FAQ Here are the answers to questions that many others
have asked.
What is OrthoK?
OrthoK is shorthand for orthokeratology. OrthoK is a vision correction therapy using a specially designed contact lens that gently reshapes the curvature of the eye to improve vision. Patients who want to improve their eyesight and who are found to be good candidates for OrthoK are fitted with custom contact lenses that are worn at night while sleeping. You can think of orthokeratology like orthodontics. It's somewhat like wearing braces for the eyes, but very gentle braces in the form of specially designed lenses. Just as an orthodontist adjusts braces to straighten teeth, your orthokeratologist will use custom fabricated contact lenses to reshape your eyes until they have reached an optimum vision correction shape. OrthoK means better vision. Better vision overnight. It is ideal for active people who want freedom from wearing glasses or daytime contact lenses - without undergoing surgery. It is also ideal for children with myopia, also called nearsightedness. Orthokeratology goes by many names. Here are some of the most common: Ortho-K, OrthoK, Corneal Refractive Therapy, CRT, Vision Shaping Treatment, VST, Gentle Shaping System, The Gentle Vision Shaping System, Corneal Molding (CM), Advanced Orthokeratology, Custom Accelerated Orthokeratology, Corneal Reshaping, Wave Front Corneal Molding and Gentle Molding. In addition, the OrthoK lenses themselves come in a variety of names which can also be confusing but which effectively are all referring to the same thing. Some of the names are: Retainer Lenses, Vision Retainers, Retainers, OrthoK Lenses, Corneal Molds, Molds, Wave Lenses, and CRT Lenses. These may differ in design, but they all are used in orthokeratology treatment.
How well tested is OrthoK vision improvement?
Over the past 40 years OrthoK has been tested worldwide on hundreds of thousands of patients in every age group. Numerous studies have been conducted evaluating all aspects of the procedure.
How have OrthoK lenses changed over the years?
Space age polymers and breakthroughs in new high oxygen-transmitting lenses permit safe overnight wear. Modern computer-assisted lathe technology enables us to fabricate lenses to degrees of accuracy never available in the past. Advances in computer topographical cornea mapping allows your doctor to customize a lens specific to your eye.
How successful is OrthoK vision improvement?
The success rate is very high. Many doctors report 20/20 vision in over 90% of their patients, similar to Lasik surgery. Results, however, depend on your original prescription, treatment goals and how your individual eyes respond. A comprehensive exam conducted by a doctor who practices OrthoK will provide a better idea of your probability of success.
Can children be fitted with OrthoK?
Can OrthoK improve the vision of children with myopia?
Yes. Children are especially good candidates. They are highly motivated to be free of glasses and thus they care for their lenses responsibly. It frees them from glasses or contacts for their active lifestyles in youth sports and other recreational activities. It can help with self-esteem if they are shy due to wearing glasses. Most importantly, it actually slows down or stops them from getting more nearsighted every year.
My child really doesn't have any problems with wearing glasses or contact lenses.
Is there any reason they should have OrthoK treatment instead?
Yes. You won't have to continue paying for progressively stronger lenses as your child's nearsightedness gets worse each year. In addition, increasing nearsightedness can increase your child's risk of serious sight-threatening eye disease such as detached retina or possibly glaucoma. Slowing or stopping the nearsighted progression should be a priority. One of the most exciting research findings within the last three years is that OrthoK slows down or in most situations actually stops the progression of nearsightedness, unlike glasses or contact lenses. OrthoK is ideal for treating child myopia. Instead of being told that your child is more nearsighted each year and needs stronger lenses, the usual outcome to OrthoK wear is "You are doing fine. No changes. Continue wearing your lenses each night." That's a wonderful change from what doctors have been able to say in the past.
How is OrthoK different from Lasik?
How do the risks of OrthoK compare to Lasik?
No surgery is involved in OrthoK. Where OrthoK is fully reversible, Lasik is not. Lasik is permanent surgery involving tissue removal with risks of scarring or weakening of the cornea. OrthoK, on the other hand, involves gentle vision shaping using special contact lenses with little risk of scarring. The full risks of Lasik are not known. Decades after the introduction of Lasik, medical researchers are reporting an increase in corneal bulging (ectasia). In April 2008 the FDA launched public hearings on the risks of Lasik. As a result the FDA advisory panel has recommended that the risks of Lasik be made clearer to patients.
How do Lasik risks compare to contact lens risks?
A study published by the School of Optometry and Vision Science at the University of New South Wales, Australia found that while there are some 700 cases of vision loss reported per 100,000 refractive surgeries such as Lasik, only 50 out of 100,000 contact lens wearers suffer from contact lens-related corneal infections every year and only six (6) out of 100,000 contact lens wearers suffer some form of vision loss each year. Corneal infections are the greatest risk to OrthoK patients but the risk is very low and can be reduced by following proper lens care and handling instructions from your OrthoK doctor.
How much does the OrthoK procedure cost?
How does this cost compare to Lasik?
OrthoK costs generally range from $1500 to $2500 - about half the cost of Lasik as shown in the chart below.
Cost Comparison Chart
OrthoK Lasik OrthK Cost Andvantage
High $2,500 $6,000 -58%
Medium $2,000 $4,000 -50%
Low $1,500 $4,000 -50%
Cost figures are for both eyes. Sources: Business Week, Washington Post, Los Angeles Times and NPR
How safe are OrthoK lenses?
How do they compare to conventional contact lenses?
