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Orthokeratology (Ortho-k) & myopia control



Orthokeratology is a non-surgical and reversible procedure that eliminates the need for glasses or daytime contact lenses. It consists of the fitting of specially designed gas permeable contact lenses that you wear overnight. While you are asleep, the lenses gently reshape the front surface of your eye (cornea) so you can see clearly the following day after you remove the lenses when you wake-up.

Ortho-k lenses are prescribed for two purposes:

  1. To correct refractive error. Eliminating the need for glasses or daytime contacts makes it a great option for athletes, dry eye sufferers, patients who are frustrated with soft contact lenses and patients who are looking for a non-surgical alternative to LASIK
  2. To slow the progression of childhood myopia (nearsightedness). The prevalence of myopia and high myopia has significantly increased worldwide and in the United States.
    A new study by investigators at the American Academy of Ophthalmology, Genentech, the National Institutes of Health and UC Davis Eye Center has found that 9.6 million U.S. adults are highly myopic, or severely nearsighted, and of those, nearly 820,000 have a degenerative form of the disease and more than 41,000 suffer myopic choroidal neovascularization, a complication that can cause long-term vision loss, especially in women. The serious implications of these trends are being recognized. Myopia is not just a minor inconvenience requiring vision correction with glasses or contact lenses, but a disease process creating significant risk of serious vision-threatening eye disease. The Collaborative Longitudinal Evaluation of Ethnicity and Refractive Error (CLEERE) researchers suggested that children who have two parents with myopia are inherently predisposed to have eyes that are shaped like those of a nearsighted person, and are also likely to become nearsighted over time. This research confirmed the presence of a genetic/anatomical relationship in myopia development and progression.

Content below courtesy of The American Academy of Orthokeratology and Myopia Control

Information below courtesy of The American Academy of Orthokeratology and Myopia Control

WHO IS A GOOD CANDIDATE?

Orthokeratology can be effective on farsighted, nearsighted (myopic), and astigmatic patients. Ideally, your prescription should be in the range of +2.00 to -6.00 with no more than -1.75 diopters of surface astigmatism. In some cases your Orthokeratologist will attempt higher prescriptions.

If you have been unable to wear contact lenses for any reason (discomfort, allergies, inconvenience, dryness, etc.), you are also a great candidate because this lens is so easy to use and it’s worn while you sleep. This greatly reduces any discomfort you may have experienced while using conventional contact lenses.

You are also a great candidate if you need excellent vision without the use of contacts or glasses. Ortho-K benefits pilots, police officers, military personnel and those with safety concerns such as professional athletes, parents of small children, lifeguards and many others. 

Finally, if you just don’t want to be bothered with wearing glasses or contact lenses during a variety of activities such as hiking, playing sports, swimming, skiing, camping, off-road driving, biking, snorkeling, scuba and more, Ortho-K is for you.


WHY ARE CHILDREN GOOD CANDIDATES?

Studies from around the world have indicated that Ortho-K can keep your children’s nearsightedness from getting worse. Currently, an ongoing 5 year FDA study is seeking to confirm previous studies and prove anecdotal evidence to this fact. Increasing nearsightedness is also a risk factor for detached retina and glaucoma.

Your child is an especially good candidate if they have a tendency to lose or abuse their contact lenses/glasses, or if wearing them interferes with their active life.

IS AGE A FACTOR?

No, unlike the age limits imposed on refractive surgery, your Orthokeratologist can fit young children. 
And, there is no upper limit on age either. 


I SUFFER FROM DRY EYES, AM I A CANDIDATE?

Dry eyes are usually not a problem while you sleep as there is little tear evaporation in a closed eye, and Ortho-K lenses are only worn while you sleep. If your dry eyes are a problem while you sleep, dry eye treatment is a simple option. Orthokeratology can provide those unable to wear conventional contact lenses due to dry eyes with excellent vision with no compromise to their comfort.

If you have dry eye disease due to severe arthritis or a collagen-vascular disease, you may not be a candidate. However, a comprehensive exam will give us a better idea of your chances for success


I USED TO WEAR CONTACT LENSES, BUT STOPPED DUE TO DISCOMFORT. AM I A CANDIDATE?

Yes, your corneal reshaping lenses are worn at night while you sleep. This greatly reduces any discomfort you may have experienced while wearing contact lenses during the day.

HOW LONG WILL IT TAKE TO ACHIEVE GREAT VISION? 


This depends on your prescription, age, and treatment goals. In adults, the higher prescriptions can take two to four weeks to achieve good vision but children’s corneas are much more easily molded. 
Some patients are seeing clearly in as little as one night of retainer lens wear.


IS THE VISION IMPROVEMENT CREATED BY THE CORNEAL RESHAPING MOLD LENSES PERMANENT?

Patients who wear their lenses as prescribed find that they have great vision well into the evening. Some patients are even able to wear their lenses every other night and still maintain their enhanced vision. However, if you stop wearing your lenses while sleeping, your vision will return to its original state.


CAN I SEE WHILE WEARING MY ORTHO-K RETAINERS?

Yes. This allows you to read in bed or watch TV before falling asleep.


WHAT DO I DO ABOUT MY VISION WHILE MY EYES ARE IN THE PROCESS OF RE-SHAPING?

During the first few days of the Ortho-K process, you may find that your vision is quite good for a few hours, and then begins to diminish. Your Orthokeratologist may fit you with a soft lens to wear that will improve your vision when it begins to fade. Often these are only worn as needed and are reduced in strength as your vision improves.


HOW SUCCESSFUL ARE CORNEAL RESHAPING LENSES?

The rate of success is very high, but it depends on your original prescription and treatment goals. During your initial evaluation your Orthokeratologist will give you information about your potential outcome.


HOW SAFE ARE THE RETAINER MOLDS?

They are very safe. However, there is a small risk of infection or abnormal blood vessel growth involved when any contact lens is worn. This risk is minimized by adhering to scrupulous disinfection and care procedures, by wearing your retainers only as instructed and by coming in for regular progress checks.


ARE THEY DIFFICULT TO INSERT AND REMOVE?

Your retainers are actually easier to insert and remove than most oxygen permeable lenses and much easier than a soft lens.


HOW OFTEN DO MY RETAINER LENSES NEED REPLACING?

Your Orthokeratologist may recommend replacing your retainer lenses every year depending on their condition. Molds that have become warped or have that have deposits and build up will not allow proper oxygen to the cornea, may even lead to infection, and will not produce a consistent treatment. At your yearly exam, you will be advised if they need to be replaced.


WHAT IF I LOSE A LENS?

Orthokeratology is different than wearing regular contact lenses. If you discontinue wear for one night, your vision may be impaired the next day. Immediate replacement of a lost retainer is necessary. 
Your Orthokeratologist may recommend always having a spare pair of retainer lenses as a back up… just in case.

WHAT IF I SLEEP LESS THAN MOST PEOPLE?

Great results can be achieved in as little as four hours of sleep each night. Some people prefer to sleep for several short time periods of time rather than one consecutive period. This isn’t a problem, just insert your retainer lenses in when you sleep and remove them when you wake.