Lively Themes and Designs

The children and families that utilize pediatric cancer centers are typically worried about the diagnosis, the upcoming treatments, and the potential prognosis after treatment. To take their minds off of the situation and let kids be kids as much as possible, most cancer centers are bright and lively, with toys and games in main areas. Even individual rooms may be colorful and have fun drawings and other child-friendly attributes.

Play Therapy

To help kids cope with their feelings and work through complex emotions, some cancer centers integrate creative play with other types of treatment. Doctors and therapists may bring props that will get kids laughing and encourage them to talk about their fears and thoughts. This type of therapy has shown to be effective for some patients.

Cutting Edge Treatments

Most pediatric cancer centers are supported by the Children’s Oncology Groupand the National Cancer Institute. This international network of support allows pediatric cancer centers to have access to some of the most cutting edge research, technology, and clinical trials. For pediatric retinoblastoma patients, this may increase the odds that vision will be retained while also combating the cancer.

A Network of Peers

One of the things that many families of children with pediatric retinoblastoma find most helpful about pediatric cancer centers is the network of peers that the center puts families in touch with. The other children and families present at the center are dealing with many of the same struggles, worries, and issues. It can be reassuring and helpful to have someone to talk to that is going through the same life changes and trying some of the same coping techniques.

While dealing with a pediatric retinoblastoma diagnosis can be tough, having top quality care and support from a pediatric cancer center can improve the prognosis and provide peace of mind.

Obstacles to Eye Care for Low Income Children

An app that can be used to detect pediatric retinoblastoma and other serious eye conditions in children is effective in getting around a few of the obstacles to early detection that children in lower income families face. Transportation issues and doctor visit costs may prevent lower income families from seeing an eye care professional. Since the app is free, parents can use the app to determine whether a trip to a specialist is needed before footing the bill.

About the Retinoblastoma App

The app that can be used to detect pediatric retinoblastoma is called CRADLE. The app works by analyzing pictures in a smartphone and comparing the eyes in the pictures to many other pictures of eyes in order to assess health. The app was developed by a professor named Bryan Shaw after his son received a late diagnosis of pediatric retinoblastoma that cost him an eye.

Smartphone Use and Lower Income Families

According to Pew Research Center, smartphone use among U.S. families earning $30,000 or less per year skyrocketed to 64 percent as of January 2017. Smartphone ownership in developing countries has also been rising quickly, with many countries approaching the same percentages of smartphone owners as developed nations. This widespread and growing smartphone use helps to put apps like CRADLE into the hands of those who need them most.

How the App Can Help the Disadvantaged

In the United States, the cure rate for pediatric retinoblastoma is about 94 percent, but many children in lower income families lose their vision or their eyes due to later detection of the deadly disease. In some developing nations, the cure rate is less than 30 percent. The CRADLE app can help with early detection that can save lives and help to mitigate the need for invasive or intensive treatment that damages eyes and vision.

By using the free app to analyze pictures regularly, parents around the world can spot potential eye problems in very early stages. This can give disadvantaged families the time needed to seek medical treatment, particularly in remote areas where it may not be easy to get to a doctor.

If that doesn’t happen right out of the gate – or even within the first week or so of your child’s birth – don’t get nervous and don’t be afraid. Children’s eyes are not fully developed at the time of birth. However, it’s important that you do everything you can to protect them from environmental factors and take steps to spot potential problems that can reduce their vision.

Get a Second Opinion When You Need to

It’s important to trust your doctors. Your pediatrician will likely provide you with a host of important lessons, tips, and helpful hints to really assist you as new parents in making sure that your children develop just as happy and as healthy as humanly possible. A significant portion of these talks should revolve around protecting and encouraging their eyesight development.

However, if you feel at any point that you might want a second opinion, don’t hesitate to get one. Pediatric retinoblastoma is a highly aggressive disease, and every day counts toward getting the right treatment.

Run Through Critical Tests

Almost immediately after your baby is born, the delivery doctor (and later your pediatrician) is going to put your baby through a battery of relatively simple and noninvasive tests. These tests are going to focus on looking for congenital cataracts or more serious eyesight conditions like neonatal eye problems or pediatric retinoblastoma (a very rare but serious type of children’s eye cancer).

Let your doctor run through these tests but make sure that they keep you informed every step of the way, and trust in their ability to develop appropriate action plans to resolve any issues that may arise.

Follow Up with Regular Eye Tests

Yes, you are going to be exhausted for the first couple of years of your child’s life, but you have to make sure that you don’t miss out on any necessary tests, examinations, or regular checkups. Be sure that development is right on track and that your child’s eyesight and health isn’t at risk.

