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In an operating room in Los Angeles, California, an optic surgeon stood over his patient, a nine-year-old girl.
He lifted his pair of specialized forceps, which are kind of like tweezers, and he opened up the two blades, sliding them carefully into either corner of her eye socket. Then he gently grabbed on to her eyeball with these forceps, and slowly he pulled her eyeball out of its socket until he heard the pop of air and the squish of soft tissue, which told him the eye was now fully dislodged from the socket. Now only the thick optic nerve still attached the eyeball to the girl's skull.
The surgeon turned the eye over until he was looking at the back of it. And there he saw a hard black mass on the inner part of the eyeball. He touched the mass gently. It was so thick that for a moment the doctor wasn't sure how he was going to remove it. He needed to use enough force to get it off his patient's eye, but it would be very easy to overdo it and cause serious damage. So he had to proceed with extreme caution.
With an even smaller set of forceps, the surgeon pinched the black mass and slowly began to tease it off the little girl's eye.
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From Ballin Studios and Wondery, I'm Mr. Ballin, and this is Mr. Ballin's Medical Mysteries, where every week we will explore a new baffling mystery originating from the one place we all can't escape, our own bodies. If you like today's story, please tell the follow button you'll teach them how to play golf, and immediately after their first tee, call the marshal and complain they are playing too slowly. This episode is called Jade's Eye.
In March of 2013, nine-year-old Jade Howe sat in the nurse's office at her elementary school in Kona, Hawaii. It was the annual vision screening at her school, and Jade was busy telling the visiting optometrist all about the cupcake her mom packed her for lunch and how excited she was for hula dancing class after school. The optometrist laughed and asked Jade to sit up straight so he could examine her. Jade straightened her back and smiled as the optometrist dimmed the lights and then shined a flashlight into her left eye.
Right away Jade flinched. The light made her head hurt a little. But then her eyes adjusted. She was used to eye exams. She had worn glasses for most of her life, so she knew what to expect. Normally, she would just read charts on the wall while the optometrist gave her different lenses to try. But today was different.
She'd had a headache off and on all morning, and her vision felt blurred, like everything was fuzzy around the edges. So it was harder than usual for her to read all those charts. The optometrist clicked his tongue a few times like he was thinking through a problem, and Jade got the feeling that something might be wrong.
Just as Jade was about to ask if everything was okay, the optometrist handed her a black plastic spatula and told her to use it to cover up her right eye. Then the doctor held up a sheet of paper with rows of letters on it and asked her to read the lines aloud using just her left eye. But when Jade put that spatula over her right eye, her vision from her left eye became so blurred that she could barely see anything at all.
She lowered the spatula and inspected it as if the spatula was to blame. But when she saw no issue with the spatula, she just put it right back over her right eye, but again, she could barely see out of her left eye. She asked the optometrist what happened to her left eye, but the optometrist just scribbled on a pink notepad and ripped off the paper, and he handed it to Jade and told her to give it to her parents the moment she got home from school.
That afternoon, when school let out, Jade ran to her mother, Ho'olai Berman, who was standing on the sidewalk waiting for her. Jade immediately handed her mother the optometrist's report and watched a worried look come over her face as she read it. Jade asked her mom if something was wrong with her eyes, but her mom just smiled and told her not to worry. They'd schedule an appointment with the optometrist when they got home. Jade very likely just needed new glasses.
Jade felt very relieved and just nodded, and then she shifted her focus and just began digging through her backpack for her lunchbox. She had saved a fruit roll-up for the walk home. Usually, Jade and her mother would stop at a park near their house to play and unwind after school, but today, when they got to that park, Jade didn't really feel like playing. She still had a headache and she could barely see out of her left eye, so she ended up just sitting in the sandbox eating her snack.
Jade was absentmindedly digging in the sand when a dog wandered over to say hello. She had seen this dog before. It was a stray and it was a little scraggly looking, but it was always friendly and Jade knew it loved belly rubs. And so after a few minutes of playing, the dog wandered off to a garbage can to look for food. And then Jade's mom came over and sat down beside Jade and asked her how she was feeling. Jade didn't answer. She just leaned over and put her aching head in her mother's lap. She was relieved when she heard her mom say that it was time to go home.
