In August 2023 Megan Mulholland noticed that her nine-month-old daughter Nuala’s left eye was bloodshot. It looked like a burst vessel — a subconjunctival haemorrhage, usually harmless. Then the eye began to bulge and change shape. An urgent MRI at Alder Hey Children’s Hospital in Liverpool showed a mass behind the globe. Formal diagnosis took weeks: alveolar soft part sarcoma (ASPS), a rare soft-tissue tumour that appears in about six people a year in England and almost never in a baby, behind an eye. ASPS does not respond to chemotherapy. The choices were radiotherapy, with lifelong risk to a growing skull, or removing the eye. The family chose surgery. Nuala had three operations. Two weeks after her first birthday her left eye and the muscle behind it were taken out with the tumour. In January 2024 she rang the end-of-treatment bell.

What remained was an empty socket in a toddler who had already been anaesthetised many times. The usual method for an ocular prosthesis is a wax impression of the socket under anaesthetic, then a silicone mould. Consultant paediatric ophthalmologist Ankur Raj and the prosthetics team at Aintree University Hospital skipped that. They used MRI and CT scans already taken at Alder Hey, plus photographs, to reconstruct the orbit in three dimensions and match the surviving eye’s position and colour. The finished piece is only a little larger than a one-pound coin. Nuala did not need another general anaesthetic to make it. By about 20 months she was in nursery, learning to walk, and wearing the prosthesis. Her mother said she adapted as she had to everything else — three days after one operation they were in a soft-play centre. She has an older brother, Jack.

ASPS can still return. Nuala will be scanned for years. The story that travelled with the pound-coin photograph is not that cancer is simple. It is that a parent who refused to accept “just a burst vessel,” a hospital that could name a tumour almost no one sees in infants, and a prosthetics lab that could build an eye from scans instead of another trip to theatre, turned a red eye into a child who points at the television with two matching lids.

Sources
BBC News Merseyside, “Baby girl given new prosthetic eye after rare cancer” (25 July 2024)
Alder Hey Children’s Hospital Trust statement on the Aintree collaboration (25 July 2024)
Sky News and The Independent / PA coverage of the same date
Liverpool Echo and The Mirror interviews with Megan Mulholland
Alder Hey Children’s Charity follow-up on Nuala’s later ambassadorship