Orthokeratology Specialist

Orthokeratology and Myopia Control Q & A

Who is Ortho-k for?

Ortho-k is mainly used to correct near-sightedness (Myopia). This vision problem can also usually be corrected by eye glasses, regular contact lenses, LASIK or PRK. Orthokeratology is a surgery-free way for some people to leave their glasses behind and not have to wear contact lenses all the time.

Ortho-k is sometimes recommended to correct children’s vision. Vision can continue to change for some children into adulthood and their 20’s. Vision correction surgeries like LASIK are not recommended until vision is stable. There is no firm evidence that Ortho-k can slow down the progression of myopia in children, but this is also being studied as a possibility.

How does Ortho-k work?

The cornea is a clear, dome-shaped window in the front of your eye that focuses light onto the retina and is responsible for most of the eye’s ability to focus. Its tissue is very flexible.

Your ophthalmologist or optometrist will map and measure the surface of your cornea using an instrument called a corneal topographer and then design a lens especially for your eye. The cornea map is created by reflecting light off the surface of the eye. The machine doesn’t touch your eye, and there is no pain. The corneal topography map shows your eye doctor the shape and curves of your cornea.

The lenses work by flattening the center of the cornea, changing how light is bent as it enters the eye. Most Orthokeratology lenses are worn overnight to flatten the cornea, then removed during the day. These overnight lenses are rigid, gas-permeable lenses that are sturdy enough to reshape the cornea, but also allow oxygen through so your eye stays healthy.

When Ortho-k lenses are removed the cornea stays flattened for a while and vision is corrected without the need for glasses. If you stop wearing the lenses at night, your eyes will eventually go back to their original shape and the refractive error will return. You have to keep wearing the lenses regularly to keep the vision correction.

What can you expect from Ortho-k?

It can take two weeks or longer to attain the maximum vision correction from Orthokeratology, although some people experience significant vision improvement in days. In clinical studies of Food and Drug Administration-approved Ortho-k lenses, most patients achieved 20/40 vision or better.

You may need a series of temporary Ortho-k lenses to see properly until you reach the desired prescription. Typically, up to three pairs of Orthokeratology lenses are used, one after the other, to achieve the best vision correction. Once you’ve reached the desired prescription, you’ll use the same shape of lens each night to maintain the correction.

Until you get used to them, you will probably feel the lenses on your eyes until you fall asleep. With time, they usually become more comfortable. Once your corneas have gotten the final desired curve, you will use a retainer lens—as often as your eye doctor recommends—to maintain your vision.

Is Orthokeratology safe?

Wearing properly fitted hyper-oxygen permeable rigid (RGP) contact lenses at night makes it a safe treatment method. However, there can be side effects of Ortho-K, which include staining and edema of the cornea, redness, discharge, visual distortion, irritation, or infection, all of which can be prevented by proper instruction, maintenance and follow up.

 It is important to choose a knowledgeable and experienced ophthalmologist or optometrist to manage your Ortho-K. Long-term success of OrthoK treatment requires a combination of proper lens fitting, rigorous compliance to lens care regimen, good adherence to routine follow-ups, and timely treatment of complications.