Regular vision checkups (every three months or so at first, and then twice a year until they are two or three is probably a good baseline) will help you to catch serious issues like pediatric retinoblastoma that can move very quickly and aggressively.

Understand Regular Development Milestones

While infants’ eyesight may develop at different rates, there are some milestones that can be used to benchmark normal development:

• Most newborns have peripheral vision
• Focus of up to three feet develops within the first weeks
• By two months, most babies can focus on and track objects
• Distance vision develops by four months old
• Color vision is usually fully developed by about four months old
• Depth perception, focus, and convergence may continue to develop through age seven

If there are any delays in normal vision development or if issues with the eyes are identified, it is important to see a doctor as soon as possible. Spotting issues and eye conditions may help to preserve your child’s vision and potentially his or her life.

The majority of these cases form in children under 5 years of age, and are caused by irregularities in the development of special retinal cells called retinoblasts. For children like Parker, such a diagnosis is a prescription for months of arduous treatments and surgeries.

Many children may lose an eye to the disease, or tragically lose their battle entirely. As with all cancer cases, early observation and treatment is vital to improving the survival odds of a patient.

The Importance of Screening

In the past, conditions such as pediatric retinoblastoma have all too often slipped by the notice of doctors who have performed only cursory eye exams on children, rather than the scrupulous screenings required to spot many hidden, serious problems. Thankfully, this position is beginning to change as the medical community wakes up to the real risk involved in not carefully screening children for these maladies.

The eye is a very complex and subtle biological machine. It can appear to be working at a very high level, but all the while be masking some kind of serious flaw or defect. Most of the time, these issues will just involve vision problems. On rare occasions, however, they can prove to be a lot more serious.

Regular screening by a trained professional is absolutely vital, especially in the first five years of a child’s life.

Modern Technologies

New medical tools are being developed that can help diagnose illnesses such as retinoblastoma at very early stages, including digital photography tools developed by researchers at Harvard and Baylor Universities. MRI scans, ultrasounds and bone scans can also be used to detect a tumour. If a problem is discovered, there are a number of established treatments and promising clinical techniques to combat a retinoblastoma.

Optometric physicians have all the tools at their disposal to detect this illness early and to start a child on an immediate treatment program. In the modern age, there is no excuse for a child not to receive a comprehensive eye exam from a trained professional, or indeed for that professional not to recognize any potential future problems.

Please note that for the privacy of the client and defendant, personal details of the story have been changed.

A Seemingly Normal Life

Nadia and Omar Koury lived life just like any other family. After the birth of their first child Isaac, they sought out Dr. Griffin, a trusted and recommended pediatrician in Philadelphia. The Kourys took Isaac to all of his scheduled checkups. According to the pediatrician, he was in perfect health.

However, when Isaac was two years and two months old, his parents noticed something that their pediatrician never did.

Isaac’s left eye seemed to be stationary, failing to move or function the way his right eye did. The Kourys took Isaac to Dr. Griffin, who immediately referred them to a pediatric ophthalmologist who specializes in medical and surgical eye issues in children.

That same day, they visited the ophthalmologist, who immediately diagnosed Isaac with pediatric retinoblastoma.

A Devastating Diagnosis

As pediatric retinoblastoma is a very aggressive form of cancer, the tumor took up nearly 75% of Isaac’s left eye. His retina was completely detached, leaving him blind in the affected eye. The tumor had spread to the sclera, or the white part of the eye. The family discussed and debated treatment options with their specialist.

However, the diagnosis came too late: Isaac lost his eye to the cancer.

The Legal Process Begins

Fast forward nearly 10 years, and the Koury family finally found a lawyer who was equipped to take the case. Bill Ruffier and the team at Dellecker, Wilson, King, McKenna, Ruffier, & Sos immediately went to work.

The team discovered photographs of Isaac when he was just 10 months old, showing one of the most telltale signs of pediatric retinoblastoma: leukocoria. In photos taken with a flash, Isaac’s left eye was white, while the other eye was normal.

This revealed that Isaac’s pediatric retinoblastoma was diagnosable by his pediatrician for at least 16 months before he was actually diagnosed.

Failing to Perform the Job

During the deposition, Ruffier asked about the red reflex exams that Dr. Griffin was required to perform during Isaac’s Well Child visits, under requirements by the American Academy of Pediatricians. The requirements stated that the lights in the exam room must be dimmed for the ophthalmoscope to properly detect issues.

When asked why Dr. Griffin failed to dim the lights, he responded with the untrue statement that young children have wide irises, making it unnecessary to dim the lights.

