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Eyes-Excimer Laser Surgery


Question

My daughter does not keep her glasses on. She continues to throw her glasses every chance she gets. She has very poor vision without the glasses. Our ophthalmologist suggested Excimer Laser surgery. How do you feel about Excimer Laser Surgery for children who have CdLS?

Answer of our experts

There is a difference of opinion among doctors as to whether LASIK is appropriate for children in certain situations. The family should use the following information to help their decision making process.

Laser surgery is not performed on most children in the general public. In fact, adults are cautioned to wait until they stop growing prior to having surgery. This is typically after the age of 18.

In cases where children will not wear glasses, and Laser is being contemplated, general anesthesia is required. Anesthesia carries its own risks in all patients, and in patients who have CdLS as well.

Many of the children with CdLS may refuse to wear glasses. Many of the developmentally delayed children that I see (most of whom do not have CdLS) need glasses. Some will wear them and some do not. Over the years, I have concluded that if the child perceives a benefit from wearing the glasses, they will indeed keep them on. If they don't notice a benefit, they may refuse to wear them. When they are developmentally ready to Òexpand their worldÓ they will then keep them on.

In making this decision, I would ask the parents if they see any change in the childÕs behavior when they have the glasses on. If they see an enormous difference in behavior, then the Lasik surgery might actually be of some benefit.

SS/TK 7-13-10

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Recommendation(s)

The eyes and the visual system

R36
Surgical correction of ptosis should be considered if vision is significantly affected or if the individual is lifting their chin in attempt to see more clearly and it is affecting the individual’s ability to move around.
R37
Blepharitis in individuals with CdLS should be treated conservatively with lid hygiene. Nasolacrimal duct obstruction (blocked tear ducts) should be suspected if symptoms are not improved with lid hygiene.
R38
Vision should be regularly evaluated in all individuals with CdLS, especially in infancy and childhood. Problems with vision should be corrected early to prevent amblyopia (lazy eye), although children may have difficulty tolerating glasses or contact lenses.

Legal Disclaimer

Please take note that the Ask the Expert service is comprised of volunteer professionals in various areas of focus. Answers are not considered a medical, behavioral, or educational consultation. Ask the Expert is not a substitute for the care and attention your child’s personal physician, psychologist, educational consultant, or social worker can deliver.

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