Orthokeratology
The vision of Lasik, without the risks of Lasik
About OrthoK
Orthokeratology (or Orthok for short) is a non-surgical procedure using specially designed contact lenses which gently reshape the curvature of the front surface of the eye in order to improve vision. Some of the benefits of Orthok are:
- After correction, you simply see better without eyeglasses or daytime contact lenses.
- Your vision improves while you sleep, non-surgically and painlessly.
- Improvement begins within a matter of days.
- Lenses may only have to be worn for a few hours each day or only once or twice each week.
- Appropriate for all ages. Often used as preventative vision care for children.
- Natural vision for recreation, sports, and leisure is enhanced dramatically.
- Provides good unaided vision for occupations that require it, such as pilots, policemen, firefighters, or any jobs that requires better visual acuity.
- The process is safe, convenient, and comfortable, not disrupting your visual performance as your vision is being improved.
- Completely reversible, unlike LASIK and other corneal refractive surgeries.
Who can benefit from OrthoK?
While many patients benefit from Orthok, several groups obtain the greatest results:
- Children whose parents wish to significantly slow or stop the progression of myopia (nearsightedness). University studies of large samples of nearsighted children show that when Orthok is done properly, myopia can be halted and even reversed over a period of years with the great majority of nearsighted children.
- Patients who need corrective lenses, but wish to be free of their regular contact lenses and eyeglasses during their waking hours, while maintaining clear and comfortable vision without any corrective lenses.
- Patients who require excellent uncorrected visual acuity in each eye for their career. This includes patients seeking employment in aviation, or entry into our nation’s military academies.
- Young people whose myopia (nearsightedness) is progressing are excellent candidates for orthokeratology. As young people are very active athletically, this allows them the visual freedom to play sports without eyeglasses or conventional contact lenses.
What is the typical treatment?
The initial treatment phase usually lasts several weeks. Your vision improves as the curvature of the cornea (the front surface of the eye) changes. New lenses are made, dispensed, and evaluated on the eye during this time period.
How often will I wear the lenses overnight?
Once the treatment is over, you can wear the Orthok lenses at night only and see well during the day without any corrective lenses. Many of our patients wear their lenses every other night. Others only wear their lenses once or twice a week. Patients need to be seen regularly to ensure that their lenses are fitting well and that their eyes are remaining healthy.
Are the OrthoK lenses comfortable?
For daytime wear, rigid lenses are generally considered to be not as comfortable as soft lenses. But remember, OrthoK lenses are worn overnight only! Accordingly, Orthok is well accepted since the main cause of rigid lens discomfort during waking hours is the feeling of the eyelids moving over the lens edges while blinking. Since the Orthok lenses are worn when the eyes are closed for sleep, there is no blinking and therefore no residual feeling of the lenses after a short adaptation period.
How long until the full effect is Seen?
The cornea experiences a significant degree of adaptation within hours or days, although full adaptation often requires several weeks. During this initial period patients’ vision will be changing. Some patients will experience a rapid change while others will note a more gradual change. Once adapted, FDA trials showed over 65% of patients achieved 20/20 eyesight and over 90% achieved eyesight 20/40 or better (the typical US requirement for driving without corrective lenses). In the USA, overnight Orthok wear is approved by the FDA for up to-6.00 diopters of myopia and a maximum of 1.75 diopters of astigmatism.
How long until my old prescription returns?
The corrective effect of orthokeratology is stable but reversible. Without the lenses, the eye will slowly return to its previous prescription, taking around three days to return to its former vision. As such, Orthok lenses are worn regularly to preserve the corrected shape of the eye. Again, some patients may only need to wear their Orthok lenses once or twice each week.
How Safe is OrthoK?
The risks of OrthoK are comparable to or less than ordinary contact lenses. OrthoK lenses are typically worn for much shorter periods (6 to 8 hours, rather than all day or continuous 24/7 lens wear). OrthoK lenses are also worn while asleep, rather than when active.
How do the risks of OrthoK compare to LASIK and PRK?
Orthok is safer than surgical corrections (such as LASIK and PRK). Since no surgery is involved, the numerous risks associated with laser vision correction are eliminated. In the USA and Canada, Lasik is not done on anyone younger than 18 years of age, whereas Orthok can be done on chlidren as young as 6 or 7. LASIK corrects vision at a single point in time. Patients may be back in glasses once the treatment wears off (called “regression”). Permanent irregular astigmatism and dry eye are recognized complications of LASIK for which there may be no cure. With Orthok, since no surgery is involved, corrections to the eye’s shape can be handled over time, safely and reversibly. It is important to remember that, as with all contact lenses, maintaining good cleaning and hygiene discipline is essential.
Who is not a candidate?
Patients who are not good candidates for Orthok include patients with dry eye syndrome or who are taking medications that can create a dry eye condition.
Are there other long term benefits to OrthoK?
35% of all retinal and vitreous detachments are due to high myopia. In addition, cataracts, glaucoma and retinal and vitreous degenerations are more prevalent in adults suffering from high myopia.