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Abstract
Correction of ametropia in children is a challenge to pediatric ophthalmologists, particularly in children with behavioral disorders. A subpopulation of children with bilateral high myopia, anisometropia, accommodative esotropia and neurobehavioral disorders have difficulties wearing spectacles and are ill suited to correction using contact lenses. The markedly blurred images in these children cause profoundly low functional vision. The visual impairment tends to exacerbate the behavioral disorder by impeding visual attention, interaction with objects and persons, and motor skills (a constellation of findings is labeled ”visual autism”). Excimer laser correction of high errors of refraction in children is a recent innovation, with results to date indicating that the methodology is safe and effective. (Tychsen et al, 2005)
Over the past two decades, refractive surgery has expanded to include PRK, LASIK and phakic IOLs. With these new techniques, the range of treatable refractive errors has expanded to include higher degrees of myopia, hyperopia, and astigmatism. The type and degree of refractive error may determine the type of refractive surgery that is most appropriate e.g. for low myopia several options available (e.g. PRK and LASIK), for high myopia e.g., (LASIK and phakic IOLs), AK for astigmatism, while PRK, LASIK, and phakic IOLs, for hyperopia. (Nucci and Drack 2001)