LASER FOR LAZY EYE
Laser eye surgery is nothing new, but performing it on children is. Doctors are now using the procedure to correct "lazy eye", a condition that often causes kids years of physical and social discomfort.
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This is what lazy eye looks like. One eye is much weaker than the other.
Kenneth Wright, M.D.
"So the brain is real smart. It just shuts down that eye. The good eye sort of just takes over."
That's what happened to Kiley Bedwell. For years, he wore glasses with a thick lens over his weaker left eye, and clear glass over his good eye.
Kiley Bedwell
Had laser surgery
"I used to play video games looking to the side, just so my right eye could see the whole thing and my left eye wouldn't. And I would play sports that way, too."
At age 12, Kiley became one of the first children with lazy eye to undergo PRK laser surgery.
Kenneth Wright, M.D.
Pediatric Ophthalmologist
Cedars-Sinai Medical Center
Los Angeles, CA
"We gently remove a few cells from the surface of the cornea, and then the laser does its work and re-shapes the cornea, so that the image is in focus."
The procedure, much like this one, is performed while the child is fully awake. There's no actual "cutting into" the eye. Now sixteen, kiley no longer needs glasses.
Linda Bedwell
Kiley's Mother
"I know when I tell people, they're like, 'What?' They think we were nuts to do it, but there's no regrets."
Though some doctors are hesitant to perform the surgery on children, doctor wright says study results are very encouraging.
Kenneth Wright, M.D.
"Once we get our data that shows that this is gonna work and it's gonna be safe, then I think we can move down to younger children, and even one day, we might do children, under anesthesia, as young as one or two years old."
So far, doctor wright has performed the p-r-k laser procedure on two kids as part of his clinical trial at cedars-sinai medical center in los angeles. He's now looking for ten more patients. He predicts within five-to-ten years, laser surgery will be a common treatment for lazy eye patients nationwide.
EYES THAT DISAGREE: Doctors call it hypermetropic amblyoopia. For the children and their parents who have to grapple with the affliction, it's better known as "lazy eye." Lazy eye describes a condition where a child is born with one eye much weaker than the other. In some cases, the "bad" eye can be legally blind. Though some patients are easily identified due to an obvious "cross-eyed" look, roughly half of all lazy eye patients appear perfectly normal, and can only be diagnosed with an eye exam. Lazy eye is a self-perpetuating condition. From the earliest stages of development, the "bad" eye presents the brain with a blurred image. The brain, in turn, shuts down development and dependence on that eye and shifts all attention to the "good" eye. As a result, corrective lenses are often insufficient to reverse the problem. Traditionally, young patients have been treated through the use of lopsided glasses with a thick lens over the bad eye and clear glass over the good one. Additional treatments have included contact lenses and patching the good eye for years at a time to force the brain to make better use of the afflicted eye. Such treatments would be inconvenient and uncomfortable even for adult patients, but can be especially difficult for children both from a physical and social standpoint.
A NEW APPROACH: Kenneth Wright, M.D., a pediatric ophthalmologist from Cedars-Sinai Medical Center, is part of a new group of eye specialists who perform laser surgery on children. Dr. Wright has been given government approval for a clinical trial regarding photorefractive keratectomy (PRK) for children with lazy eye. The surgery involves the use of a laser to reshape the cornea so the visual image is clear. Dr. Wright has already performed the procedure on two children, ages 10 and 12, with successful results. He says PRK will likely be the treatment of choice for many lazy eye patients within 5 to 10 years.
OBJECTIONS: Traditionally, some people in the medical community have been reluctant to perform laser surgery on children for two reasons. First, they say a child's eye is still developing, and may "outgrow" the surgical repair. Second, they say laser surgery requires the patient to lie absolutely still, which can be difficult for children.
Dr. Wright says he only repairs the weak eye to the level of the good one. The hope is that both eyes will continue to develop at the same rate. As for the necessity to lie still, Dr. Wright says he has had very good luck so far. His clinical trial authorizes him to work on children as young as age 7. Eventually, he says, PRK might very well be used on patients as young as 1 or 2 years old. Those patients, however, would require general anesthesia.
Tina Kiss
Cedars-Sinai Medical Center
8631 West 3rd Street, Suite 304-E
Los Angeles, CA 90048
(310) 423-6963
www.wrighteyecare.com
kisst@cshs.org
Copyright © 2003 Ivanhoe Broadcast News, Inc.
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