Orthokeratology, commonly called ortho-k, is a method used to correct myopia (nearsightedness) by wearing rigid gas permeable contact lenses overnight, so that no vision correction is needed during daytime hours.
Gas permeable (GP) lenses specialized for ortho-k are inserted at bedtime and worn as you sleep. Throughout the night, the lenses reshape your cornea gently so that your vision becomes clear on the following morning. The correction is temporary, and ideally no eyeglasses or contact lenses will be needed on the next day or two. In order to maintain sharp visual acuity on a daily basis, you need to wear the ortho-k reshaping lenses every night.
At our Big Sky Eye Care in Hamilton we use three brands of orthokeratology contact lenses that are approved for use by the FDA. Euclid Emerald, usually prescribed for myopia control, Paragon Vision Sciences, who produces “Corneal Refractive Therapy” (CRT), and Bausch and Lomb, who manufactures “Vision Shaping Treatment” (VST).
Candidates for Ortho-K
Ortho-k is very suitable for nearsighted people who are not appropriate candidates for vision correction surgery, such as children. Individuals of all ages with healthy eyes can try ortho-k at our practice in Hamilton, Montana namely because it can be discontinued at any point without permanent effects to the eyes.
People who require vision correction and engage regularly in sports or work in extremely dusty, dirty environments will also appreciate the convenience of ortho-k.
Vision Results from Ortho-k
Success rates for ortho-k are generally higher for more mild vision prescriptions. The ideal goal is to provide 20/20 vision without any need for eyeglasses or contacts during the day.
According to FDA trials conducted on both CRT and VST lenses, more than 65% of ortho-k patients were provided with 20/20 visual acuity. A whopping number of more than 90% of ortho-k patients achieved 20/40 vision or better (this is the legal requirement for driving without vision correction in most states). Consult with your eye doctor to find out if your vision prescription is within range for successful ortho-k treatment.
Note that although improvement in vision is generally reported within a day or two of wearing ortho-k overnight, the full effects may not be experienced until the lenses are worn for a few weeks. During this transition period, your vision will probably not be as crisp as it was with regular contacts or eyeglasses, and glare or halos around lights may be visible. Until ortho-k works fully, a temporary pair of eyeglasses may be required for specific actions, such as driving at night.
How Does Ortho-k Feel?
Although some people have trouble wearing regular gas permeable contact lenses during the day, ortho-k GP lenses are worn while sleeping – so discomfort and awareness of the lenses in your eyes is generally not an issue.
Is Ortho-k expensive?
Professional fitting for ortho-k requires a series of visits to your eye doctor. A number of pairs of contact lenses are also generally needed. GP lenses that are special for ortho-k are more costly than standard contacts. In sum, the fees for ortho-k add up to a higher total than regular contact lenses.
LASIK after Ortho-k
Refractive surgeries, such as LASIK, are possible after treatment with ortho-k lenses. Yet because ortho-k works to reshape your cornea, you are required to stop wearing the lenses for approximately several months before undergoing LASIK. This allows your eyes to return to their original shape.
It’s important to inform your LASIK surgeon if you’ve been wearing ortho-k lenses, and you will be advised as to how long of a wait is necessary before having the laser procedure.
- Please describe what Ortho-Keratology is and give a basic sense of how it works.
- Ortho-Keratology is a hard contact lens that is used to slow down the progression of myopia. It is a lens that is worn at night and molds the shape of the cornea to give good vision without correction during the day.
- How does Ortho-K assist in treating nearsightedness, and astigmatism.
- By reshaping the cornea it corrects the refractive error. If the lenses are stopped for a couple days the vision goes back to its normal state.
- Are there different types of ortho k, if yes which one do you recommend and why
- There are different companies who make lenses that correct myopia in a similar way. Paragon vision makes a lens called the CRT lens. They are a reputable brand and have a wide range of powers. We also use them because of their great customer service and ability to help problem solve issues with the fit of the lenses.
- How does Ortho-K slow the progression of childhood myopia.
- The exact method is not understood but the theory of how it works has to do with how light focus on the retina. The Ortho-K changes the way light hits the peripheral retina while still providing crisp clear vision and stops the signal for the eye to change.
- Are the effects of Ortho-K instant?
- After the first night of wearing the lens a younger patient with have an instant change. That change will wear off as the day goes on but after wearing the lenses for a few days the vision lasts the full day. Older patients take a little longer to get the full effect as their corneas are a little more stiff and resistant to change.
- What is it about this particular technology that you find most exciting, or the component that made you feel you need to use in this for your practice?
- I get excited about fitting Ortho-K because is allows kids and adults to not wear any correction during the day. I have seen 9 year olds who were changing perscription every six months go years without having to change their prescription. It is very exciting being able to slow the progression of nearsightedness and keep someone from becoming very nearsighted.
- How effective is it? What results can a patient expect from being treated with Ortho-k?
- The effectiveness depends on how hight the prescription is and how much astigmatism someone has. We only have a certain power range that we can treat so there are some people that would not be good canidates.
- Can you describe the patient experience when being treated with Ortho-K?
- There are a series of visits when being fit in an Ortho-K lens. The first visit we determine the lens and try it on the first time. The lenses are somewhat uncomfortable at the start and after sleeping in the for a few nights the eyes adjust and aren’t as irritated. The vision with the lens on is also very good. After the first night in the lens we follow up first thing in the morning to make sure the lens is doing its job. When the lens is on the eyes the vision is really good as well.
- Who is a good candidate for Ortho-k? From what age can a patient have Ortho-K?
- There are no age limits on the Ortho-K lenses. We have successfully fit 8 or 9 year olds. If a child isn’t able to handle the lenses then we wait a year and try again.
- Are there specific patients for whom the use of Ortho-K is particularly helpful or useful? Why?
- The lenses work good for any age range but kids get the added benifit of slowing down their progression of nearsightedness. People who are interested in LASIK but shy away from surgery are great canidates. Ortho-Keratology is similar to LASIK as it reshapes the eyes but Ortho-K is reversible.
- Can you share a particular patient success story, in which by treating with Ortho-K, you were able to provide a patient with a solution which you would otherwise not have been able to provide?
- 4 years ago a new family moved into town and their 9 year old daughter who just got new glasses before moving already could not see out of them. Her prescription had been changing every 6 months. They were so excited to try them after we told them about the lenses. Like most peopel they did not know they existed. She had 3 years in the same lenses before ordering new lenses. The family saved money in the long run by not having to buy glasses and contacts every year and her prescription has barely changed since starting the contacts.
- What are some of the benefits of Ortho-k over glasses?
- Not having to have any correction on during the day is the biggest advantage of Ortho-k over glasses. Especially if someone is involved in sports or outdoor activities. People can purchase plano sunglasses which saves a lot of money.
- Is Ortho-k good for athletes?
- Ortho-k is a great option for athletes. They do not have to worry about glasses or rec spec getting in the way. They do not have to worry about a contacts getting dry or losing one. Swimmers especially love being able to see without worrying about the contacts getting water on them.
- Is Ortho-K safe?
- Ortho-K is very safe. It carries the same risks as any contact lenses do and if people take care of them the risk of an adverse event like an eye infection is very low.