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Orthokeratology

Orthokeratology, or "ortho-k," is the process of reshaping the eye with specially-designed rigid gas permeable (GP) contact lenses. The goal of ortho-k is to flatten the front surface of the eye and thereby correct mild to moderate amounts of nearsightedness and astigmatism.

How Ortho-k works

The GP lenses for ortho-k are applied at bedtime and worn overnight. While you sleep, the lenses gently reshape the front surface of your eye (the cornea) to correct your vision, so you can see clearly without glasses or contact lenses when you're awake. The effect is temporary - generally enough to get you through a day or two - so you must wear the reshaping lenses each night to maintain good vision during the day.
There and different designs of FDA approved orthokeratology lenses, including:
  • Corneal Refractive Therapy (CRT) from Paragon Vision Sciences
  • WAVE Custom Ortho-k Lenses
  • Fargo
  • Vision Shaping Treatment (VST) from Bausch & Lomb.
Some doctors have given ortho-k their own proprietary name such as Gentle Vision Shaping System (GVSS), GOV, Driem, etc .  The name is not what is important, but rather the success of the procedure and the experience of the doctor doing the procedure.  Dr. Roth has prescribed orthokeratology for over 20 years and has been recognized and interviewed by newspapers as someone who is well experienced in orthokeratology.

Who is a candidate for Ortho-k?

Orthokeratology is frequently a good option for nearsighted individuals who are too young for LASIK surgery or for some other reason are not good candidates for vision correction surgery. Because it can be discontinued at any time without permanent change to the eye, people of any age can try the procedure, as long as their eyes are healthy.

Ortho-k is particularly appealing for people who participate in sports, or who work in dusty, dirty environments that can make contact lens wear difficult.

What results can you expect from Ortho-k?

The goal for ortho-k is to correct your vision to 20/20 without eyeglasses or contact lenses during the day. In FDA trials of both CRT and VST lenses, more than 65% of patients were able to achieve 20/20 visual acuity after wearing the reshaping lenses overnight. More than 90% were able to see 20/40 or better (the legal vision requirement for driving without glasses in most states).

Success rates for ortho-k tend to be higher for mild prescriptions. Call our office to find out if your prescription is within the range that can be successfully treated with ortho-k.

How long does Ortho-k take?

Improvement in vision occur within a day or two of overnight ortho-k, and at times can become apparent even overnight.  Typically it takes several weeks for it to be fully stable.  In our office, we usually do an overnight test called an Orthokeratology Evaluation.  It is usually a good predictor of success. 

During this time, your vision will not be as clear as it was with glasses or contacts, and you are likely to notice some glare and halos around lights. It's possible you may need a temporary pair of eyeglasses for certain tasks, like driving at night, until your vision is fully corrected by the ortho-k lenses.

Is Ortho-k comfortable?

Some people have comfort issues when attempting to wear gas permeable contact lenses during the day. But since ortho-k GP lenses are worn during sleep, comfort and lens awareness are generally not a problem.

What is the Cost of Orthokeratology?

Ortho-k takes a good deal more expertise than a regular contact lens fitting.  It requires a series of office visits and at times, a series of lenses.  The fees for orthokeratology are higher than fees for regular contact lens fittings.

Can I have LASIK after Ortho-k?

Yes, it's possible to have LASIK surgery after orthokeratology because unlike LASIK, orthokeratology does not permanently alter the cornea.  Rarely, but some patients have opted to have LASIK after ortho-k.  We have had patients that have stopped wearing their ortho-k lenses and their prescriptions have continued to remain lower than they were before they began ortho-k.  They retained some of their ortho-k benefit.  

We can also do Ortho-k after LASIK surgery for those individuals who have poor outcome with LASIK and cannot see clearer.  At times, after LASIK surgery people are bothered by starbursts of light.  I guess you can say that the outcome of LASIK was "stellar".  If someone has had "stellar" outcomes, or "less-than-stellar" outcomes, Ortho-k or specialized GP lenses may be able to help regain vision.

The fact that Ortho-k is not permanent is a benefit.  If we need to re-shape the cornea, for example, after you turn 40, so that we can help you see up close, we can do that with Ortho-k.  After LASIK, once the cornea has been cut and removed, it can't be put back in.  With LASIK, once the damage has been done, it is difficult and often impossible to reverse the damage already caused.  

To learn more about orthokeratology, click here:  page 1, page 2

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