optometric Management, Issue: December 2000