Hands On EyeCare

Ortho What?

It is derived from Greek roots orthos meaning "straight or proper"; and kerat - meaning "horn" also used for the word cornea.  It sounds like the words orthodontics and orthopaedics except orthodontics corrects teeth and orthopaedics corrects skeletal injuries.  In this case orthokeratology (ortho-k) corrects the cornea (front surface of the eye).

Orthokeratology is a natural, non-surgical, reversible procedure in which specially designed contact lens are used to gently and gradually re-shape the surface of the cornea. These lenses are mainly worn during sleeping hours. Upon awakeining the lenses are removed. The reshaped corneal surface allows clear and natural vision for the rest of the waking day without the need for prescription glasses, contact lenses, or destruction of corneal and corneal nerve tissue through laser refractive surgery.

Orthokeratology is a process of gently molding the cornea to reduce or eliminate nearsightedness and astigmatism (sometimes farsightedness and the need for reading glasses) all by the programmed therapeutic application of specialized contact lenses.

Orthokeratology is ideal for children and adults with prescriptions ranging from -1.00 to   -4.00 diopters of myopia (nearsightedness) and for those with up to 1.50 diopters of astigmatism. 

How Does Ortho-K Work?

While you sleep, a specifically designed gas permeable contact lens gently molds the cornea using natural fluid forces to conform the cornea to a programed shaped.  This flattens the cornea causing the wearer to have corrected nearsightedness for clear vision. 

Improvements in vision can usually be seen within a few hours up to the next day. The improved vision usually wears off gradually by the end of the day, but can last as long as 3 days or more between contact lens use. Then after the vision begins to returns to its previous state, the wearer will just wear the lenses for that night, much like charging your cellular phone over night, except he/she will be "charging up" their vision.

Sometimes it may take a week for the procedure stabilize.  Ortho-K does not make any permanent changes to the eye surface. Your eyes will revert to their former state within 1–4 weeks if you stop using the lenses.

The risks involved with the treatment are relatively low ranging from allergies (mainly to contact lens solution) or rare bacterial infections due to poor hygiene. Also, instances of corneal abrasions have been reported.

The lenses are surprisingly comfortable to wear and most people comment that they forget they have lenses in the eyes after the first night of sleeping with them in.

Who Benefits from Ortho-K?

Ortho-K is particularly beneficial for:

• People who participate in sports, especially contact and water sports
• People working in dusty or dirty environments
• People who are contact lens intolerant due to dry eyes, allergies or environmental factors
• Children

In short, Ortho-K works best for people who don’t want to wear glasses or contact lenses all day, but don’t mind wearing contact lenses while they sleep.  It is essentially a surgical alternative to LASIK and conventional refractive surgeries.

Ortho-K is not for everyone. You must have a relatively healthy cornea. The same corneal health criteria that holds true for any of the refractive error surgery corrections—such as LASIK—holds true for Ortho-K.

Ortho-K and Children

Myopia, or nearsightedness, is a condition of the eye that refers to a person's ability to see objects at a distance. People who are myopic have blurry distance vision and clear near vision.

What causes myopia? Myopia occurs when the eyeball grows too long in relation to the power of the lenses of the eye. This causes light rays to focus at a point in front of the retina, rather than directly at its surface.

Many believe myopia is genetic but, environment may play a strong role as there has been a reported 66% increase in cases of nearsightedness over the past 25 years.  

Therefore in addition to genetics, myopia could be an adaptation to the heavy reading, computer demands, proliferation of hand held devices such as cell phones, and video games.

Some researchers report that one of the advantages of wearing Ortho-K lenses seems to be 'control' of myopia. Researchers in Hong Kong and the US have conducted clinical studies that specifically investigated myopia progression and Ortho-K. Both studies demonstrated that children who wear Ortho-K lenses show 50% less progression in myopia than children who wear spectacles.

