Lawrence Tychsen, M.D., professor of ophthalmology and visual sciences and ophthalmologist-in-chief at St. Louis Children’s Hospital, St. Louis, developed specialized testing and now does refractive surgery on children with cerebral palsy, Down syndrome and neurobehavioral disorders such as autism. About 80% of children with severe neurological disorders have some kind of vision impairment, and about 10% have a severe impairment, according to a Washington University School of Medicine news release.

Tychsen and his staff perform LASEK, which is safer for children, who will inevitably rub their eyes after surgery. Because many of the children Tychsen treats are unable to communicate clearly or are uncooperative, he and his team use several noninvasive, electronic techniques to measure eyesight and determine the success of surgery. A computer-recording method measures the improvements that can be achieved in the visual brain while the child is awake. Other instruments take precise measurements before surgery while a child is under anesthesia. Although the surgeries can make significant improvements in the child’s vision and overall quality of life, most laser-treated children will see mild regression in their vision over time and about 10% require repeat surgery.