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t m c » p u l s e | j u n e 2 0 1 5 9 A drianna salutes the judges' table and mounts the balance beam. She pauses briefly to raise both hands before beginning a series of judiciously rehearsed cartwheels and handstands, executing each until she hears the punctuated thump of a perfect landing. Amid cheers, her gaze shifts once more to the judges' table and she smiles, though she can barely make out their faces. Diagnosed with congenital glaucoma as an infant, Adrianna, who is now 12 years old, is legally blind. "We could tell something was wrong really early on," recalled Asha Kenebrew, Adrianna's mother. "She was so sensitive to light. Her eyes would water a lot, and she was very uncom- fortable whenever we took her outside. When I voiced these concerns to her pediatrician, I remember she checked her eyes three different times and then told us to go straight over to Texas Children's Hospital, that there was a pediatric ophthalmologist waiting for us there. They determined that night that she had glaucoma." A rare disease of the eye affecting children at birth, congenital glaucoma is characterized by abnormally high intraocular pressure, or pressure within the eye. The disease originates from an imbalance in the mechanisms responsi- ble for circulation; in a healthy eye, fluid flows in and out through a network of cells and tissues, but with glaucoma, the fluid does not drain properly, causing pressure to accumulate. The buildup of pressure often causes permanent damage to the optic nerve, resulting in varying degrees of vision impairment. Symptoms of the disease include photophobia, or light sensitivity, exces- sive tearing, and involuntary closure of the eyelids, known as blepharospasm. If diagnosed and treated early, congen- ital glaucoma does not always lead to vision impairment, and many pediatric patients will not experience lasting symptoms. If suspected, parents should contact their pediatrician immediately so any pressure inside the eye can be relieved as soon as possible. Despite detecting her glaucoma at just four months old, Adrianna's disease has been aggressive and difficult to treat. As an infant, she underwent multiple surgeries to relieve the intraocular pressure and has since completed numerous additional procedures including shunt implants and various incisions designed to drain the excess fluid from her eyes. She has subsequently developed cataracts, had an additional surgery as a result, and follows extensive maintenance and treatment guidelines including the use of three different eye drops, twice a day. Just this past October, after an unexpected further deterioration in her sight, she underwent a laser procedure to help suppress her eyes' fluid production. "She's responded very well to this last surgery and her vision is definitely better than before, but there was a long healing time associated with it," said Kenebrew. "The crazy thing is, Adrianna, who was diagnosed with congenital glaucoma as an infant, practices gymnastics at the Texas Academy of Acrobatics and Gymnastics. Going for Gold She's a 12-year-old Olympic hopeful—oh, and she's legally blind She's an inspiration. Everyone has deficits, and it doesn't matter what they are, you just have to learn to work with the things you have been given, and she's done a great job of that. — KIMBERLY G. YEN, M.D. Pediatric Ophthalmologist at Texas Children's Hospital and Associate Professor of Ophthalmology and Pediatrics at Baylor College of Medicine B y A l e x a n d r a B e c k e r throughout all of this, she hasn't let any- thing get in the way of her gymnastics. After the laser procedure, she was using dilating drops for a month, but even with her eyes dilated she still competed and went to her state qualifier meet." Of course, Adrianna's persistence was no surprise to her parents. At just four years old, she already knew she wanted to be a gymnast after watching competitions on television. She begged her mother for lessons, and a few short years later found herself in her very first gymnastics class at the Texas Academy of Acrobatics and Gymnastics.