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 present, our Lenox Hill Eye Care Practice offers two brands of ortho-k contact lenses, both of which are approved for use by the FDA. Paragon Vision Sciences produces “Corneal Refractive Therapy” (CRT), and Bausch and Lomb 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, 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.
Ortho-k as an alternative to Lasik
We have many patients in both our New York City and Roslyn office who have told us they find glasses or contact lenses to be uncomfortable. They are looking to avoid these traditional vision correctors. Lasik surgery and Ortho-K both offer the ability to see clearly without either glasses or contact lenses. However, Lasik surgery is exactly as it is written, surgery. People are often afraid to have surgery. They feel Lasik isn't 100% full proof. In addition, Lasik can be very expensive, often not covered by insurance. Patients who have had Lasik may even need vision correction or bifocals later on in life.
Ortho-K is a safer alternative that allows the patient the comfort of not wearing contacts or glasses throughout the day while avoiding surgery. While the development of Lasik has improved immensely over the years, there is still an aspect of once it happens, there is no turning back. Ortho-K is something you can try for a time and if you don't like it, can stop. It has also been proven to slow myopia, as outlined above.