What is Orthokeratology?
Orthokeratology, also known as Ortho-K, is an FDA-approved, non-surgical treatment in which custom-designed corneal molds (similar to contact lenses) are used to gently reshape the cornea of the eye. The corneal molds are worn while sleeping and removed upon awakening, giving clear vision during the typically day without the aid of glasses or contact lenses. Orthokeratology can correct refractive errors like nearsightedness (myopia), farsightedness (hyperopia), astigmatism and sometimes presbyopia (unable to focus clearly at near after 40 years of age).
Ortho-K is completely reversible and non-invasive; discontinuing to wear the corneal molds will result in the cornea to return to its original shape.
Ortho-K holds particular appeal for certain groups of people:
- Children with progressive myopia
- People who want freedom from their glasses or wearing their contact lenses during the day
- People who play sports – especially contact and water sports
- People working in dusty or dirty environments
- People with dry eyes or allergies
Children with progressive myopia– Ortho-k can be an ideal vision correction method for children who are genetically prone to having their nearsightedness progress year after year. Ortho-K is scientifically proven to dramatically slow, or potentially halt the progression of myopia. Numerous studies have shown that Ortho-k slows myopia progression on an average of 45%. This reduction in myopia can have a positive impact on the long-term health of a child’s eye(1)
People who want freedom from their glasses or contact lenses during the day-Being able to see clearly throughout the day without wearing eyeglasses, contact lenses or having a surgical procedure like LASIK done is one of the main benefits of Ortho-k.
People who play sports– With Ortho-K, individuals can enjoy the freedom of playing sports without worrying about their glasses getting damaged or contact lenses falling out. Ortho-K lenses are only worn at night while asleep, leaving one with perfect vision during the day on the sports field, court or in the swimming pool.
People working in dusty or dirty environments -Some people find it uncomfortable to wear glasses or contact lenses during their daily activities. Ortho-k allows one to not wear corrective lenses during the day and yet see clearly for all activities.
What is Ortho K?
It is the night time wearing special lenses that neutralize the eye’s power, allowing clear vision on removal.
What prescription range does it work for?
Generally, up to about -6.00 myopia with about -1.50 astigmatism. However, in deciding who it will work best for, an accurate eye shape mapping is required as such factors as corneal steepness and prescription orientation can rule out individuals. Eye mapping is extremely important in Ortho K assessment as it is used in the ongoing assessment of treatment. As well as nearsighted correction, it can also be used for low plus prescriptions.
Why not use normal contact lenses?
The biggest problem for soft contact lens wearers is dryness and lens comfort after a period of wear. While modern materials have greatly improved and more people successfully wear lenses, lens comfort and stable vision is still an issue for people with drier eyes, and astigmatism lenses. Normal contact lenses are not suitable for certain occupations and sports. In addition to wearing Ortho K lenses for better comfort, they also have an important role in preventing nearsightedness from getting worse. (Nearsightedness has a tendency to get worse as children grow especially where there is a strong family connection. There is now strong evidence that Ortho K lenses help stop or slow myopia progression.)
Will they take long to work?
Ortho K lenses work from the first night of wear. The full effect may not be achieved in one night but wearers can see there is a big difference on the first removal. In the first week of wearing Ortho K lenses, two things are changing. 1) the quantity of correction increases ie how much you can see and 2) the quality of vision improves ie how well you can see throughout the day.
Are they comfortable?
Most new Ortho K wearers are previous soft contact lens wearers. They all report being more aware of Ortho K lenses in the beginning but once eyes are closed there is no discomfort. By one week, few comfort issues are reported whether eyes are open or closed.
Are they worn every night?
Yes, in most cases.
Can I see with the lenses in?
For safety reasons, it is essential that you can see with, as well as without, Ortho K lenses in. Should you have to get up in the middle of the night and drive – no problem.
What about eye infections?
Wearing any type of contact lens brings a slightly increased risk of eye infection. While the record of Ortho K is very good, it is essential that wearers take responsibility for basic hygiene rules and should consult their eye care practitioner, when in doubt.
I have allergies. Can I wear Ortho K lenses?
Yes. As you are only wearing the lenses to sleep in, you should not be affected by any itching from contact lenses that you may experience during the day.
How safe are these lenses?
There are numerous studies proving the safety of ortho k lenses, even when worn by younger patients.
What about bifocal correction?
Individual assessment will provide a reliable indication of likely success.
Why not have laser surgery?
Laser surgery is not suitable for everyone. Approximately, one-third of candidates are excluded due to dry eyes. As a medical procedure, laser surgery is not without its complications: when things go wrong, the effects may not be reversible. Ortho K is completely reversible within days to weeks of stopping lens wear.
Are contact lenses hard to put in and take off?
Ortho k lenses are smaller than traditional soft lenses. With pediatric patients, usually by about age 9 they are able to insert and remove the contact lenses by themselves! For some younger patients, parents will help to facilitate safe insertion and removal.
What about for children?
Lots of studies have demonstrated that children benefit from a confidence boost in not wearing glasses. They are also very convenient for active kids and adults who want to enjoy sports activities with no need for glasses or daytime contacts. Research also demonstrates that Ortho K lenses have a great benefit in helping to slow the progression of nearsightedness.
I have dry eyes. Can I wear Ortho K lenses?
In many instances of dry eyes, Ortho K lenses can be worn successfully. We would attempt to address the underlying causes of the dry eye, as part of the treatment regime ( in about 70% of dry eye cases, eyelid problems contribute to the dry eye. Improving the eyelid condition alleviates some or all of the dry eye. It may still be necessary to use some eye drops but appropriate advice will be given.)
How often are lenses changed?
To ensure vision remains stable and the eye remains healthy, lenses are changed annually.
Can I store my lenses in water?
No. You should never allow tap water to come in contact with your lenses or storage case. Hands should be dried thoroughly after washing before handling your lenses. Eyes should be kept closed if lenses are worn in the shower.
How can I check my eyes for problems with my lenses?
If in doubt about your eyes you need to ask three questions: how do my eyes feel, how do my eyes look, do I see well (no unusual blurring with either eye)? If you can’t give a ‘normal’ answer to each of these, you should consult your eye care practitioner.
Can the lenses get stuck or lost in my eye?
No. There is a clear membrane (the conjunctiva) that covers the white of the eye and folds back onto the upper and lower lid to prevent lenses or foreign bodies getting behind the eye.
How much do Ortho K lenses cost?
Once fitted the ortho k lenses are less expensive than the best daily disposable lenses. The yearly fitting and evaluation fee (covering all visits and lens changes needed) reduces in cost substantially from the first year to subsequent years.
Will I still need glasses?
There will always be occasions when you can’t wear your Ortho k lenses eg during illness. It is good to keep any spectacles you used pre-Ortho k fitting as the correcting effect will largely disappear over about 4 days. When you resume lens wear, the correcting effect will return very quickly.