A few days later, Jade's mother, Ho'olai, sat in the corner of an optometrist's office watching him finish up Jade's eye exam. The optometrist switched off the lights and smiled at Jade and then said he'd actually like to take some x-rays. Jade's mom was a little surprised but agreed to any extra cost if it helped her daughter see. The optometrist took the x-rays right there in his office and 15 minutes later they all gathered around his computer screen looking at the enlarged images of Jade's left eye.
To Jade and her mother, the image they were looking at just kind of looked like a big grape with veins running through it. But the optometrist immediately pointed at a small black mass located on the retina at the back of Jade's left eye. He was certain that this black mass was causing Jade's vision loss.
The retina's job is to focus the eye, and so the mass was clearly getting in the way. But he wasn't sure what the mass was. The best thing to do was treat it like an infection and start Jade on antibiotics. Then they could see if that cleared it up and go from there. On the car ride home, Jade complained that her headache was back. Her mom sighed and said that it sounded like something only ice cream could fix. Jade smiled and started bouncing with excitement in her seat.
Ho'olai laughed as she started driving towards the nearest ice cream shop, convinced that her daughter would feel better in a few days. But after a week, Jade was not feeling any better. Her head still hurt and she could barely see out of her left eye. So her mom called the optometrist, who told her it was time for them to go see a doctor who has a specialty in these types of issues.
The next morning, Jade's mom sat beside her dad, Jack, in the eye specialist's office. Jade curled up on her father's lap, playing a game on his phone while they waited for test results and x-rays. A moment later, a stout man in a lab coat walked into the office and sat on a stool opposite Jade and her parents. He pulled the stool closer to his desk, pulling Jade's x-rays up on his computer screen and flipping through a clipboard on his desk. He told Jade's parents that the antibiotics had not cleared up the black mass on Jade's eye.
Then he pointed to the dark spot on Jade's x-ray. The doctor explained that the mass behind Jade's eye appeared to be inflamed. And when he compared the x-ray taken that morning to the x-ray taken last week, the mass really seemed to be growing bigger. Which meant that Jade's sight loss would likely only get worse. Her headaches might become more severe too. And if the mass got too swollen, Jade could lose all sight in that eye.
Jade's mom suddenly felt a lump in her throat as she asked the doctor what could be done. The doctor looked over at Jade with a hint of pity on his face, and then he said that he'd like to try injecting steroids directly into the mass, which would hopefully reduce the swelling and clear up the mass completely. It was a scary-sounding procedure, he said, but it would be done with anesthesia and it would only take a minute. And once it was over, Jade really should be cured.
Jade would have this procedure done, but two days later, when Jade and her mother Ho Ola'i returned for a follow-up appointment, the specialist walked into the examination room with a glum expression on his face, and he told them that the injection had not worked, and worse than that, he said he was out of ideas. They were going to have to find a new doctor.
And so over the next few weeks, Jade and her mother visited three other eye specialists, but none of them could figure out what was causing this black mass on Jade's left eye either. Jade's mother was really frustrated and very upset. She remembered what the first specialist had said about her daughter potentially losing all the sight in her eye, and so now she felt like if they didn't find an answer soon, it would just be too late.
By the time Jade and her mother found themselves waiting anxiously in the exam room of the most experienced eye doctors on the island, it had been almost three months since Jade's eye began to hurt, and both Jade and Ho'olai were fighting a growing feeling of hopelessness. Jade's mom would never give up on her daughter, but she was tired and scared. The door finally opened, and a tall man with short black hair and a prominent chin strode inside.
His name was Dr. Eugene Ng, and he was a retina surgeon. He squatted down in front of Jade and asked her gently if he could look at her eyes. Jade smiled and nodded and let go of her mother's hand. Her mother felt relief rise in her chest. She liked Dr. Ng immediately, and it was clear Jade did too. But as Dr. Ng shined a flashlight into Jade's eyes and conducted a few quick tests, Jade's mother tried to tamp down her optimism.
