FROM THE WALL: Pushing Boundaries, Building Confidence

Throughout her 29 years, Michelle Ward Caton has embraced life with unwavering curiosity and gusto. Determined to test her abilities and not be limited by vision loss from Leber congenital amaurosis (LCA), she is, among other things, a competitive adaptive rock climber and teacher of the visually impaired (TVI).

Growing up in North Haven, Connecticut, Michelle’s route to an LCA diagnosis took time. Initially, her parents noticed that she wasn’t focusing on faces. “Once I was walking, I bumped into a lot of things! But when this was discussed with my pediatrician, he said it was Michelle being Michelle,” she said. “When I was three, we moved into a new house, and while running around, I hit my head on the kitchen island overhang. My concerned parents took me to a pediatric ophthalmologist, where my poor eyesight was finally confirmed.”

Several years later, the eye doctor detected white blood cells in her eyes and sent her to a Boston eye specialist. By the time they got to Boston, the white cells were gone. However, it wasn’t until she did genetic testing during high school that Michelle was diagnosed with LCA8 from a mutation in the CRB1 gene.

Michelle Ward Caton stands outdoors during a climbing trip with her first guide dog, Ryder, wearing climbing gear

Michelle on a climbing trip with her first guide dog, Ryder

The Journey

Early intervention services started at age three, and by age five, Michelle had a TVI. Refusing to be sidelined, she did everything that her older sister did at the same time. “If she learned to bike ride or swim, I did too!” Michelle said. We were only a year apart, and it was almost like being twins. But determined to keep up, I did many daring things for a blind person.”

Her resolve to play softball in elementary school was dashed, she said, “When my dad took me outside and tossed a few softballs at me until I realized I couldn’t play. When you’re a kid, you think you can do anything. Sometimes, you have to realize you can’t.”

Michelle’s parents exposed her to various activities, including the piano, flute, and bass guitar. Later, she participated in gymnastics and was a ballroom dancer throughout high school. “I did Brazilian jiu jitsu and then Muay Thai, a form of kickboxing, which my dad practiced with me, allowing me to get the rhythm of the sport and have incredible workouts,” she said.

In college, Michelle tackled the gym and weightlifting, and when she was at UMass Boston working on her TVI degree, she met a friend who did rock climbing. “I began climbing with an adaptive climbing group that participated in competitions,” she said. “I went to nationals and placed second, got on the United States team, and went to the international competition in France,” she said.

Rock Climbing Lessons

Michelle and her husband, Jason, continue to climb and discuss competing again. “It’s important to go out of your comfort zone. I still have some vision, and being outside and up high with a view is incredible,” she said. “When I’m climbing in the gym and hit the spot where I’ve fallen many times and finally figure out the right move and body positioning, it’s a small victory. It’s great getting to the top of the wall, whether I can see it or not. The top of the wall isn’t necessarily the prize. It’s the fact that you did it that builds confidence.”

Michelle Ward Caton competes on a climbing wall at the national adaptive climbing competition

Michelle at the 2019 national adaptive climbing competition

Children with visual impairments often find body awareness and balance difficult, but these can also be tough for adults. Sometimes, when Jason tells Michelle how to move on the climbing wall, getting her correct body part to the right location is challenging. “Jason might say to move my right foot three feet, and I move my left foot one foot,” she said.

Helping children with body awareness is something Michelle focused on teaching in her preschool classes during TVI training. “I’d set up obstacle courses for the children to climb over, under, or step through or over,” she said. “I think climbing and jiu-jitsu are some of the best sports for kids with vision impairments because they help build body awareness.”

Vision Changes

When Michelle was about 26, her vision dramatically worsened. “I abruptly lost acuity, and my nystagmus got much worse. There was no time to adjust,” she said. “I’ve always had some nystagmus but could focus through it; now my vision always vibrates.”

As a TVI, Michelle teaches braille, but she also uses it to access all of the appliances in her home. She also does most of her visual work in the morning because the nystagmus exhausts her by evening. “You have to adapt your scenario to your specific needs. It feels like I’m constantly adjusting. I keep puzzling things together to see what works,” she said. “This is the reality for everyone with LCA; each situation is different, and you must finesse things until something works.”

