Most children with refractive errors can be treated successfully with glasses or even contact lenses. For those who cannot wear corrective lenses or glasses, refractive surgery can be an alternative. Fortunately, the number of children who need refractive surgery is quite low.
Refractive surgery in children has been in use for many years. It is the right choice in some situations when they develop severe visual impairment, if the refractive error cannot be corrected conventionally. Amblyogenic situations that lead to functional blindness are:
- When there is a high degree of myopia or astigmatism in both or one eye.
- The inability to achieve excellent vision correction by the standard approach, due to the lack of cooperation with the young child or intolerance of the contact lens or the absence of a positive response to wearing glasses during the most intensive development of a visual function.
Refractive surgery is recommended in children with special needs and high myopia associated with another ocular. It is sometimes recommended in medical problems such as autism, Down Syndrome, cerebral palsy, and other neuromuscular diseases, etc., and also where the standard approach is ineffective. In these situations, without laser correction, these children remain “functionally blind” or with minimal vision function, and this is another stigma that burdens the already difficult psychosocial status of these families.
Global Eye Hospital provides this blog with the details about:
- What is refractive surgery?
- What causes it?
- How are Refractive Conditions Treated?
- To Whom refractive surgery is used for treatment?
- Treatment with glasses is first?
- Refractive surgery procedure in children?
What is Refractive Surgery and What Causes It?
Errors of refraction or focus cause the most common visual impairment. Commonly when light enters the eye through the cornea and lens refraction occurs. But, Refractive errors occur when light rays do not focus on the retina, which causes myopia, or astigmatism.
How Are Refractive Conditions Treated?
Aim of refractive procedures in children is not to release the dependency on glasses or contact lenses in adults. There is a chance to reduce anisometropia in children and achieve visual balance in both eyes.
To completely correct the high refractive error, this is much better than standard treatment, thus allowing for better development of the visual function, and better quality of visual acuity along with binocular-stereo vision.
Refractive errors in children can be treated with laser or implanted intraocular lens in the eye. The choice of laser over an intraocular lens depends on the size of correction needed, and shape of the child’s eye. An excimer laser reshapes the corneal surface to adjust focus. Intraocular lenses also adjusts focus but do so by increasing or decreasing power from the natural lens of the eye. The main goal is to eliminate or reduce the need for glasses or contact lenses.
Who is the Ideal Childrens For Refractive Surgery?
Ideal candidates are children who have problems with vision correction through glasses or contact lenses — suitable candidates in children with significant differences in medical prescription treatments.
Treatment With Glasses is First:
Glasses are the first step for anisometropic children. Glasses serve two purposes: Glasses are made from prescription so that the retinal images of both eyes are equally focused, and the brain does not choose a favourite. Polycarbonate lenses protect the eyes, which is very important for healthy eyes. We always want the child to first get glasses, and when amblyopia develops, we begin to stick. Contact lenses are another option, but some patients may find it difficult to bear.
Anisometropic children would visit the hospital, for one reason or another if a child did not want to wear glasses or contact lenses. Doctors suggest parents that child is not the right candidate for refractive surgery because their eyes are still growing. This surgery might be appropriate if their eyes no longer grow.
Parental training is essential, especially if the child is not wearing glasses for social or cosmetic reasons. At this point, parents often ask for surgical solutions. Practice or guiding the children through available non-surgical procedures, including contact lenses, before considering refractive surgery is most important. Only a small number of children are eligible for this procedure because most children are very responsive to conventional treatments, but some patients do not respond.
Refractive Surgery in Children
When you decide for surgery, the question may arise that when and how the surgery performed?
Age 10 is referred to as the upper age limit for refractive surgery in children with anisometropic amblyopia. In general, you have to compensate for refractive errors and rehabilitate your eyes until the age of 10. However, children over the age of 2, as well as adolescents, are treated successfully.
Techniques used, in Global Eye Hospital India, PRK is the most commonly used refractive procedure for children. The main reason for choosing PRK over LASIK is safety. PRK does not pose a risk of flap dislocation, and pediatric patients are treated more quickly and less likely to experience pain than adults treated with PRK.
PRK: (Photorefractive Keratectomy): In PRK, the thin outer layer of the cornea (epithelium) is removed and discarded before the underlying corneal tissue is reshaped with an excimer laser. The epithelium recovers within a few days after surgery (grows again over the surface of the cornea).
LASIK: In LASIK, thin corneal flaps are made with microkeratome laser. This flap is removed to detect the underlying corneal tissue and replaced after the cornea transformed with an excimer laser.
For more information about the procedure of the surgery, contact Global Eye Hospital.
Parental advice is essential and Pediatric surgeons should tell parents about possible complications and problems that are expected to occur in their child’s age.
As children grow up, children will continue to grow, and their refractive errors will continue to change. This operation is not intended to protect the child from glasses forever. But, to help the child develop good eyesight in one or both eyes, and then use refractive lenses or glasses to compensate for the remaining effects. As the child grows, there is a big difference between refractive surgery to get the child out of the glasses and the child’s visual development surgery.
For more information about refractive surgery for paediatric patients, call Global Eye Hospital.