Teen Shifts from Learning Braille to Driving a Car
URMC ophthalmologists, rheumatologist collaborate to restore boy’s vision
August 27, 2013
Dan Krenzer began learning Braille in third grade because eye disease degraded his vision. Legally blind, he could only see shapes and colors.
Matthew Gearinger, M.D., pediatric ophthalmologist
A team of doctors at the University of Rochester Medical Center successfully reversed the problem, restored his sight and gave the 16-year-old a green light to hit the road. Now he is maneuvering K-turns and parallel-parking under the watchful eye of his parents, Ed and Denise Krenzer of Henrietta.
“I’ve always thought about driving – who doesn’t,” said Dan, a junior at Rush-Henrietta schools.”I wanted to just immediately get in a car as soon as I turned 16.”
Doctors at the Flaum Eye Institute and Golisano Children’s Hospital, who collaborated to manage his care, are thrilled with his success and look forward to him passing his driver’s test.
Yousuf Khalifa, M.D., uveitis and corneal specialist
“Learning to drive is a wonderful step forward and we’re all proud to have contributed to Dan’s success,” said Matthew Gearinger, M.D., pediatric ophthalmologist at URMC’s Flaum Eye Institute.
Dan has an inflammatory eye disease called uveitis, which hit hard and caused serious complications – cataracts, glaucoma, and retinal and corneal problems. According to the National Eye Institute, uveitis affects about 280,000 people and causes 15 percent of blindness in the U.S. each year. While the disease is rare in children, it can be associated with systemic inflammatory diseases, such as juvenile idiopathic arthritis.
Gearinger has cared for Dan for the past decade, along with ophthalmologists Yousuf Khalifa, M.D., and Mina Chung, M.D., and pediatric rheumatologist David Siegel, M.D., M.P.H. The collaborative team stabilized and improved his vision to 20/25. Dan still wears glasses and takes medications, but he is in the driver’s seat.
David Siegel, M.D., M.P.H., pediatric rheumatologist
“It’s fantastic that he was able to get a driver’s permit and achieve this milestone that matters so much to teenagers,” said Khalifa, an uveitis, cataract and cornea specialist who joined the Flaum Eye Institute in 2010.
Vision problems were first detected when Dan was 6 years old. One eye was turning inward and he “failed miserably” at a vision exam, according to Denise Krenzer. She took her son to the Flaum Eye Institute, expecting to purchase eyeglasses since most of her daughters are near-sighted.
The diagnosis of uveitis surprised the parents and led to immediate treatment and an appointment with Siegel, the rheumatologist. Concerned about the gravity of the situation, the family began “quite a journey with Dan,” said Ed Krenzer
“I never really thought about him possibly going blind until we went to Boston for a second opinion and they laid it out for us,” he said. “The good thing is they confirmed everything our doctors here in Rochester were doing was exactly what they’d do and we were confident that we were getting great care.”
Standard treatments of steroid eye drops didn’t keep the disease at bay for Dan. A visit to Siegel, the rheumatologist, didn’t reveal any systemic disease or detectable signs of arthritis in his joints, but Siegel prescribed immunosuppressing medication culminating with infusions that continue today.
“Dan benefited from use of a newly developed biologic agent found to be effective in uveitis called infliximab. It has worked well in managing the symptoms over the years,” said Siegel, of Golisano Children’s Hospital rheumatologist. Infliximab is an immunosuppressant delivered every few weeks and the hope is to eventually end those treatments if the eye problems subside.
Over the decade, the teen suffered challenging complications, including cataracts, glaucoma, and retinal and corneal damage. The disease was so severe that, at one point, he could only distinguish shapes and colors and he began Braille and cane training.
Ophthalmologists performed five surgeries to repair damage to his retinas, remove cataracts in both eyes and implant devices to reduce pressure from glaucoma, all of which contributed to getting him on the road to quality vision.
“There was a lot of teamwork that came into play with Dan’s care,” Siegel said. “When the inflammation in his eyes flared-up, we would all work together to determine the next best course of action to get it under control. He’s a resilient young man and this is an exciting time for him.”