AVA Grace had been a happy and healthy toddler, but everything changed when she was just 14 months old.

After catching hand, foot and mouth disease, her parents Vicki Cooper-Bird and Ian Bird noticed something unusual in her eyes. Within hours, her iris had changed from light blue to dark blue and her pupil stopped dilating properly, prompting an urgent trip to the GP.

Unable to see the back of Ava’s eye, the GP referred her to a paediatric assessment unit, where she stayed for three days for tests and monitoring.

An ultrasound found the pressure in Ava’s eye was more than twice the normal level. Doctors suspected retinoblastoma, a rare eye condition.

Ava had complete retinal detachment and had already lost sight in the affected eye. At a specialist clinic in Birmingham, doctors confirmed a 22mm grade E tumour, the highest grade, and diagnosed her with retinoblastoma on November 2.

Vicki, 37, said: “Ava’s diagnosis completely blindsided us. We had no idea.

“It was really aggressive, and there wasn’t anything they could do to save the eye. We just sat in the car and cried.”

Thankfully, the condition had not spread along the optic nerve, so Ava did not need chemotherapy before surgery.

On November 14, just three days after her parents’ wedding, Ava underwent surgery to remove the affected eye.

The recovery brought new challenges. She struggled to adjust to her prosthetic eye, often pulling it out, meaning the family returned to hospital two or three times a week. In her first year, Ava tried six different prosthetic eyes.

She has also faced infections, healing difficulties, insomnia and emotional challenges. Vicki said Ava often wakes four to six times a night, but she now attends play therapy and has been prescribed melatonin.

Now three, Ava attends a specialist clinic at Birmingham Women’s and Children’s Hospital, one of only two UK sites offering retinoblastoma treatment. Her parents travel 200 miles each way and she has had 64 appointments over the past two years.

Despite everything, Ava is now in remission, although her family says a long medical journey remains ahead.

When she underwent surgery, a nurse gave Ava a cuddly penguin named Pip with a removable eye – just like hers. The toy became a source of comfort during hospital visits.

This Christmas, Vicki urges parents to learn the signs of retinoblastoma, which can sometimes be spotted in flash photographs. One important warning sign is a white pupil or glow, while the other eye shows a red reflection.