Patrick Brown and Dennis Kohler with their children, Karissa, Isabella and Derek.

The eyes are the window to the soul, they say, but what happens when those windows are faulty in some way?

Parents such as Patrick Brown and Carmen Gely have lived through the uncertainty of having children with serious eye issues.

Children can have misaligned eyes, so-called lazy eye and even cataracts. While some conditions are quite rare, others are not — an estimated one-third of babies have a blockage in the tear duct system.

"Ninety percent of what children learn in the early years is visual," making eye problems a big concern in a child’s development, according to Dr. Karen S. Shimshak, an eye physician and surgeon who practices in Glendale and Milwaukee.

Brown is the father of triplets — Karissa, Isabella and Derek — who were born so early (25 weeks) that blood vessels in each baby’s retinas were abnormally developed. The children were closely monitored, and both girls eventually needed eye surgery.

Most times, the condition, known as retinopathy of prematurity, resolves itself. In other cases, it can be devastating causing a detached retina and sometimes blindness — which is what led to singer Stevie Wonder losing his eyesight as an infant.

The combined birth weight of Brown’s triplets was less than 5 pounds. No surprise then that they experienced a variety of medical problems. Isabella even needed open-heart surgery.

It was a lot for Brown and his partner, Dennis Kohler, to absorb.

"The doctors were really good at not overloading us," says Brown. "They’d tell us about the things that might happen in the next week or two, but they didn’t tell us, ‘chances are, one or two of your kids might be blind.’"

Now 9 years old, all three children wear glasses — Karissa for reading and Derek to correct his distance vision. Isabella has about 20/80 acuity in one eye and 20/200 in the other; besides wearing glasses, she uses an electronic print magnifier and special lighting to help with schoolwork. The family, which lives in Germantown, is active in sports, scouts and Irish dancing.

Meanwhile, Gely’s daughter, Aviana Rodriguez, had surgery last spring for a misaligned eye; the medical term is strabismus, but most people would call it crossed eyes. For the eyes to see three-dimensionally, they need to have similar vision and focusing ability. Some children need only glasses or a temporary eye patch to correct the problem.

"Parents are often the first people to notice a child has crossed or wandering eyes," says Dr. Brett Rhode, ophthalmologist at Eye Care Specialists’ West Allis and downtown Milwaukee clinics and head of ophthalmology at Aurora Sinai Medical Center. "It’s best to follow your instincts if you think something isn’t right. Schedule a comprehensive dilated eye exam with an eye care specialist as soon as possible."

Aviana has had surgery twice — at age 2 to relax one muscle in each eye, and again on her right eye in April just shy of her fourth birthday. Rhode, who performed the surgeries, says her prognosis is excellent.

"I’m glad I did it," adds Gely, who lives in Cudahy. Aviana’s eyes are aligned, her vision is normal, and she’s an active kid who likes gymnastics.

Amblyopia, more commonly called lazy eye, is another concern that should be addressed. When the eyes don’t see equally, the weaker eye essentially shuts down to avoid double vision. Screenings at day care centers and preschools often reveal the problem.

"Sometimes 3-year-olds don’t comprehend what’s being asked of them, or are too shy to perform," notes Dr. Mark S. Ruttum, a pediatric ophthalmologist and medical director of ophthalmology at Children’s Hospital of Wisconsin. "When they’re 4, they’re still at a good age for appropriate treatment, whether that be glasses or patching."

Brown advocates eye care for children not just because his own kids had problems. Professionally, he is executive director of Vision Forward Association, a Milwaukee-based agency providing specialized services and programs to people of all ages and at all stages of vision loss.

"Parents need as much support as their children in order to be good parents and to deal with the emotional grief they might have," he says.