[Refractive surgery for children with developmental delay : Indications, techniques and results]

Visual stimulation and communication with the surroundings are crucial factors for childhood development. In children with intellectual disability the developmental delay can be exacerbated by visual impairment leading to visual autism. Uncorrected refractive error is one of the leading causes of visual impairment and spectacles are the gold standard for treatment. For some children with developmental delay or intellectual disability, the fitting and wearing of spectacles can be impossible due to severe craniofacial malformations, poor neck control or involuntary head movements. In these cases, if wearing contact lenses is also impossible the refractive error remains untreated and the child visually impaired. In certain situations cornea-based laser refractive surgery or lens-based refractive surgery can treat these refractive errors to enable better unaided visual acuity and therefore enhanced stimulation and integration of these developmentally delayed children. This article describes and discusses the indications, technical aspects and results of refractive surgery for children with developmental delay and intellectual disability.