A Lifetime of Challenges

Fortunately, DWKMR&S was able to win the case for the Koury family, successfully proving that Dr. Griffin’s failed to follow his medical obligations, which put Isaac in serious danger and caused him to lose his eye.

Unfortunately, Isaac faces a lifetime of challenges. As a teenager now, he experiences severe shame and embarrassment from his glass eye. When he’s older, he’ll have difficulty performing everyday tasks like driving. He’ll be restricted from a number of careers due to his lack of depth perception.

Today, thanks to the hard work of doctors, volunteers and those dedicated to finding a cure, 4 out of every 5 children diagnosed with cancer will survive 5 or more years. Their commitment and perseverance has almost halved mortality rates of certain cancers, and we are closer every day to finding a cure to the #1 disease-related killer of children in the US. Even if you or a loved one are not directly involved with cancer, there is still a lot you can do this month to help.

What Can You Do?

The good news is that plenty of foundations make raising awareness a simple and enjoyable thing, no matter your age or schedule. We’ve put together a list of some charities dedicated to helping affected children, teens, and their families, so you can get involved.

St. Baldrick’s Foundation

Saint Baldrick’s Foundation is a volunteer organization wholly dedicated to finding a cure for children’s cancer. They have raised over 200 million dollars for cancer research in 27 countries world-wide.

Through their website, you can get involved in your community, find videos to share on social media, leave a donation, or even learn how to start your own fundraiser this September.

The American Childhood Cancer Organization

The American Childhood Cancer Organization (ACCO) is another group leading the way in support for patients and families. You can visit their online shop where you can purchase items to help raise money and awareness, or purchase specially-designed resources geared towards helping those battling cancer themselves. The best thing about the ACCO is that, via their website, you can get involved directly with groups in your local area that fundraise and provide support.

The Children’s Cancer Research Fund

The Children’s Cancer Research Fund is a revolutionary group that has been advancing how pediatric cancer is treated since 1981. Whether it’s your child, a child you know, or even if you want to just get involved, their website is a great resource for practical information on how to help.

With amazing organizations and volunteers working tirelessly, hopefully one day we’ll be able to eradicate childhood cancer for good. So this month, tie on a gold ribbon and help raise awareness for children across the globe. Together we can help find a cure.

Cancer Genetics Advancements

During the 1970s, scientists observed that some forms of cancer are hereditary. However, they weren’t able to explain how some with a family history could remain cancer-free, while others with no family history could be struck by the disease. Dr. Knudson’s work presented the medical community with a breakthrough in understanding the underlying mechanics of cancer genetics. His research has paved the way for a number of subsequent cancer advancements.

Focus on Pediatric Retinoblastoma

To study the conundrum of cancer genetics, Dr. Knudson opted to examine cases of pediatric retinoblastoma. He chose this form of cancer due to the fact it develops early in life, which means that patients are less likely to have experienced possible genetic mutations that adults may experience over their lifetime. He viewed retinoblastoma as a relatively pure form of cancer, and studied and statistically analyzed the two types of retinoblastoma: hereditary and non-hereditary.

Cancer’s “Two-Hit” Hypothesis

In 1971, Dr. Knudson published his world-famous findings on the “two-hit” theory of cancer genetics, also referred to as the Knudson hypothesis or the multiple-hit hypothesis. He theorized that hereditary retinoblastoma patients inherited one or more damaged genes from a parent, which is not enough to result in cancer. However, cancer may develop after a “second hit” to the patient, which may be a DNA defect, radiation exposure, and the like. In non-hereditary retinoblastoma, the patient has healthy parental genes, and therefore must experience two genetic hits.

Later, he used this research to theorize the existence of antioncogenes, or genes that stop cells from becoming cancerous. A decade later, this was confirmed, and they are now known as tumor suppressor genes. As years passed, Dr. Knudson’s work in pediatric retinoblastoma laid groundwork for all types of hereditary cancer. He’s opened the doors for early detection and prevention in individuals with known cancer predispositions.

Knudson’s Accolades

As one of the most renowned researchers of the field, Dr. Knudson has garnered esteem from the world over. In 1998, he received the Lasker Award, which is referred to as the American Nobel Prize. In 2004, he won the Kyoto Prize that recognized him for opening the horizon for cancer genetics and playing a key role in its developments.

Dr. Knudson’s dedication and service continues to garner respect and esteem from the medical community. To learn more about his life and work, visit the American Association for Cancer Research.