This was the same thing every other doctor had done, and when Dr. Ng clicked off his flashlight and stood up, she braced herself to hear him say, well, there's nothing we can do, go find another doctor. But, unlike all the other eye specialists, Dr. Ng said he was fairly certain he knew what was wrong with her eye. Jade's mother could barely believe this. She smiled and let herself hope, just for a second, that finally her daughter would get the help she needed.
But then she realized that Dr. Ng was not smiling back at her. Instead, he looked almost grim as he told her that while he could diagnose Jade's problem, nobody in all of Hawaii had the expertise to actually fix it. Jade needed immediate medical attention that was not available on the islands, so she would have to be flown to the mainland of the United States as soon as possible. Mr. Ballin Collection is sponsored by BetterHelp.
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Sign up for a $1 per month trial period at Shopify.com slash Mr. Ballin, all lowercase. Go to Shopify.com slash Mr. Ballin to take your retail business to the next level today. Shopify.com slash Mr. Ballin. A week later, Jade sat with her mother in the back of an Uber that was driving them from the Los Angeles International Airport to their hotel.
Jade watched the other cars on the highway blur past and noticed how beige and concrete everything looked in Southern California compared to the lush green of Hawaii. Jade was really missing her father. Jack had had to stay home in Hawaii to work, and he was also going to miss Jade's birthday, which was in two days. Jade dreaded the idea of turning 10 without her father around, and she also dreaded seeing another specialist that afternoon.
Even though her left eye was now completely blurry and her headaches had only been getting worse, Jade was scared of going to see another doctor. She was afraid that whatever treatment they would give her would be more painful and more uncomfortable than what she was already experiencing.
But Jade tried to push her worry from her mind. After all, she was in the city where all her favorite movies were made. Her mom had even promised her that they could go do some sightseeing when they weren't at the doctor's office. And so Jade decided she was just going to have fun on this trip no matter what. That afternoon, Jade sat in another examination chair, this time at the Children's Retina Institute in Los Angeles.
A doctor with red hair and a neatly trimmed beard was drawing blood samples from Jade's arm while Jade told him all about the last time she'd been poked with a needle and how much it had hurt. The doctor's name was Dr. Khaled Tawanzi, and Jade's mother had told Jade that he was actually the one who started this institute. Jade watched the blood flow from her arm down through a plastic tube and into small vials. It didn't hurt at all, and Jade actually found it fascinating to watch.
She asked Dr. Tawanzi what he was going to do with her blood, and he smiled at her. He explained that he'd send her blood to a very special laboratory where scientists would run all kinds of tests. Then, in a day or two, they'd know for sure if Dr. Ng was right about what was causing the blindness in her left eye.
Jade imagined an all-white laboratory full of shiny machines and scientists in blue scrubs. She'd seen something like that in a movie once. It made her feel safe, like the best doctors in Los Angeles would be working to save her vision. Dr. Tuanze told Jade that in the meantime, her very important assignment was to have as much fun in Los Angeles as possible. Jade smiled as her mom assured him that they had plenty of plans for that.
Two days later, Jade peered over the side of a tour trolley, watching a shark's fin move through a man-made pool set to the iconic Jaws movie soundtrack. It was her 10th birthday, and her mother had taken her to Universal Studios Hollywood. Just as the music reached a crescendo, an animatronic shark came leaping out of the water. Jade leaped back from the edge of the trolley, and then she laughed and clapped with the rest of the tour group. By the time Jade and her mother got off the trolley a few minutes later, Jade felt better than she had in a long time.
For just a moment, she had forgotten all about her troubles. She decided it was birthday magic. As she led her mother away from the studio's tour, Jade heard her mother's cell phone ring. She turned to look at her mom, and Ho'olai dug through her purse, pulled out her phone. She looked at the caller ID and asked Jade to wait a minute. It was Dr. Tawanzi calling. Jade sat down on a nearby green plastic bench while her mom paced and listened. Jade watched as the smile on her mother's face faded.