The Right People

Dating during college helped Michelle discern that “it’s the people that don’t care about my vision that make the best friends. I’d meet someone, and when they found out about my vision impairment, they would shift from ‘You’re cute!’ to ‘You’re a science project.’ They’d ask me how many fingers they held up and what I could see. I got all of the stereotypical questions.”

Michelle loves that her husband doesn’t care that she is blind. “Jason does things for me that I don’t even notice. I’ll be looking for something, and he will grab it, hand it to me, and walk away without commenting. Or he will get out of the car and offer me his arm. We never talked about my limitations—he just got it!”

Jason and Michelle, with guide dog Ryder, at Arches National Park

She said finding supportive people who don’t coddle is essential. “Jason encourages me to learn new things that a friend might say are dangerous. Instead, he teaches me how to do it. He doesn’t make assumptions about what’s possible for me.”

A sense of humor is vital for navigating a degenerative condition; Michelle explained, “I trip and fall and knock things over all the time! My visual decline in the last couple of years has been very tough, which makes it essential to find someone who laughs with you. Being morose doesn’t work!”

Family Interactions

Reflecting on growing up with LCA, she said, “My parents always treated me like my sister. Being blind was a characteristic that only meant I did things differently. My sister didn’t acknowledge my being blind for a long time. I don’t think she fully realized what it meant. Instead, she would stare at me and say, ‘Just do it,’ which is what a big sister does.”

“My parents never wallowed in my diagnosis, and we had many real-life conversations about my vision loss. But my dad struggled because he knew my vision would get worse, and I would face lifelong challenges.” Michelle said. “In high school, we met Robin Clark, a teacher passionate about ensuring kids had the independent living skills to live successfully. We implemented creative strategies, worked on things at home, and discussed what would help.”

TVI Responsibilities

As a TVI, Michelle travels between schools in New Hampshire, helping elementary through high school-aged students based on their individualized education plans (IEPs). “I love working with the teams that work daily with the kids to support their vision in class,” she said. “Life with LCA is like rock climbing. Starting out, you have no idea what you are doing, but you feel your way along, and eventually, you’re competing!” 

A New Chapter: Reflections on Seven Years of Hope and Inspiration

Angélica Bretón Morán, a 29-year-old musician and educator from Mexico, was born with Leber congenital amaurosis (LCA) due to RPGRIP1 gene mutations (LCA6). In 2018, she shared her inspiring story with Hope in Focus (HIF), and since then, she has attended several LCA family conferences. We checked in with her seven years later to see how her journey has evolved. Through a Q&A, Angélica reflects on her experiences and insights.

What changes have you experienced over the past seven years?

I graduated from college in 2020 with a degree in music as a pianist, just as COVID-19 started. The plan was to take two exams—one as a soloist and another with the chamber orchestra but the pandemic delayed graduation. Graduating students were instructed to upload their performances to YouTube, and our professors evaluated them. The results were announced during an online graduation ceremony.

In October 2020, I began an online master’s degree in education at Universidad Tecmilenio. At the same time, I was working on my project titled “Area of Musical Research for the Blind and Visually Impaired,” which I had been volunteering on since I was age 10. It resulted in my job as the creator, founder, and leader of that department, later renamed the Music Research Center for Visual Disabilities (CIMUDIV). I completed my master’s degree in 2022, became certified as a professional instructor to conduct workshops, took a leadership course, and completed a diploma in music psychology.

At ISU University, I began a doctorate in the Development and Innovation of Educational Institutions in November 2024 to create academic content about the inclusion of people with visual disabilities in professional music. This area has very little content developed by someone who has lived this reality firsthand.

Can you share more about your job?

I work at the Faculty of Music of the Universidad Autónoma de Nuevo León (UANL). As the coordinator, founder, and creator of the Music Research Center for Visual Disabilities (CIMUDIV), we make the curriculum accessible to students with visual disabilities, including creating braille sheet music and providing personalized student support. It is not a special program for blind students. Instead, students use the same materials and perform like their sighted peers in their classes. I teach musicography to students with visual disabilities so they can read sheet music, and I support their teachers when needed.

We are constantly searching for tools and strategies that make our work and the students’ learning easier, which involves researching, experimenting, and adapting. It’s not unusual to find people with visual disabilities who are active music community members, but much still needs to be done! Changing our mindset and that of society requires patience.

