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    Refractive surgery for special needs children: The time is now

    For many, living in a visual blur promotes fearfulness, blunts social interactions

    Take-home message: The time for refractive surgery for special needs children seems to be at hand, considering that advancements in laser and IOL technologies have been proven to be efficacious. Correcting a special needs child’s vision can reduce fearfulness and improve their behavioral challenges.



    St. Louis —Most medications and devices that are used on a routine basis to treat pediatric patients are used off-label. These medications and devices were not developed to treat children but rather were adapted from innovations that were designed to treat adults. If the innovations prove to be effective and safe in children, they may become part of standard practice.

    The time for this in refractive surgery seems to be at hand, considering that advancements in laser and IOL technologies have been proven repeatedly to be efficacious, according to Lawrence Tychsen, MD, who described his approach to treating select spectacle-noncompliant visually impaired pediatric patients with anisometropic amblyopia and isoametropic blur-induced blindness.

    Most of these children, he pointed out, have neurobehavioral disorders, such as cerebral palsy, autism, Down syndrome, and developmental encephalopathies and are not compliant with spectacle wear and cannot wear contact lenses.

    “Bilateral high ametropia can trap these patients in a cocoon of visual blur that promotes fearfulness and blunted social interactions that exacerbate the behavioral disorder,” Dr. Tychsen explained. He is the John F. Hardesty, MD, Distinguished Professor of Ophthalmology and Visual Sciences, Pediatrics and Neurobiology, St. Louis Children’s Hospital, Washington University, St. Louis.

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