Children's Mercy

Parents, Keep Your Eyes Open Refractive errors in children aren't always easy for parents to detect but might cause these symptoms. A Look at Refractive Surgery A small number of children with refractive errors are candidates for surgery to reshape the cornea—and their vision of the world around them. R efractive errors occur when irregularities in the eye, such as an abnormally shaped cornea, hinder the ability to focus on objects. The refractive errors that typically affect children are familiar to most adults, especially those who wear glasses or contact lenses: nearsightedness (myopia), farsightedness (hyperopia) and astigmatism. Problems with focus usually become clear during vision tests performed by pediatricians when children are preschool or kindergarten age. (See "Parents, Keep Your Eyes Open" to learn about signs of refractive errors.) Most children overcome refractive errors by wearing glasses or, when they're responsible enough, contact lenses. A few may require a laser procedure to achieve clarity. "It is extremely rare for children to need surgery for refractive errors; glasses are usually the best treatment," says Erin D. Stahl, MD, ophthalmologist at Children's Mercy and Assistant Professor of Ophthalmology at the UMKC School of Medicine. "However, children who have normal vision in one eye and a significant refractive error in the other, children with severe developmental delays whose refractive errors compound their disabilities, and children with craniofacial abnormalities that prevent their wearing glasses might benefit from surgery." FIXING PRECIOUS PEEPERS This past spring, Children's Mercy became just the third pediatric hospital in the country to provide refractive surgery when Dr. Stahl operated on the first group of patients. She performs photorefractive keratectomy—a procedure in which a laser is used to make miniscule changes to the cornea—four days per year when a mobile laser unit visits Children's Mercy South. "Making very subtle alterations to the surface of the cornea can improve refractive errors pretty significantly," Dr. Stahl says. "Patients wear shields over their eyes for four days after surgery to prevent rubbing." With the world in better focus, children can see their full potential. Scan this QR code with your smartphone or visit www.childrensmercy.org/MichaelMotelet to read about Michael Motelet, one of Children's Mercy's first refractive surgery patients, and how clearer vision made a big difference in his life. 6 Safe & Sound Winter 2014 Nearsightedness—difficulty seeing distant objects—is often fairly apparent by children's squinting. Squinting is also a symptom of astigmatism, which occurs when light reaches the retina unevenly. Farsightedness is tougher to identify; your best clue might be reports of inattention or frustration at school. If your pediatrician thinks your child might have a refractive error based on the results of a routine vision test, follow up with an ophthalmologist to confirm the diagnosis. Children's Mercy has 18 pediatric ophthalmologists and optometrists dedicated to the unique needs of developing eyes. Clinics are conveniently located at Children's Mercy Clinics on Broadway, Children's Mercy South and Children's Mercy Northland.

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