What has been encouraging?

Angélica Bretón Morán performs on stage at the 2024 Blind Concert in Mexico

Angélica Bretón Morán at the 2024 Blind Concert in Mexico

Something that thrilled me was the Blind Concert performance held in November 2023. Because it was canceled during the pandemic, I thought we might never experience it again. The concert, held for 11 years in various locations, raises awareness through music by taking the audience on an emotional journey. For me, music is a powerful language that reaches the deepest fibers of the soul. Seeing the entire cast reunited was an unforgettable and emotional experience. In May 2024, the concert was performed outdoors for the first time before 300 people, achieving another milestone.

What are your observations related to LCA?

Learning never stops, and it is fantastic to see how the topic of LCA has progressed. We’re talking about clinical trials, experimental treatments, research, and new diagnoses, things that seemed unthinkable 20 years ago. When I was younger, we weren’t sure if I had LCA. Now, hearing that someone has a genetic diagnosis is incredible.

It’s become easier to access the LCA community, which is more informed and has more people willing to share their experiences. The support network is stronger, and patients of all ages are involved. Social media and Facebook groups allow us to stay in touch with other families and organizations like Hope in Focus.

One exciting breakthrough is that Odylia Therapeutics is developing a gene therapy for my mutation, the RPGRIP1 gene, and testing it on mice. As a 29-year-old blind person, the idea that my vision might improve in the future is exciting and terrifying!

What are your thoughts about the LCA Family conferences you’ve attended?

My experiences at the conferences have been wonderful! I met many people whom I now care deeply for. At the 2023 conference, we met Toprak and her family from Turkey. Toprak’s parents saw my story on the HIF website, and it was touching to hear that my story gave them hope. It’s important for adults with LCA to attend the conference and share their experiences with other families.

Angélica Bretón Morán stands beside Dr. Emily Place at the 2023 Hope in Focus Family Conference in Indianapolis

Angélica Bretón Morán (right) with Dr. Emily Place (left) during the 2023 Hope in Focus Family Conference in Indianapolis

We hear from the researchers, foundations, and people who make LCA research possible during the conference. At the first LCA conference, I met Dr. Emily Place, who gave me my genetic result when I was 20. I couldn’t believe she was standing before me, and I hugged her with gratitude.

Meeting Toprak reminded me of another family at my first LCA conference. We met a 2-year-old girl named Dafne and her parents. Our parents started talking, and the girl and I had similar characteristics. My parents said that seeing Dafne was like seeing me when I was little, and the anxiety expressed by her parents was similar to theirs. I understood how important it was to be at the conference and how difficult it is for other families to process what I live with daily. I felt a moral commitment to be more involved in the LCA community as an adult.

At another conference, I met a mother with LCA traveling alone with her baby, who did not have LCA, leaving her other children at home. I was a teenager and had never met a mother with LCA. This woman became a role model for me. 

I’ve learned the most about LCA at the conferences. There, we can ask our questions directly to professionals, listen to others’ concerns, and learn from their stories. I’ve also seen how the LCA community has grown in numbers and knowledge. Moreover, there’s yet to be published scientific information shared, which feels like privileged access.

Attending the LCA conference feels like reuniting with a big family. I am deeply grateful to HIF for all the support they’ve given. Every second I’ve spent at the conferences has been worth it.

How do you bring conference content back to your LCA community?

Whenever someone contacts me, I tell them about HIF and ask them to follow its social media. I also share my conference experiences and explain why attending and getting involved in the community is so important.

Our Spanish-speaking WhatsApp group has people from different parts of the world. We share what is discussed when I attend conferences or when a group member attends other LCA-related events. Many members speak only Spanish, so I support them when they need translations, but I also encourage them to write in Spanish in the Facebook groups. Many people from other countries post in their languages, but we can translate texts easily thanks to technology.

Also, artificial intelligence and technology are quickly advancing, so the language barrier is now less complicated. I encourage people not to let language be a limitation. My dad and I started attending these conferences when we spoke little English and didn’t understand much. That experience pushed us to improve our skills.

You are an ambassador for LCA in Mexico. How did that evolve, and what did it look like?

