Boy triumphs with prosthetic eye after rare cancer diagnosis

In a remarkable medical feat, a toddler diagnosed with a rare form of cancer has successfully fitted a prosthetic eye, designed by doctors using scans of his face. Nuala Mulholland, a 20-month-old from Liverpool, was diagnosed with alveolar soft tissue sarcoma when she was just 10 months old. The diagnosis came after his mother noticed his eye was bloodshot and bulging, symptoms initially mistaken for a subconjunctival hemorrhage, a typically harmless condition.

The rare cancer diagnosis presented the family with a difficult decision: opt for radiation therapy, which could have lifelong implications due to Nuala's young age, or remove the eye. The family chose the latter, and Nuala was given full clearance in January.

The design and creation of Nuala's prosthetic eye was achieved using a novel method, which was less invasive than traditional approaches. Typically, patients requiring a prosthetic eye undergo a lengthy process that involves a wax mold of the eye socket, which is then made into a silicone mold. However, due to Nuala's age, this was not feasible.

Instead, Nuala's surgeon, Ankur Raj, a consultant in pediatric ophthalmology at Alder Hey, worked with the prosthetics team at Aintree University Hospital. They used a series of MRI scans, CT scans and photographs to reconstruct Nuala's face. These images were used to shape the prosthesis, while photographs were used to match it to the position of the other eye. Color matching to Nuala's skin was done in person.

This method also eliminated the need to anesthetize the toddler, a relief for her parents, who had already been anesthetized about 15 times. Nuala had her first fitting in June, and doctors recommended she wear it for a few hours each day to acclimate.

Nuala's mother expressed her surprise at the results and praised her daughter's resilience. “Like everything, he's adapted so well,” she said. “She takes a lot of it in her stride. She's been very, very resilient.”