Serenity Wheeler and Blindness
Serenity Wheeler is a side character from Yu-Gi-Oh, and an after school and Saturday morning anime from the early 2000’s. Serenity Wheeler is the sister of Joey Wheeler and his motivation to enter the Duelist Kingdom tournament, in order to earn enough money to pay for a surgery to cure her blindness. I am not an expert on healthcare policy, let alone the intricacies of the Japanese healthcare system, so I am going to leave the question of how and why a teenager has to enter a crazy tournament to raise money for his sister’s surgery for another time. (FYI- It is my own opinion that this sort of situation probably wouldn’t happen in the real world.) What I am going to do is my usual thing and talk about what possible eye conditions Serenity Wheeler could have had and what surgery might have been performed.
The anime gives us little to no information about Serenity’s condition, beyond the fact that Serenity Wheeler cannot see when she is introduced in the anime. It is implied through flashbacks that at one point Serenity Wheeler could actually see to some degree, which means that her condition was progressively getting worse. This progression continued to the point where Serenity Wheeler could no longer see images clearly and is considered blind. Her eyes can still detect light, they just can’t focus on the image. The point at which Serenity Wheeler is considered legally blind would be when her eyesight is 20/200 or less with corrective lenses.
Visual acuity refers to how clear an individual’s vision is and is represented by numbers like 20/20. This is actually an American conversion of 6/6 which means that at 6 meters you can tell that two lines 1.75mm apart are actually two lines instead of one line. However, this can get a little complicated so I will give you a simplified version. 20/20 vision means that you can see at 20 ft what a normal person can see at 20 ft without any assistance. 20/40 vision means that at 20 ft you can see what a normal person can see at 40 ft, meaning that your eyesight is worse. If you have 20/15 vision, you can see at 20 ft what a normal unaided person would have to be at 15 ft to see.
Progressive Eye Conditions
Getting back to Serenity, we know that her problems started when she was a child and got progressively worse. On top of this it can be assumed from her appearance and behavior that her medical condition is focused on her eyesight.
That still leaves a long list of conditions, but there is one last bit of information that Yu-Gi-Oh gives us that narrows down the list significantly. This is the fact that Serenity’s vision problems are cured by surgery.
Most of the conditions on the list can also be treated with a variety of methods and do not always require surgery. The two most likely candidates are pediatric glaucoma and pediatric cataracts since they can happen in children, and surgery is often used to treat the conditions. Pediatric glaucoma can be ruled out for three reasons: 1- When it occurs in young children it often appears as an infant, and it is implied that Serenty’s problems began later than that. 2- Pediatric glaucoma is very rare: 1 in 10,000. 3- Untreated pediatric glaucoma can damage the optic nerve, causing vision problems even after the glaucoma is treated, and Serenity is shown to have no lasting issues with her vision after the surgery.
A cataract is a clouding of the lens in one or both eyes that scatters the light entering the eye, causing blurred vision.
Normally the lens of the eye focuses light onto the retina, much like how the lens of a camera focuses light onto the film or CCD in a digital camera. Cataracts disrupt this process, resulting in blurred vision.
There is a variety of types of cataracts, depending on the material that is causing the lens to cloud, and the location in the lens where the cataract begins to form. I will not even begin to try to speculate the type of cataract Serenity had because her damaged eyes are never shown in the anime. Pediatric cataracts can be subdivided by age, and while most pediatric cataracts are infantile (meaning that they are present at birth or develop soon after), Serenity’s cataracts develop later in her childhood, meaning they are juvenile.
The cause of juvenile cataracts can be either genetic or environmental. Given the severity of Serenity’s condition, I think it is highly probable that her cataracts are genetic, but the progression was potentially worsened by her environment. Cataracts can be caused by defective genes inherited in an autosomal dominant, autosomal recessive, or X-linked recessive manner. It is unlikely that the cataracts were caused by an autosomal dominant gene because it is implied that Serenity’s mother and father have normal vision. The X-linked recessive genes can be ruled out for the same reason, because she would have to inherit a defective X chromosome from each parent and her father is implied to have normal vision. Men only have 1 X chromosome, so if he carried a cataract-causing gene, he would have cataracts. This just leaves the autosomal recessive genes, of which there is one that only causes cataracts and no other conditions.
Condition– Congenital nuclear cataracts 2
Chromosome location- 22q11.23
The speed at which her condition progressed could have been influenced by her mother’s lifestyle. We are not given many details about Serenity’s mother beyond the fact that she is an alcoholic gambler, which doesn’t mean much, but if she were a smoker, then second hand smoke might have sped the progression of Serenity’s cataracts.
The treatment for cataracts includes, glasses and other visual aids. The final treatment option is surgery when the blurred vision has significantly impaired the patient’s life, which is what happened in Serenity’s case. The type of cataract surgery depends on the severity of the patient’s condition, in the case of Serenity Wheeler, I think we can imply that it is severe, given that she is blind from her cataracts.
This means Serenity Wheeler had extracapsular cataract surgery due to the size and density of a cataract that causes blindness. During the surgery a large incision is made into the eye and the lens is cut up and removed one piece at a time. The last step in the surgery is to replace the removed lens with an artificial one. The type of artificial lens is determined by vision issues that are not discussed in the anime so it is impossible to determine the exact lens used. The surgery takes longer and requires a longer recovery time: additionally the patient’s vision takes longer to return. This is somewhat shown in the anime, with a long period of time implied between the surgery and her recovery.
Where the anime really blows it is with Serenity’s recovery after the surgery. Initially Serenity Wheeler is shown wearing protective bandages, which makes sense. What doesn’t make sense and more than likely would have made things worse is diving into water, which is not part of the approved recovery from cataract surgery until weeks after the surgery.
Yes, Serenity Wheeler did save her brother and it made for good drama, but she probably just hurt her recovering eyes.
Considering this is an anime made about a card game for little kids, I’m going to just say that the animators got lucky with the parts they got right. That doesn’t mean there isn’t any fun in dissecting it, and I hope you enjoyed it and learned a few things. Please leave any comments or questions in the comments section below. FYI- I won’t be posting on Saturday as I will be at Zenkaicon this weekend presenting- Anime Chemistry 101, Sake 101, The Biology of Monster Girls, The Science of Mecha, and Teaching with Anime.