When I was young, no community or information about LCA existed in Mexico. My parents were very worried about my development and diagnosis. However, one day, they read a letter from a 22-year-old Italian girl with LCA who studied music, giving them great hope.

When I was 22, I wrote a post on my Facebook blog about my experience with LCA and mentioned not knowing other people with my genetic mutation. The response was unexpected! Many people and organizations shared my story, and that’s how I met people from Mexico and Spain.

Most of the people with LCA who reach out to me do so via social media or through the families in our WhatsApp group. Using WhatsApp, we share any relevant information we find. If a question arises, I consult with my geneticist in Mexico, and some members offer to check with their doctors. When I find people or communities on social media sharing information related to LCA, I invite them to join the group or follow related pages. Our goal is to provide information and mutual support.

I also created a Facebook group for people with my genetic mutation, similar to the RPE65 group and others. In the RPGRIP1 group, we communicate closely with Odylia Therapeutics. 

In 2019, I started a civil association in Mexico, equivalent to a United States foundation. My idea was to help and receive support, but Mexico’s legal aspect is very complicated. After careful consideration, my family and I decided to dissolve the association and continue supporting the community in other ways.

What are your hopes for the future?

I hope to find better ways to continue supporting the community and that everyone with an LCA diagnosis finds a strong support group. From experience, unity is more powerful than material resources. It is crucial that we not only look out for ourselves but also for others. Although the future is uncertain, that’s nothing new to me. I do everything within my power and fully trust that my safety is in God’s hands. He knows what I don’t, and that’s enough to keep moving forward.

Life Through a Different Lens: They Just Talked About Eyes!

Christine and Anthony Gonzales dreamed of having a large family and were thrilled when their first child, Iliana, was born in August 2018. However, within a few months, their excitement turned to concern. “About a week after Iliana received her four-month childhood vaccine, we noticed her eyes making erratic movements,” Christine said. “We took her to Lucile Packard Children’s Hospital (LPCH) at Stanford and stayed a few days. They ruled out neuroblastoma and did whole-body MRIs to make sure everything was negative. Her eye movements decreased, so she was cleared.”

As Iliana moved into toddlerhood, the couple noticed some things seemed “off.” “Iliana was learning to walk, and occasionally, she would trip and run into things or halt if the lighting changed,” said Anthony. “At other times, she couldn’t locate things or find us. As the months passed, we realized that she wasn’t growing out of it and that something else was at play.”

Increasing Complexity

Then, just before Iliana turned two, her sister Malaya was born in June 2020. At the same time, Iliana’s eye movements increased in frequency.

The couple decided to take both girls to LPCH. “Iliana’s extensive workup, which included genetic testing and an eye exam under anesthesia (EUA), revealed retinal inflammation. They also recommended genetically testing Malaya because getting the results takes a while,” Christine explained.

Although the cause of Iliana’s inflammation wasn’t clear, a member of the Stanford medical team treating Iliana, whose clinical focus was ocular inflammatory disease, suggested treating her with steroids. As a nurse, Christine was acutely aware of possible side effects, and she and Anthony had serious questions about treating the inflammation without knowing its source. But hoping it might help, they consented.

“In December 2020, Iliana was hospitalized again, and the doctor suggested doing infliximab (a drug used to treat autoimmune diseases) infusions in addition to the steroids because the inflammation was so severe,” said Christine. “We started Iliana’s infliximab infusions in January 2021, and Malaya’s first EUA was in February 2021. According to the retinal specialist, Iliana’s inflammation was worse than Malaya’s, causing her vessels to become “leaky.”

At about the same time, the genetic tests revealed that both girls had the CRB1 mutation. “Even so, the doctor recommended continuing Iliana’s once-a-month infusions, which were given for a year,” Christine said.

At Iliana’s follow-up EUA in April 2021, their doctor admitted that the inflammation hadn’t reduced as much as anticipated. But it was still coming down, and he wanted to continue the infusions. “After the December 2021 EUA, he suggested using methotrexate, a chemotherapy drug, but we said no,” said Christine.