Jade's stomach lurched. She knew that whatever news her mother was receiving, it could not be good. Jade swung her legs nervously as her mother hung up with the doctor and then made a second phone call, which was much shorter. And when her mother turned around, Jade could tell she was extremely upset. Ho'olai strode over and sat on the bench next to her daughter. Jade held her breath as her mom explained what the doctor had told her.
Jade needed surgery. Jade felt tears well up in her eyes as she asked her mother if the surgery would actually save her eyesight. Her mom frowned and struggled to find the right words. Finally, she explained that they didn't know if this procedure could actually save her eyesight. But without this surgery, it was fairly likely that she could lose her entire left eye. If that happened, she would have to have a glass eye instead.
Jade tried to picture the doctor cutting out her eye and what it would feel like with a glass ball in her eye socket. The very thought of it sent tears running down her face and she turned to her mom and sobbed into her chest. The next morning, Jade's mother stood next to Jade's gurney at the Children's Retina Institute. Jade looked frightened and kept looking around for her father who had gotten on the first plane available to come join them. Jack was supposed to have landed more than an hour ago and Jade's mother was worried he would miss the surgery.
Ho'olai squeezed her daughter's hand as Dr. Tawanzi propped open the double doors that led to the operating room. He asked Jade if she was ready, and her mother beamed proudly as Jade nodded her head bravely.
Then they heard a commotion down the hall. They all turned to see Jade's dad, Jack, burst into the hallway and run toward the gurney. When Jack reached them, he leaned down and planted a big kiss on Jade's forehead. He whispered in Jade's ear, happy birthday, and that he loved her. Finally, a nurse said it was time to take Jade into surgery, and so Ho'olai and Jack both blew kisses at their daughter as she was rolled into the operating room.
The parents held each other as they watched the doors swing closed. It all felt so unfair. Their daughter was barely 10 years old and she might lose her eye. And now all they could do was wait and hope. In the operating room, Dr. Tawanzi waited until Jade was completely asleep before using a speculum, which is like a small vice grip to pry open her left eyelid.
Once her eyelid was propped open, Dr. Tawanzi began the careful process of removing Jade's eye completely from its socket so that only the optical nerve was connecting it to her body.
Once Dr. Tawanzi had freed Jade's eyeball from its socket, he held it up and turned it around until he was looking at the back. He had seen scans of the mass on Jade's eye, but he was still shocked by how it looked in person. It was a thick, dark mass, and it was caked on so hard it felt like a rock.
Dr. Tawanzi could tell it was going to be extremely difficult to remove it without permanently injuring Jade's eye because the doctor knew there was a risk that this mask was not just on Jade's eye, it might be embedded inside of Jade's eye. And if that was the case, Jade would very likely lose her eye entirely no matter what Dr. Tawanzi did. But Dr. Tawanzi would not know how bad this was until he attempted to remove it.
It took Dr. Tawanzi nearly three hours to remove this foreign mass from Jade's eyeball, slowly pulling it off one tiny piece at a time. It almost felt like he was tearing cardboard with each pull. But finally, with one last gentle pull, the last of the black lump dislodged. Dr. Tawanzi placed it all on a dish and a nurse whisked it away for testing. Then he lifted Jade's eyeball with his forceps and slid it back into the socket, hoping it could be saved.
The first thing Jade saw when she woke up was her parents' smiling faces. However, she only saw them through her right eye. A protective patch was covering her left eye following the surgery. Jade felt groggy, but she was so relieved to see her parents, especially her dad, who told her she looked so cool like a pirate. But then Jade began to panic as she touched her patch and wondered if she still even had an eye behind it. Was there a glass eyeball now?
But her mom took Jade's hand and told her, "Don't worry, she still had her eye. Dr. Tawanzi was able to save it." Jade smiled huge with relief. Her mom was crying and told Jade what a great job she did. A few moments after that, Dr. Tawanzi walked into the recovery room. Jade and her family grinned and thanked him for his help. But Dr. Tawanzi said they were not out of the woods yet. He told Jade and her parents that Dr. Ng had been right about his diagnosis.
