Have you ever wanted clear and crisp vision without wearing glasses, daytime contact lenses or having surgery? Ortho-K lenses may be what you're looking for. Many of my patients have asked me about this increasingly popular non-surgical vision correction method. Here, I'll share everything you need to know about Ortho-K lenses...
WHAT ARE ORTHO-K LENSES?
Ortho-K (or Orthokeratology) lenses are special rigid gas permeable lenses, approved for overnight wear, to reshape the corneas while you sleep. This altered shape allows for vision correction so that prescription glasses and regular daytime contact lenses don't need to be worn during the day. Wearing the lenses before bedtime and removing them in the morning, produces clear and sharp vision all day. This can be advantageous when you are playing sports or pursuing high-movement activities, where wearing glasses and contacts aren't convenient.
|Ortho-K lenses can free you from wearing glasses and day-time contact lenses.|
WHAT TYPE OF VISION PROBLEMS CAN IT CORRECT?
A majority of Ortho-K lenses are designed to correct myopia (i.e., short-sightedness) up to -6.00DC. Higher myopic prescriptions can be achieved in some patients, with some new lens designs. It can also correct combination myopia with low to moderate astigmatism. Low hyperopia (i.e., long-sightedness) can now also be corrected. Please note that wearing Ortho-K lenses only provides a temporary vision correction and needs to be worn continuously to retain the shape of your corneas.
WHAT RESULTS CAN PATIENTS EXPECT?
It typically takes patients less than 2 weeks to see improvements in their vision, and some even after 1 night of using Ortho-K lenses. Patients can expect to achieve at minimum, driving vision or classroom vision throughout the day, which is 6/12 visual acuity. However, many achieve better, even to 6/4.8! The results depend on the degree of prescription, corneal shape, corneal malleability and ocular surface disease (e.g., dry eyes). Patients are made aware that vision, particularly during the early days of treatment, may fluctuate as the cornea is being reshaped.
WHAT DOES THE ORTHO-K PROCEDURE INVOLVE?
At the initial visit, a thorough eye examination is performed, including taking topography maps of the corneas. This allows the practitioner to screen for any corneal irregularities and diseases. If the corneas are relatively healthy, calculations are performed to determine if the patient requires spherical lenses or toric lenses. Toric lenses are required if the patient has a relatively non-spherical anterior corneal surface. Lenses are then trialled to assess vision and fitting on the eyes. You will have to see the practitioner again the day after your first trial to discuss fit, and then have follow-up reviews for the next 6 months.
ARE ORTHO-K LENSES COMFORTABLE?
Most of my patients found wearing the lenses reasonably comfortable, with some saying they experienced mild discomfort on their first night. To give you an idea, the comfort level will sit somewhere between wearing disposable soft contact lenses and daytime hard lenses. When the lenses are placed on, patients can see clearly. This means during the night when they wake they can see well. In the morning, when lenses are removed, the shape is retained until bedtime, when they need to reinsert these retainer contact lenses.
WHO SHOULD GET ORTHO-K?
- Anyone who wants to be free of daytime contact lenses or spectacles.
- Adults who are interested in laser surgery but don’t want to necessarily go through surgery.
- Myopia control, particularly in children. Ortho K lenses are the treatment of choice when possible in slowing myopia progression. There is no age restriction. I have fitted children successfully as young as six years old.
- Anyone with dry eyes who cannot tolerate daytime contact lenses.
- Children who play a lot of sports and can't wear daytime contact lenses or who have trouble inserting/removing lenses. As Ortho-K lenses are worn at night time, parents are around to deal with any issues.
|Anyone who wants to be free of spectacles or daytime contact lenses may want to consider orthokeratology treatment|
WHO MAY NOT BE SUITABLE FOR ORTHO-K?
- Patients with corneal disease such as significant dry eyes, keratoconus, previous corneal injuries resulting in an abnormal surface are generally not good candidates. In some mild cases, Ortho-K can still be fitted successfully as long as patients are aware that success rates will be lower.
- Patients with very high myopia may not be suitable. There has been a case internationally where a doctor fitted a -20D myope!
- Young patients who don’t have a guardian/parent to help them remove/insert lenses at home.
- Patients who are non-compliant with instructions will have Ortho-K treatment stopped.
ARE THERE RISKS AND SIDE EFFECTS?
- Infection: This is a key side effect that I always discuss with my patients, even though infection rate for contact lenses is very low. A majority of contact-lens related infections are due to non-compliance, such as patients not washing or drying their hands properly before handling contact lenses. Contact lens cases need to be replaced regularly and daily cleaning needs to be done properly. Reviews with your eye care professional are performed every six months to ensure the lenses are working, eyes are healthy, and compliance is good.
- Glare: Patients may experience glare when driving at night time and in low-contrast environments such as underground parking as you adjust to the way light enters the eye. With the majority of cases, this settles as the effect of the treatment lasts longer on the eyes.
- Dry Eyes: Dry eye is a progressive ocular surface disease. Most patients are unaware they have dry eyes. Mild cases can wear Ortho-K lenses successfully. However, as the dry eyes develop, eventually it will become uncomfortable to wear Ortho-K lenses, until they seek treatment for dry eyes. Ortho-K lenses work best on ocular surfaces that can retain moisture.
HOW MUCH DOES ORTHO-K COST?
Costs of Ortho-K fitting varies, but generally most practitioners charge $1500-2500. This depends on the practitioner’s skills, the brand of lenses they use, the type and degree of refractive error, warranty of lenses offered and the period of care covered. Most practices will include a set of lenses (lasting 12-18 months, warranty covered between 3-6 months) and all appointments for 3-6 months. After this, there is often a small nominal fee at six monthly follow-ups.
There we have it! My last advice to patients considering Ortho K treatment is to speak to a qualified practitioner to discuss your situation, then assess the pros and cons. Choose a specialist who has experience fitting Ortho-K lenses for many patients and ask them about results they have seen.
If you still have questions about whether Ortho-K is right for you, visit your local eyecare plus practice.
About the Author:
Denise Lee graduated from the University of Melbourne with a Bachelor of Optometry in 1995. She has spent her career working in private practice, and is experienced and confident in all aspects of optometry. She obtained a Postgraduate Degree in Ocular Therapeutics from the University of NSW, qualifying her to prescribe ocular medication, when diagnosing and treating ocular disease.
Denise has a special interest in orthokeratology, particularly in its use in helping children reduce myopia progression. She has obtained certification to fit Paragon CRT orthokeratology contact lenses. To book an appointment with Denise, visit www.eyecareplus.com.au/springvale