Weighing Choices

The fact that their doctor was leaving Stanford, the relative ineffectiveness of the infusions, and that the Gonzales family was moving all contributed to the decision to stop the treatments. This choice provided Iliana with a much-needed break from the poking, prodding, and stress associated with the infusions and testing. It also gave Christine and Anthony the time and space to evaluate their situation, which was now even more complex with Malaya’s diagnosis. They planned to monitor the girls and get a second opinion.

Between 2018 and 2024, the Gonzaleses consulted with eight doctors at four different medical facilities in California to identify what was affecting their daughters’ vision. While the genetic testing revealed the CRB1 mutation in 2020, the focus of the retinal specialist at that time was on treating Iliana’s retinal inflammation. A definitive diagnosis of LCA wasn’t made until 2024, when the Gonzaleses took their daughters to see Jacque Duncan, MD, at the University of San Francisco. Dr. Duncan confirmed a diagnosis of Leber congenital amaurosis (LCA) for both girls and connected the family with the Foundation Fighting Blindness (FFB) to help them find more resources and a supportive community.

Embracing a New Reality

Receiving the genetic diagnosis was simultaneously helpful and crushing. Throughout their medical journey, Christine had done extensive online research, and it was discouraging when she discovered no treatment was available for the CRB1 gene.

It is an understatement to say that the recessive gene mutation had already handed the family a one-two punch, but it wasn’t done. In October 2022, their son Amari was born and found to be a CRB1 carrier. While this diagnosis wouldn’t impact his vision, the information could have implications later in life if he decides to have children. With no family history of eye disease, their children’s genetic diagnoses were shocking for Christine and Anthony and their extended family.

“What was so hard about this process is that young children can’t express what they are feeling or experiencing. There is only so much you can do. It’s like banging your head against the wall, and there is a lot of self-doubt as a parent,” said Christine. “But it’s tough to get the genetic diagnosis. After all of the searching and finding, it comes down to us, as their parents, causing this by passing on a gene mutation we didn’t know we had.”

Amari, Iliana, and Malaya Gonzales sitting together at the table
A sibling photo of Amari, Iliana, and Malaya.

Creative Next Steps

Determined to soldier on, Christine and Anthony decided to homeschool the children. Iliana is currently in the first grade and is a bright and eager student. Malaya and Amari are too young for school and are very active and curious, which means there is never a dull moment in the Gonzales household. The couple share child care and homeschooling responsibilities via a carefully choreographed work schedule. Anthony is employed at a local hospital in the dietary department, and Christine, an RN, works nights at the same hospital. The family is working with the county and school to create an individualized education plan (IEP) for Iliana and one for Malaya when she starts kindergarten.

Regarding the girls’ current vision status, Iliana was tested in 2024 and found to have significant peripheral vision loss. For now, Malaya’s vision may not be as impacted as Iliana’s. “Malaya is strong-willed,” Anthony explained, “and she isn’t very compliant at this point, so testing is tricky! But we’re noticing similarities in Malaya’s vision that we initially observed with Iliana.”

Like Iliana, Malaya struggles with night blindness. “It’s hard when the light is dim at night, and they can’t see us,” said Anthony. “And if Malaya drops a toy, she has trouble locating it. Seeing them both feel around for things hurts.” The Gonzaleses have a follow-up visit for the girls with Dr. Duncan in November to learn more about their daughters’ vision status.

Eager to Learn More

Christine and Anthony Gonzales sitting on a circular outdoor bench with their children Iliana, Malaya, and Amari Gonzales, smiling together
The Gonzales family smiling at the camera outside on a street corner.

When Christine and Anthony heard about FFB’s June VISIONS conference in Chicago, they decided to attend and bring Iliana. During the information sessions, Iliana sat quietly beside her parents, dangling her feet over the seat as she beamed smiles to everyone around her.

The Gonzaleses were relieved to learn more about inherited retinal diseases (IRDs) and LCA at the conference. Anthony said it was impressive to see so many people managing well with a visual disability or blindness, but it was also emotionally challenging. While the information was beneficial, it confirmed that the repercussions of LCA would be a life-long journey for their family.

Excited to be at the conference with her parents, Iliana absorbed as much information as a five-year-old could. When the family returned to California, Iliana’s grandfather asked her about the conference. She quickly summarized her experience without missing a beat by saying, “They just talked about eyes!”