Jade's condition was much more dangerous than anything doctors in Hawaii could treat, and the surgery was not a guaranteed solution. Because Jade's eyeball had been invaded by living creatures. The creatures, he said, were parasites called Toxicara, otherwise known as roundworm. Dr. Tawanzi explained that usually Toxicara is spread through dog feces. He asked if Jade had a pet dog at home.
Jade said no, but then she told Dr. Tawanzi about the stray dog that she sometimes played with at the local park. Dr. Tawanzi nodded and said that it was very possible to pick up Toxicara at a park frequented by stray dogs or even just by pets and their owners. All it would take for Jade to get this infection would be for her to touch a tiny bit of dirt with dog feces on it and then touch her mouth.
Toxicara is not rare. In fact, they are one of the most common parasites in the world. About 5% of American adults have antibodies in them that show they have been exposed at some point in their lives to Toxicara. But most people who ingest Toxicara eggs don't get a single symptom and never even know the parasite was inside of them at all. Typically, the body forms a hard shell around the parasite and expels through the intestines.
But in some cases, the body is too slow to react and the parasites migrate through the body and end up in organs like the liver, kidneys, and sometimes even the eyes. And that's what had happened to Jade. She had developed a very rare condition called ocular toxochoriasis. In ocular toxochoriasis, the body does finally form that protective shell around the parasites, but only after the parasites have attached themselves to the eye.
That's why the mass on the back of Jade's eye was so hard. Her body was trying to protect her, just a little too late. Jade got lucky. Her body's response had come in time to stop the parasites before they completely destroyed her eye. And Dr. Tawanzi was pretty sure he managed to remove every last parasite from her body. Still, he told Jade and her parents that she would have to be watched very closely in the days ahead to make sure he had not missed any.
Most of Dr. Tawanzi's explanation went way over Jade's head, but she grimaced at the disgusting thought of accidentally eating dog poop. And Dr. Tawanzi actually laughed a little bit when he saw Jade's face. He told her, "It's much more common than you think. Just make sure you always wash your hands after the playground and you'll be okay." Jade grinned as a wave of relief washed over her. She was ready to be done with doctor's offices and dog poop. A few days later, the family all flew back home to Hawaii.
Jade's eyesight in her left eye would come back. However, it really never fully recovered. But other than her vision, she would be okay. Jade would go on to be a cheerleader for her high school, and she would also continue to dance hula. From Ballin Studios and Wondery, this is Mr. Ballin's Medical Mysteries, hosted by me, Mr. Ballin.
A quick note about our stories: we use aliases sometimes because we don't know the names of the real people in the story, and also, in most cases, we can't know exactly what was said
but everything is based on a lot of research. And a reminder, the content in this episode is not intended to be a substitute for professional medical advice, diagnosis, or treatment. This episode was written by Aaron Lan. Our editor is Heather Dundas. Sound design is by Andre Pluss. Coordinating producer is Sophia Martins. Our senior producer is Alex Benidon. Our associate producers and researchers are Sarah Vytak and Teja Palakonda. Fact-checking was done by Sheila Patterson.
For Ballin Studios, our head of production is Zach Levitt. Script editing is by Scott Allen and Evan Allen. Our coordinating producer is Matub Zare. Executive producers are myself, Mr. Ballin, and Nick Witters. For Wondery, our head of sound is Marcelino Villapondo. Senior producers are Laura Donna Pallavoda and Dave Schilling. Senior managing producer is Ryan Lohr. Our executive producers are Aaron O'Flaherty and Marshall Louis for Wondery. Wondery.
Hey, I'm Mike Corey, the host of Wondery's podcast, Against the Odds. In each episode, we share thrilling true stories of survival, putting you in the shoes of the people who live to tell the tale. In our next season, it's July 6th, 1988, and workers are settling into the night shift aboard Piper Alpha, the world's largest offshore oil rig.
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