We saw the Neuro-Opthamalogist last Tuesday and now we have a better idea of what is going on with Ethan's eye. He has been diagnosed with Third Cranial Nerve Palsy, which is the nerve that controls his pupil dilation, his eyelid and his eye movement, in, up and down. He still has the use of these three things, but not fully and it is still getting worse. So, what does that mean?
The doctor we met with was excellent. She was really good with Ethan and explained everything to us. She told us that the TCNP can be cause by a virus or head trauma, but in those cases the symptoms would be sudden and complete, meaning you would lose the use of your eye overnight. So that is not the cause with Ethan. Since his has been a gradual loss of those movements, it is likely there is something along the Third Cranial Nerve that is causing it--possibly tiny tumors or lacerations. If there are any tumors, she said they would be benign.
We learned that Ethan still has good vision--20/30 in the right eye and 20/40 in the left--and that he squints or closes his left eye sometimes because he is seeing double. Because he doesn't have the full movement in that eye, when he looks up or down or in, it makes him see double, so he compensates for that by closing it. This symptom seems to be more and more frequent as the days go by.
She looked over the MRI closely and then even took us to her computer and went over it with us. The good thing is that is showed there were no brain tumors pressing on the nerve. But the MRI did show the muscles on Ethan's left eye were a tiny bit thinner that his right, pointing to less usage of that eye. The unfortunate part is that the MRI images are not high-def enough on the third nerve, and the images end about an inch before the nerve does. So she said she needs better imaging to determine what is actually causing Ethan to lose the movements in his left eye. Basically that means another MRI for Ethan. Ugh.
The doctor said she needed to have a "pep talk" with the radiologist at primary children's to see how good of images he can get her. If it's not good enough, she may send us to the U Hospital or IMC. But we'd all rather have them done at Primary because they specialize in sedating children. We are praying for that. I have to call tomorrow to see what the doctor has decided.
So until then, we are just waiting...
It seems that Ethan's condition is not too common. We had the doctor, along with three resident doctors in our room, to check out Ethan. I think it's a rare thing, and they all wanted to see it.
Another thing we discovered prior to going to this appointment, is that these symptoms actually started way back in April, not August, like we thought. We sat down and started going through pictures and there starts to be a slight difference in Ethan's pupil starting in the end of April this year. And a VERY obvious difference by June. Ugh, I feel awful about that. I feel like a horrible parent. But it did also show that his symptoms are definitely progressively getting worse, because it was when his eyes started drifting that I noticed something was wrong. And now he is squinting the left eye quite frequently, and in lots of pictures.
So what is to come? She couldn't say really until she gets better images, but she did say that once his eye stabilizes (stops getting worse) there are surgeries that can be done. We asked if they would remove the tumor if they found one, and she said, "Well, you remove the tumor and you lose the eye." And she also said that sometimes the tumors are so small they can't even see them on the imaging, until 5 years or so down the road. Crazy. We'll see what happens...
**Update: We have another MRI scheduled for Ethan at Primary Children's Hospital. Hopefully this will be the last and will give the doctor the information she needs to determine what is wrong with his third cranial nerve. We would love any prayers offered in Ethan's behalf. :)
On his birthday we surprised him at work with some cookies, a "Thirty things we love about Daddy" book, and the boys in their THIRTY shirts. 
These shirts were my favorite part of his birthday. "Daddy's Biggest Fan," "I love Daddy," and "MY DAD ROCKS," complete with the number thirty on the back. I love T-shirt transfers! I had fun making these!
And for Jake's birthday dinner, we got a babysitter and went out for a date! We went up the canyon to Snobird and ate at El Chanate, a mexican restaurant with patio dining. It was so nice to stare at the beautiful mountains while we ate. We highly recommend it! And we were even lucky enough to get have fried ice cream for dessert! (Or should I say I was lucky enough!) 