The Gonzaleses met the Hope in Focus (HIF) team at VISIONS 2024 and plan to attend the HIF Family Conference in Minneapolis, MN, on June 20-21, 2025. There, they hope to meet other families and members of the LCA community and glean more information and support to help them guide their children on this unexpected life journey.

A TREATMENT JOURNEY: Jumping Hurdles, Taking Risks

“If someone told me that having access to perfect vision tomorrow meant not having impaired vision for my entire life, I would not change the past. While my visual impairment has created many challenges, it has shaped who I am and influenced me in many positive ways. I’ve become more resourceful, compassionate, creative, and resilient.” —Jack McCormick

Jack McCormick lives a story of hope, tenacity, and measured success while embracing an unknown visual future. When Jack was two, a diagnosis of cone-rod dystrophy confirmed that he had impaired vision. As a teenager, genetic testing revealed that he had Leber congenital amaurosis type 2 (LCA2), due to a mutation in the RPE65 gene and that he was losing his vision. This form of LCA interferes with the production of the RPE65 protein affecting the eyes’ ability to process Vitamin A, leading to progressive vision loss. “It was tough to accept. I was only 15 and thought my life would be a certain way. Now, it was going to be different,” Jack recalled.

Fast-forward to 2022, when Jack, now 25, was treated with LUXTURNA®, a gene therapy for RPE65, becoming the first Canadian to receive a gene therapy. But his journey to treatment involved overcoming substantial hurdles with the Canadian healthcare system, even as his sight declined.

To have a chance for treatment, Jack realized he had to advocate for LUXTURNA to be available in Canada. “I wrote letters to Parliament and was interviewed on national television to create awareness and to help expedite the process,” he explained. “My vision was getting worse every time I visited the eye doctor, and my window as a viable patient for this treatment was quickly narrowing.”

Even after clearing the bureaucratic obstacles and identifying a hospital and qualified surgeons, there was still no clear path for funding the expensive treatment. “There was a year lag between Health Canada approving LUXTURNA and my lining up private funding,” he said.

While Jack wanted the treatment, the immediate or long-term outcomes were not guaranteed. His doctors set his expectations sufficiently low, saying he might see a little better in dim lighting. “My goal was to have stable vision for longer,” he said.

Jack finally received the treatment in March 2022. But the surgery was not easy. It took a long time to recover, and the effects were not immediate. His eye with the poorest vision was treated first, and the second eye was treated two weeks later.

“It is important to be realistic about the surgery. They’re injecting an air bubble and a drug into your eye. There are incisions with microscopic stitches that rub against the eye, causing an intense headache,” Jack said. “I was on my back for the first 24 hours. Later, I had to prevent putting pressure on the eye and couldn’t bend over.”

Another huge challenge was having to quickly decide after the first surgery whether to pursue the treatment for the right eye. “With my left eye, it took a week to see what I saw before the surgery,” he explained. “A few days later, my doctors began talking about the next surgery, and I still wasn’t seeing better. It was very stressful and resulted in multiple conversations with my ophthalmologists about whether to proceed.”

After weighing the risks, Jack chose to have his right eye treated. “At that point, my goal was to see as well as I did before the surgery and, ideally, a little better,” he said. “I’m very happy I did it because the treatment made a much bigger difference for my right eye.” His doctors were also pleased when testing showed vision improvement in dim lighting and an increase in color detection.

“Before the surgery, I didn’t see much walking around the city at night. Now, I might notice someone passing me. I can also see the lines of a crosswalk,” he said. “For me, these improvements are huge!” It’s unknown how long these changes will last, but it’s a future Jack is willing to live with.

His advice for people seeking treatment is to be persistent. “My obstacles were fighting the government and finding a way to pay for the treatment privately,” Jack said. “It’s also vital to find a community. It’s one thing to be a visually impaired person saying that I need this treatment. But it is much more impactful when a group says the same thing and gets others to care about it. Allying with organizations like Hope in Focus helps unite our voices while providing much-needed support and education.”

Jack McCormick graduated in 2018 from Canada’s Wilfrid Laurier University in Waterloo, Ontario. He was diagnosed in high school with LCA2 RPE65. Jack is a Hope in Focus ambassador, helping people living with LCA and IRDs. You can read his blog at jackdamccormick.wordpress.com