In observance of Children’s Eye Health & Safety month, we encourage all parents to set up an eye exam to ensure that there are no potentially dangerous issues that have gone unseen and untreated. Even outside of the eye doctor’s office, there are some simple steps to take to keep eyes safe and healthy.

When to Start Regular Eye Exams

Many parents may think that eye exams are for older children or teenagers. However, the American Optometric Association recommends that regular kids’ eye exams should begin as early as six months of age. This is especially true for children who are considered “at risk” for certain eye conditions. In these cases, more frequent checkups may be recommended by a professional.

These risk factors may include, but are not limited to:

• Family history of retinoblastoma, metabolic or genetic disease, or congenital cataracts
• Prematurity, oxygen issues at birth, or low birth weight
• Maternal infection during pregnancy, such as rubella, herpes, or venereal disease
• High refractive error
• Strabismus, or eye alignment issues such as crossed eyes
• Amblyopia, also known as lazy eye

Common Signs of Vision Problems

Especially in children who are too young to speak and communicate issues, it may be difficult for parents to decipher potential vision issues. This is why it’s important to monitor children and schedule an appointment with a professional when any potential warning signs are observed. These warning signs may include frequent eye-rubbing, squinting when trying to read or see objects, head-tilting or turning when looking at objects, and wandering eyes – to name a few.

Kids’ Eye Safety Tips

Take a look at some safety tips that can help keep your child’s vision in top condition:

• During sports, always use proper protective eyewear
• Ensure that all toys are age-appropriate
• Keep chemicals and sprays out of reach of children
• Practice safe use of items such as pencils, scissors, and rubber bands
• Place pads or cushions on sharp corners around the house
• Use locks on drawers and cabinets within reach of small children

If your child has experienced complications due to retinoblastoma, despite your best efforts to prevent them, call us at 407-244-3000 to discuss your potential legal options.

What Is Leukocoria?

Leukocoria, also called white pupillary reflex, is a white reflection that shows in the retina of the eye. Leukocoria is caused by a number of conditions, such as retinoblastoma, cataracts, retinal detachment, retinal malformation, and more. It resembles “eyeshine,” the phenomenon that occurs in cats and other animals that have an eye structure called tapetum lucidum, which causes the appearance of glowing when photographed with a flash setting on the camera. Because humans lack a tapetum lucidum, a white reflection in the eyes of a photograph is an unusual occurrence that often indicates that something is wrong.

Study Results

In 2013, Harvard University and Baylor University teamed up to study white eyes and pediatric retinoblastoma. They looked at 7,000 photos of children who did and didn’t have the condition. Not only could they use white eye to indicate that the children had a tumor, they could also predict the severity and stage of the condition. The researchers explained that the saturation of the pupil’s reflection changes depending on the tumor’s size.

An Effective Form of Detection

Pediatric retinoblastoma can be difficult to detect and diagnose. Coupled with the need for the condition to be diagnosed and treated as early as possible, it’s important for parents to stay vigilant and ensure that they’re looking out for any signs possible. Fortunately, looking for white eye in photographs has been labeled by researchers as one of the most effective “do-it-yourself” diagnostic techniques for showing signs of the condition. In fact, with this knowledge becoming more widespread, specialists are finding that the majority of pediatric retinoblastoma cases have been initiated by parents spotting leukocoria and scheduling an eye exam for their children.

Early detection is the best protection against the potentially devastating effects of pediatric retinoblastoma. However, for those who feel that their children have suffered unnecessarily due to malpractice, please call us today at 407-244-3000 to discuss your legal options.

Professional Eye Care

InfantSEE, a public health program, is designed to ensure that eye and vision care becomes an essential part of infant wellness care to improve a child’s quality of life. The program offers a free comprehensive infant eye assessment between 6 and 12 months of age as a no-cost public service. The service was developed due to the widespread lack of proper infant eyecare.

New Developments

Two years ago, a new app called White Eye Detector came to market that aids in early detection of eye diseases. The most common sign of pediatric retinoblastoma is a white glow in the center of the eye. Typically, parents are the first to detect the disease through observing the eye’s white appearance through pictures of the child. White Eye Detector is able to scan for white eyes by scanning all your phone’s pictures of your child and detecting “white eye.” Also, with the flashlight feature on, you can hold up the phone to your child’s eyes, and the software will detect “white eye” as the camera hovers near the baby’s face.

Trust Your Gut

Attorney William Ruffier, who specializes in these cases, adds that “another sign parents should look for is strabismus, or crossed eyes. In the cases where I’ve represented children suffering a retinoblastoma, the parents usually commented that they thought something was unusual about their child’s eye. As a parent, trust your gut and seek medical attention for your child.”