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Though they live in Guatemala City, it seems the Morales family was destined to find pediatric ophthalmologist Monte Del Monte, M.D., almost 2000 miles away. When Sergio Morales learned that his daughter had inherited a rare eye disorder, he began to search for a surgeon who could help. There was no such specialist in his country, so he turned to Washington D.C., where, as it turned out, one of Dr. Del Monte's mentors had treated Mr. Morales for the same disorder in 1985.
When the Washington hospital was not able to help, Mr. Morales continued his search and learned that an American physician had come to Guatemala in 2007 as part of a medical mission trip. The physician, Dr. Del Monte, had helped a little boy by performing the very same rare surgical procedure that his daughter now needed.
Both Mr. Morales and his daughter, Carmen, have congenital fibrosis of the extraocular muscles, a syndrome that affects ocular motor nerves as well as muscles surrounding the eyes. As a result, those affected have very limited eye movement, their eyes pulled into far downgaze while the head is positioned straight ahead. These patients tend to develop strabismus (misaligned eyes). Before their surgeries, Mr. Morales and Carmen could achieve partial vision only by tilting their heads far backward to peer through a narrow slit. "The position is abnormal and very uncomfortable," said Mr. Morales, who had two surgeries when he was 6 and 7 years of age, performed by Marshall M. Parks, M.D., the mentor to Dr. Del Monte.
Mr. Morales sent photos of Carmen, not quite two years old, to Dr. Del Monte, the Skillman Professor of Pediatric Ophthalmology, who generously waived his surgical fee. In May 2009, the family came to the Kellogg Eye Center in Ann Arbor, where Dr. Del Monte performed surgery to release and loosen the fibrotic and severely restricted inferior eye muscles on both eyes. This allowed Carmen's eyes, for the first time, to look straight ahead.
Two days after the procedure, Dr. Del Monte was pleased with the results. "Carmen's head position is much straighter, and so her motor skills are much better, and more natural, too," he told Mr. and Mrs. Morales. "Her right eye is wandering a bit, so Carmen will need patching to force that eye to work by itself." He gave the Morales family instructions that they could share with their Guatemalan ophthalmologist back home. Dr. Del Monte also suggested that Carmen return for a second procedure to further tighten the upper eye muscles and further elevate her eyes, "something new" since her father had his surgery.
As they said good-by, Mr. and Mrs. Morales expressed their gratitude for Dr. Del Monte's medical care and his kindness. Said Mrs. Morales, "We thank you and tell you in our heart how happy we feel."
For more information, see the Pediatric Ophthalmology Service at the Kellogg Eye Center.
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