about 1% of kids with odin’s history of retinopathy of prematurity have a "late" vitreous hemorrhage and the vast majority of those 1% have associated retinal detachment or retinal tears or whatnot that require surgery to repair. certainly the eye doesn’t fill up with blood without something significant bursting or tearing, right?

that’s the conventional wisdom and it’s usually correct. except when it’s not.

that’s right, after a long drive to have odin see one of the world’s experts, we were very suprised and pleased to learn after he performed the exam under anesthesia that odin is the one of the very rare 1 percent of 1 percenters who have a hemorrhage with no associated retinal damage!

in fact, dr. capone said that odin’s eye’s looked remarkably healthy and while he couldn’t guarantee that odin would never have another hemorrhage, he really thought we should continue to treat him like any other boy and not curtail any activities he might enjoy – even hockey.

so, how did his eye fill with blood? when odin had his rop surgery he had over 1,500 blood vessels "burned" or ablated in each retina. "normally", each one of those burned blood vessels leaves residual scar tissue, sort-of like a dead bush hanging off the retina and those "dead bushes" get pulled by the eye’s jelly, or vitreous, as the retina grows. eventually, the torsion caused by the "bushes" getting pulled by the vitreous causes a tear or detachment.

in odin’s case, he’s very lucky because for whatever reason, he doesn’t have very fibrous scar tissue – meaning the dead bushes aren’t very large and don’t provide much surface area for the vitrous to pull against. but even though they aren’t very "bushy" each one of the 3,000 dead bushes on his retinas does have a live artery behind it, and in all likelihood one of those arteries simply popped off the scar tissue causing the hemorrhage.

as an aside, odin continued to amaze us and everyone around him with his grace and good humor under difficult circumstances. we sat in a pre-op room for 5 hours(!) while the doctor was delayed in surgery, which meant that odin didn’t eat or drink anything for almost 24 hours. he sat through the 4 rounds of stinging dilation drops on an empty stomach and didn’t complain a bit other than to tell us matter-of-factly that he was quite hungry. and when we practiced breathing through the face mask that was going to help him take a nap, he didn’t express a bit of fear or apprehension. when dr. capone came out to talk with us, he commented on how remarkable a young boy he was – so observant and verbal and serene.

he paused and said simply, "he gets it."

indeed.