However, such studies should be taken with "a grain of salt," because it is not clear what the end refractive error was destined to be without Ortho-K. Thus, it should be known that Ortho-K, as well as all refractive techniques only treat myopia, they never alleviate it.  Which is the reason why it should be expected that the effects of the procedure wear off after discontinued use - albeit without any complications or side effects.

Ortho-K Fine Print

The treatment time is dependent on the individual.  When initiating the Ortho-K experience, there is a set number of visits that are necessary.  Occasionally additional visits may be required to optimize your vision. If scheduled appointments are missed, it is encouraged to make them up in order to ensure greater success. Also, the number of lenses required for this treatment is patient dependent. Nonetheless, we will guide you through the process comfortably.

Complications are relatively rare and easily managed. However, below is a list of some complications:

1. Mild lens binding on awakening (you will be taught how to dislodge a bound lens safely and easily).
2. Mild (superficial) corneal staining (which will normally heal after a few hours).
3. Solution allergy (you will be switched to another care system).
4. Fluctuating vision on certain days after myopia reduction (for which professional fitting adjustment may need to be made).
5. Slow return off vision to previous state (management to control your vision until complete regression is provided).
6. Blur and/or halos around lights or during night time driving (this is not permanent).

Nevertheless, all discomfort should be reported as soon as possible so that a remedy can be administered to reduce the risk of complication.  Most complications are easily managed and reversible.  However, as with all refractive procedures and contact lens devices, rare severe complications in contact lens wear not detected neither treated early may be a result of a corneal infection which in extremely rare cases can cause possible permanent vision loss. 

As with any procedure, complications are minimized if all instructions are followed properly.  Occasionally, you may need to temporarily wear spectacles or disposable contact lenses to correct any resolving refractive error during the day.  After, the end goal is attained (which is usually within 1 week), the final Ortho-K lens will be dispensed for you to wear. 

Appointments are important for Ortho-K to ensure the proper progression of the treatment and to answer any questions you may have about your progress.  The process includes two custom designed Ortho-K lenses, a contact lens solution, our recommended artificial tears, lens suction cup, and a basic appointment regiment necessary to monitor progress (additional soft contact lenses maybe given to aid in the adaptation process for the few who may need them).  Plus, all additional visits are covered.

The appointment program is as follows:

1. Initial eligibility assessment: Refraction, examination of ocular surface and digital corneal topography.
2. Fitting of Ortho-K lens, teaching of insertion and removal and care and maintenance regimes.
3. Lenses are then worn for the first time that night. The following morning the lenses are worn to the first appointment as early as possible.
4. One week follow-up.
5. One month follow-up.
6. Three month follow-up.
7. Six month follow-up to one year exam.
8. Visits there after are every six months to one year.

Total cost of Ortho-K treatment:

Basic Myopia: 2 eyes $1650, 1 eye $1,100
Mixed Myopia and others: 2 eyes $1850 to $2,000, 1 eye $1,500
Repacement Lens Pricing: $350 per lens

All lenses come with a 30 day warranty and contact lens solution with starter kit.

Note: HandS On EyeCare would like to acknowledge Lachlan Scott-Hoy of Innovative Contacts as the author and source of information found on this page.

Imagine doing this with glasses or contacts. It wpuld be tough!

Lasik and other refractive surgeries may not be recommended for some contact sports and professions.

Be able to see clearly when you wake up!

Technology has made fitting Orthokeratology pain-free and healthy. The process is customized for each individual's corneas.

Nearsightedness (Myopia): The shape of the cornea and the length of the eye actually determines how you will see. If you are nearsighted then the light entering your eye cannot focus directly on the retina, specifically the fovea. This results in difficulty seeing far away. 

Ortho-K: A custom made contact lens is placed on the cornea and gently and naturally molds your cornea while you sleep!

End Result: A flatter cornea, safely resulting in less myopia and clear vision!

Ortho-K is not for everyone. You must have a relatively healthy cornea. The same corneal health criteria that holds true for any of the refractive error surgery corrections—such as LASIK—holds true for Ortho-K.