ORTHO-K

Q: How do ortho-k lenses work?
A: Ortho-k shaping lenses are designed to progressively reshape the central surface of the cornea systematically, similar to the effect of lasers in reversing nearsightedness. However, unlike laser surgery, the effect of ortho-k treatment is temporary and reversible.

Q: Is everyone a candidate of ortho-k?
A: No! While orthokeratology can help most individuals (including those with certain types and amounts of astigmatism and moderately high myopia) improve their vision, the procedure is often most effective for those prescriptions falling within a specific range. Additional factors may include individual corneal rigidity and shape factors as well as an ability to wear contact lenses. A thorough consultation and examination using advanced computerized diagnostic instrumentation can easily determine if orthokeratology is right for an individual.

Q: Who is not a candidate for ortho-k?
A: While ortho-k can be performed on practically anyone with healthy eyes who can insert a contact lens and follow lens care directions, it is not recommended for people with prescriptions above 5.00 diopters of myopia or above 1.50 diopters of astigmatism. Also, people with pupils that are larger than normal (>6 mm in normal light) and those having irregular corneal astigmatism or any corneal disorder such as keratoconus are not candidates.

Q: How safe is ortho-k?
A: Ortho-k is believed to be safe when appropriately fitted and managed properly. Many people have been able to eliminate their dependence upon their glasses and standard contacts with no adverse effects. Unlike surgical procedures like radial keratotomy (RK), photorefractive keratectomy (PRK), laser assisted in-situ keratomileusis (LASIK), and laser assisted subepithelial keratecomy (LASEK), the corneal tissue is not incised or vaporized by a laser. As with all contact lenses, proper lens care and handling must be preformed to maintain eye health. The state-of-the-art, high-permeability GP materials now available provide adequate amounts of oxygen to the tissues of the eye.

Q: Is ortho-k permanent?
A: After treatment, maximum results are achieved and retainer-shaping lenses are worn to stabilize and maintain the new corneal shape. Failure to wear the shaping lens on an ongoing basis will result in a return to the pre-existing prescription. Retainer shaping lenses will likely be prescribed for overnight wear.

Q: What are the risks of wearing lenses overnight?
A: The complications of wearing contact lenses include corneal ingrowth of vessels, ulcers, and abrasions. The risks associated with wearing contact lenses overnight are higher than wearing contact lenses only while awake. Contact lenses cannot become lost behind the eye (this is anatomically impossible) and is rare for ortho-k shaping lenses to become decentered from the cornea.

Q: Once the treatment phase is completed, how frequently will I need to wear the overnight retainer lenses?
A: Most people will need to wear the shaping lenses six to seven consecutive nights in order to enjoy good, unaided vision during the entire day. Patients with lesser degrees of myopia (nearsightedness) may find that wearing them every other night is satisfactory. However, this will be determined on an individual basis by the eye care practitioner.

Q: How much myopia can a person realistically expect to be able to reduce using orthokeratology?
A: Generally, 5.00 diopters of myopia is the upper limit for myopia reduction. However, work is underway on designs that will hopefully correct higher amounts of myopia. Lower amounts of myopia are easier and faster to reduce.

Q: How about ortho-k for astigmatism?
A: The amount of astigmatism reduction achievable will depend on the amount and the type. 1.50 diopters of "with-the-rule" corneal astigmatism and 0.75 diopter of "against-the-rule" corneal astigmatism are considered the upper limits for astigmatism reduction. Ortho-k will not have an effect on residual (internal) astigmatism.

Q: How long does it take to be able to see well without glasses?
A: Rapid visual improvement normally occurs in the first few days. Stabilization then follows over the next few weeks and months. Once the wearer's eyes are stabilized, improved eyesight is maintained by wearing shaping lenses as recommended to maintain vision at the desired level.

Q: If the patient decides to return to wearing glasses, can vision be resorted to its pre-treatment level?
A: The wearer's eyes will return to their pre-treatment nearsightedness after about two weeks. Depending on how long ortho-k lenses have been worn, this process may be as long as 30-90 days. In order to provide good vision during this transitional period, patients are refitted with gas permeable lenses or disposable soft lenses while the corneas recover their pre-treatment shape.