What is Ortho-K? Orthokeratology, also known as Ortho-K, and Corneal Reshaping Therapy (CRT), among other names, is a process of gently redefining the front-most surface of the eye to allow clear vision throughout the day without the need for glasses or contact lenses. This is accomplished through the wearing of rigid corneal molds while one sleeps. The effect is temporary. It will not result in permanent correction or change of prescription if the molds are no longer worn.
Is this very new? Why haven’t I heard about it before? Orthokeratology has actually been around for about 50 years. However, due to technological advances involving corneal evaluation, lens design and manufacture, its practice has increased dramatically over the past 10 to 15 years. Even more recently, and what has really piqued our passion, is research demonstrating its ability to slow the progression of nearsightedness in children!
Is Ortho-K safe? Research indicates the same risks and frequency of complications for Ortho-K as other types of overnight contact lens wear. It is a fully reversible procedure, so once wear is ceased, prescription will return to its original level.
Can individuals be too young or too old for Ortho-K? There are no age restrictions, and most children have the dexterity to insert and remove molds independently by 8 years old. Since Ortho-K is an effective tool to slow down childhood myopia, we recommend it as soon as myopia progression is diagnosed and the child and parents are interested. Suction devices are often used for application and removal, making fine motor difficulties in adults rarely an impediment.
What does it feel like? The molds may feel scratchy if they are worn during waking hours. They are designed for closed-eye wear. Initial awareness typically diminishes over the first week.
How long does it take to see results? Most people see a noticeable difference in their vision after just one night with full effect generally achieved in 7-14 days. The higher the initial prescription the longer it will take until stable and maximum effectiveness is reached.
Do I have to wear them every night? Wearing the molds every night maintains the best clarity. Missing a day will likely result in a temporary reduction in clarity, particularly for those with higher initial prescriptions. However, many individuals notice only minor blur with an occasional missed night.
Can I see with the molds on? Absolutely! Although they don’t have “power” in the traditional sense of a contact lens, they allow clear vision when they are worn. Wearing them during the day is not recommended, however, due to issues involving comfort and the difference in fit under open-eye and closed-eye conditions
How often do molds need to be replaced? We recommend mold replacement on an annual basis to avoid problems before they occur, as even subtle warpage can significantly alter mold effectiveness.
How is Ortho-K different from traditional contact lens wear? Ortho-K molds are made from the same highly oxygen permeable materials as rigid gas permeable (RGP) contact lenses, and handle similarly. Their design and function are very different, however. Instead of mirroring the shape of the cornea, they create hydrostatic fluid forces to “mold” the cornea. They exert their effect under closed-eye conditions overnight, as opposed to contact lenses which are worn to provide open-eye daytime correction.
Can I still have LASIK in the future? Yes. Ortho-K does not permanently change the eye and the process fully reverses when wear is discontinued. However, LASIK surgeons prefer potential candidates stop wearing contact lenses at least 2 weeks prior to surgery, and often longer in the case of gas permeable lenses or Ortho-K.
Ortho-K can even help a child be a better candidate for LASIK in the future. LASIK is limited in how much nearsightedness it can correct. Wearing Ortho-K as a child can result in a 40-50% reduction in the progression of myopia. A child who is -1.00D at age 8 and progresses -0.75D per year until age 20, would be expected to wind up around -10.00D. Sometimes LASIK can correct prescriptions that high. However, with Ortho-K, if the mature prescription is -5.50, LASIK is more likely to be successful.
What does it cost? Ortho-K fees are based on prescription demands, corneal measurements and other ocular characteristics, as well as age and history. They include all professional services and mold changes during the initial two year period, and a spare pair once a final fit is established. Subsequent year charges are less than 1/4 as much. Fees are eligible expenses for Health and Flexible Savings Accounts. Care Credit, a health care credit service, is a popular choice for those wishing to spread expense over time.