Orthokeratology (Ortho-K) is a non-surgical process that gently reshapes the cornea using specially made contact lenses, reducing or correcting short-sightedness (myopia) and astigmatism. The contact lenses function like the dental braces used to straighten crooked teeth, molding the cornea to improve vision.
The big difference, however, is that your cornea is naturally elastic. For this reason, Ortho-K contact lenses will need to be worn typically either two to four nights per weeks or part of each waking day.
A pair of lenses are prescribed once the ideal corneal shape has been achieved and your eye sight has seen an improvement.
Ortho-K can provide freedom from contact lenses and spectacles for most – if not all – of your waking hours. Some people experience excellent vision after a day or two of overnight Ortho-K. But for higher prescriptions it may take longer for maximum correction.
For people with a higher degree of myopia, Ortho-K is useful in correcting myopia to achieve adequate – but not perfect – vision when the Ortho-K lenses are removed. Children and teenagers have also experienced great success to stabilize and retard the progression of myopia.
It is a great choice for sports enthusiasts, as well as police personnel, fire fighters or pilots, where wearing eye glasses or contact lenses might not be ideal.
These contact lenses also benefit persons who have gone through cornea Excimer Laser surgery (PRK, LASIK, etc.) as it fit better than other lenses.
It is a non-invasive and completely reversible process.
Many of the risks associated with wearing Ortho-K lenses result from the lack of proper lens care and good hygiene practice.
With the right schedule of care and proper consultation from qualified and professional optometrists, these risks can be greatly minimized or completely eliminated.
To minimize these risks of infection:
• You must be prepared to allow for 4 to 10 visits over 3 to 6 months periods
• You must be prepared to follow instructions precisely for the best and safest results.
“For safe ortho-k treatment, there is a need for good compliance from the practitioners, the wearers, and parents (if children are involved). Careful patient selection and monitoring during the course of the treatment are essential to minimize risk and development of serious complications (e.g., microbial keratitis) in ortho-k treatment. With proper and regular eye examination, Ortho-K can slow myopic progression in children and provide clear unaided vision for well-adapted wearers without affecting ocular health.”
Additional Reading: Retardation of Myopia in Orthokeratology
(ROMIO) Study: A 2-Year Randomized Clinical Trial by Pauline Cho
and Sin-Wan Cheung
“To our knowledge, this is the first study to investigate the long- term effects of OK on axial length growth. Our results confirmed that OK treatment is effective in slowing the increase in axial length, with this effect being most noticeable over the first year of OK treatment and largely limited to the first 3 years of treatment. “
Additional Reading: Long-Term Effect of Overnight Orthokeratology on
Axial Length Elongation in Childhood Myopia: A 5-Year Follow- Up
Study by Takahiro Hiraoka, et al.
Orthokeratology works for those with up to about 6.00 dioptres (600 degrees) of myopia and 2.00 dioptres (200 degrees) of astigmatism.
Those with higher ranges of power might find an improvement but might take a longer time and require supplementary glasses. It will also not work as effectively with very steep or flat cornea shape. The complexity of the corneal shape and the rigidity of the cornea itself are unique to each individual, and the results of Ortho-K will differ from one individual to the next.
Orthokeratology does not have any post-operative pain, and pain-killing local anaesthetic eye-drops are not needed. The hazy vision experienced by patients following laser surgery is completely absent.
Unlike laser surgery, where the Bowman’s membrane – a tough protective layer in the cornea – is removed permanently during corrective laser surgery (PRK), the corneal tissue remain intact in Orthokeratology.
Changes in eye prescription over time can be managed by modifying the Ortho-K lenses. While PRK patient must be over 21 with stable refractive error, there are no age limits for Ortho-K.
Lastly, Ortho-K is reversible.
Patient can stop wearing the lenses and allow the cornea to adjust back to its original shape. For persons approaching middle age, short sightedness can be re-introduced later to provide better near vision without needing reading or bifocal spectacles.
What are the disadvantages of Ortho-K?
• You must be prepared to allow for 4 to 10 visits over 3 to 6 months period
• Wearing of lens is essential or the cornea will revert to its original shape.
• The degree of success is high but cannot always be guaranteed.
• The rate of improvement varies from one person to the next.
• You must be prepared to follow instructions precisely for the best result.
An eye-check and consultation are needed for a preliminary assessment. This allows us to assess the general condition and health of the eyes and discuss the likely effectiveness of the procedure for each person.
Not everyone assessed will be found to qualify for Ortho-K.
We strongly believe in a stringent process of patient selection and monitoring to ensure that our patients get the best and safest possible results with Ortho-K.
Accelerated Ortho-K is possible because computerized corneal topography maps out the entire corneal in detail.
The computer programs interprets the data to help determine the best choice lens from different series of rigid, highly oxygen permeable materials fitted to gently reshape the cornea towards less curvature and an more spherical shape. This will reduce myopia and astigmatism whilst dramatically improving unaided eyesight.
Visual changes occur rapidly in the first few days and weeks requiring frequent examinations and perhaps some lens changes.
Stabilization procedures will follow at a slower pace over the next few months.
The program length varies between 3 and 6 months depending upon the degree of visual error.
After maximum results are achieved, retainer lenses are worn to stabilize the new corneal shape. A period of full time retainer wear is followed by a reduction of daytime wear.
Retainers may be worn during the day or night.
Orthokeratology requires time and several lens changes before maximum results can be accomplished. Once completed, the ongoing costs will not exceed and often are smaller than conventional contact lens wear.
Our Ortho-K package is $2000 to $2400 and will includes after-care visits and lens changes for the first year. A deposit is payable upon ordering the first pair of lenses and the balance paid when the lenses are collected.