Martin Gage ‘Tuff’ Vanderwerf is 17 years old and has never driven a vehicle. He’s never had a candlelit dinner or any nighttime activity. ‘Tuff’ was born with a deficiency in his eyes. He can see, he is not totally blind, however his peripheral vision was hindered as was his vision in dim lit areas. Thursday, March 24, Tuff underwent the first of two surgeries and is one of just four people to have had this procedure done in the United States.
The bandages were removed and the look on ‘Tuff’s’ face said it all as he held up his left hand and said, “I can see my hand here.” Smiles were everywhere with the results. This past Thursday, doctors performed the same surgery on his right eye with the results not quite as positive initially. There was a small complication following the second procedure that ‘Tuff’ explained, “It just seemed like it had a little bit tougher start. Today, they went in and stitched it up because it had loosened up. It started leaking the air out and they didn’t put me to sleep through it either.” Although as painful as it was with no medication to assist, ‘Tuff’ took it like a champion, “It’s already doing a lot better.”
When asked if he had ever seen prior to his first procedure ‘Tuff’ said, “Yes ma’am I have seen before, I just didn’t have a lot of peripheral vision and I couldn’t see at night time.” As far as being able to read, he says, “Yes ma’am I could, I just had to have lots of light.”
Vanderwerf is very humble about where he was and how far he has come, waking up after this procedure, “I think I adapted pretty well because I didn’t know any different from what I had seen. I thought for what I had I seen, I had done really good. I had worked with my cows, helped my dad with his business, and I didn’t realize until the surgery that I couldn’t see good at all. I didn’t realize I couldn’t see hardly anything compared to what I do now. I could see pretty good straight ahead, pretty decent amount far ahead. I had 20/50 vision straight ahead wise on a sunny day. If it wasn’t sunny or if it wasn’t straight away it was really a challenge.”
Vanderwerf could not see at all at night, he said, “Like when I walked into a restaurant, it’s like I couldn’t see in there at all and I had to sit somewhere where it was really light.”
‘Tuff’ attends the Florida School for the Deaf and Blind in St. Augustine and comes home during the summer, the holidays and on weekends. As far as what he will do about school this coming school year, he says, “Well, it’s hard to say, because I’d like to see how everything goes over the time of healing. I seem like I have a lot back, that I never had. I can see at night time and it’s just been a miracle. The Lord has blessed me, that’s for sure.” He’s not sure about graduation date as he is trying to graduate early if he can get his credits in to be a senior. He’s working hard on that through the summer.
Tuff is not sure what his plans are after graduation, “I’m going to tell you what Ms. Shelia I’m not really even sure. I would like to work with dad and keep going with my cows.”
The procedure was done at the Bascom Palmer Eye Institute in Miami, Florida. Electroretinography measures the electrical responses of various cell types in the retina, including the photoreceptors (rods and cones), inner retinal cells (bipolar and amacrine cells), and the ganglion cells. Electrodes (DTL silver/nylon fiber string) are usually placed on the surface of the cornea for Full Field/Global/Multifocal ERG’s and brass/copper electrodes are placed on the skin near the eye for EOG type testing. During a recording, the patient’s eyes are exposed to standardized stimuli and the resulting signal is displayed showing the time course of the signal’s amplitude (voltage). Signals are very small, and typically are measured in microvolts or nanovolts. The ERG is composed of electrical potentials contributed by different cell types within the retina, and the stimulus conditions (flash or pattern stimulus, whether a background light is present, and the colors of the stimulus and background) can elicit stronger response from certain
If a dim flash ERG is performed on a dark-adapted eye, the response is primarily from the rod system. Flash ERGs performed on a light adapted eye will reflect the activity of the cone system. Sufficiently bright flashes will elicit ERGs containing an a-wave (initial negative deflection) followed by a b-wave (positive deflection). The leading edge of the a-wave is produced by the photoreceptors, while the remainder of the wave is produced by a mixture of cells including photoreceptors, bipolar, amacrine, and Muller cells or Muller glia. The pattern ERG (PERG), evoked by an alternating checkerboard stimulus, primarily reflects activity of retinal ganglion cells.
‘Tuff’s’ mother, Paige Vanderwerf says of the procedure, “This new vision may create a challenge. I’m sure this summer will determine a lot for next year, school, career choices, etcetera. Most of all, as a 17-year old, he is most hopeful to be able to drive. I think he has enough peripheral improvement to do so. They will measure visual improvements in 30 days. We will have to come back here numerous times for follow ups. The clinical trial patients are only four years out but they have remained stable.”
‘Tuff’ is the son of Martin and Paige Vanderwerf. He has a brother, Jeb Bruner.
‘Tuff’ is truly an example for all of us to follow, never limited himself because of his eyes, plugged along and found what he could do, working with his cows and helping his father, and never once thought about what he couldn’t do. Kudos to this fine young man and his parents on a job well done.