Pediatric refractive surgery fills an important need for the minority of children with high ametropia who cannot tolerate contact lenses or glasses. Dr. Lawrence Tychsen discusses using phakic IOLs, refractive lens exchange, and advanced surface ablation to treat children with special needs. Although these children can achieve substantial gains in UCVA with these methods, they seldom achieve the precise results adults enjoy. More importantly, improving the vision of a special-needs child helps relieve their isolation from the world.