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LASIK (Laser-Assisted in SItu Keratomileusis) is a safe and effective procedure approved by the Food and Drug Administration (FDA) for use on adults aged 18 or older. However, it is not approved for children, and it is not likely to be in the near future. To understand why, let us briefly talk first about how the eye works and how LASIK corrects it.

How the Eye Works

The eye is a like a camera, with a pair of lenses, one the lens, the other the cornea, that focus light reflected from objects onto the back of the eye, the retina. At the retina, the light is interpreted and transformed into a signal that is transmitted to the brain via the optic nerve.

How LASIK Works

In people with vision defects like hyperopia (farsightedness) or myopia (nearsightedness), the light from objects focuses not on the retina, but either in front of or behind the retina. To correct this problem, LASIK reshapes the cornea to help the light focus on the surface of the retina.

LASIK Concerns in Children

In the past, there were many concerns about LASIK in children. One was that it was impossible to get an accurate assessment of a child's vision at a young age. However, new technology allows ophthalmologists to read a child's eyes directly, ensuring complete accuracy.

Another concern is that children would not be able to sit still or keep their eyes open long enough for the procedure to be completed. However, new technology has made LASIK a very quick procedure, so that moderately well-behaved children should be able to have the procedure done. In addition, there is always the option of sedating children while the procedure is done.

Others might express concern that long-term effects of LASIK are not yet known. This is true, but LASIK results have proven very stable since the first procedures conducted in 1988, so there is little reason for this to be a concern for children any more than for adults.

The main reason why LASIK should not be done on children is that their vision is not yet stable. Children often experience significant changes in their vision, since all infants suffer from mild hyperopia, which fades, while myopia often does not set in until children enter their teens or even later. The changing vision of children is related to changes in their cornea. If children have LASIK done, they will most likely need it done a second time later on. In addition, no good data exists on the effects of reshaping on still-growing corneas.

Exceptions

In some situations, however, LASIK surgery on children may be justified. One of the main situations where this may be the case is amblyopia, or lazy eye. In this condition, a child has one eye that is very much weaker than the other. Because the weaker eye is unable to focus on the objects that the stronger eye is looking at, it wanders. Treatment options for this in the past have included contacts, glasses, eye drops, or eye patches, many of which have significant side effects of their own. LASIK may be able to help children with this problem because it can make the eyes closer to one another, and because of the complications of other procedures, LASIK may actually prove to have the best risk-benefit profile.

To learn more about LASIK in children, consult your ophthalmologist to discuss the options and what might be best for your children.

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