Very safe. OrthoK lenses are worn the fewest hours (approximately 8 hours) compared to conventional contact lenses. Daily wear lenses are worn 12-16 hours per day and extended wear contacts are worn 24 hours per day. Studies have shown an increased risk of infection with 24 hour wear, but no study has shown such a risk to night-only wear. This is not to say that conventional or OrthoK contact lenses are without risk. The greatest risk is infection, which, is comparatively rare and is usually prevented by adhering to lens care instructions - simple good hygiene. One of the great advantages of OrthoK is that it is reversible. You can simply stop wearing the lenses if you choose to and normally return to your pre-treatment level.
How are OrthoK contact lenses different from regular
contact lenses?
Unlike a standard contact lens, the OrthoK contact lens is specially curved to exert a gentle pressure on the eye to reshape it, resulting in improved vision. In addition, sophisticated design technology is used to measure thousands of points on an eye's surface and customize the OrthoK lens to fit the unique shape of each patient's eyes.
Will it hurt when I am fitted for Ortho-K?
No. OrthoK does not hurt. OrthoK patients wear the lenses while they are sleeping. Before going to sleep, patients may experience some minor lens sensation when their eyes are open. The lenses are not designed for comfortable open-eye wear, although the vision is good when the lenses are on and the lenses don't hurt. However, when patients close their eyes, the lenses feel great. As with any lens, a damaged lens, mishandling or debris under a lens may result in discomfort.
How do I know if I am a good candidate for OrthoK?
A consultation with your doctor will answer this question most definitively and determine whether OrthoK vision improvement is right for you. If your doctor does not perform OrthoK, click the menu item "Advanced Doctor Search" and enter your zip code and distance to search.
Who is NOT a good candidate for OrthoK?
Not everybody can be a candidate for orthokeratology. OrthoK requires a healthy cornea without significant scars or other problems. Poor hygiene, inability to handle the lenses, severe dry eye, inflammations, infections and other problems may all prevent successful treatment. OrthoK is a challenge for those with very high levels of myopia or those who are farsighted (hyperopic) but experienced doctors have shown very good results with these conditions. If you are nearsighted or have astigmatism, the odds are in your favor that you are a candidate.
What if I am not happy with the results?
What happens if OrthoK doesn't work for me?
Easy. You just stop wearing your OrthoK lenses. Unlike alternatives such as Lasik eye surgery, OrthoK is fully reversible. If a patient doesn't like the outcome or decides to withdraw from the OrthoK treatment, for whatever reason, their eyesight will return to where it started before treatment . This is one of the most exciting and compelling advantages of OrthoK compared to alternatives such as laser eye surgery. OrthoK is not without risk, but the risks have not been proven to be any worse than standard contact lens wear.
If I wear reading glasses, progressive lenses or bifocals
am I a good candidate for OrthoK eyesight improvement?
We can address your reading correction alternatives including monovision OrthoK or presbyopic OrthoK. With monovision OrthoK, one eye is corrected for long distance vision and the other eye is corrected for near vision. With this treatment your brain automatically chooses the appropriate eye for the task. Presbyopic OrthoK is in the early stages of development. Some doctors are seeing good success. If you simply wear glasses for reading and have great distance vision, OrthoK may not be as effective for you. Another alternative is to have both eyes corrected for distance vision and just wear reading glasses whenever you need to do up close work.
Am I a candidate for OrthoK vision improvement if I suffer
from dry eyes?
Yes, in fact many patients suffering from dry eye say their eyes are actually better WITH OrthoK. For those patients who have dry eyes and who are unable to wear conventional contact lenses, orthokeratology may provide excellent vision with no compromise in comfort. Some patients with severely dry eyes may need special treatment prior to starting their OrthoK treatment.
In the past when I've worn contact lenses they have caused me discomfort so I stopped wearing them.
Am I a candidate for OrthoK?
Yes. You probably recall when you were experiencing discomfort with your contact lenses that closing your eyes relieved the discomfort. Your OrthoK lenses are worn at night while you sleep - while your eyes are closed. This effectively reduces any discomfort you may have experienced during the day while wearing contact lenses.
What will my vision be like when I'm wearing the OrthoK contact lenses? Will I be able see at night?
Or will I have to remove them in order to see?
You will be able to see while wearing your OrthoK retainer lenses. You will also be able to see at night while wearing them. With your OrthoK lenses, for example, you'll be able to read in bed or watch television before falling asleep. Please note, however, that your OrthoK lenses are not designed for extended open eye wear.
My daughter plays youth soccer. Because she is nearsighted she has to wear heavy-duty athletic glasses when she plays. Does OrthoK mean that she won't have to wear glasses anymore when she plays?
Yes. With better vision through OrthoK it won't be necessary for her to wear glasses during the day if she is a good candidate.
I suffer from insomnia so I sleep less than most people.
Will that be a problem?
No, that's not usually a problem. Usually six hours of sleep per night is enough. Great results can be achieved in as little as four hours of sleep each night. Some people prefer to sleep for short periods of time rather than sleep for one full consecutive 8-hour period. If that's your preference, just insert your OrthoK retainer lenses in when you sleep and remove them when you awaken.
Will I just need one pair of OrthoK eyesight improvement contact lenses?
Or will I need to have them replaced periodically?
The lenses need replacing periodically, normally somewhere between one and three years. Your doctor will determine your replacement schedule. Spare pairs are always recommended for back-up in case a patient loses a lens.
Are OrthoK vision improvement lenses difficult to put
on and remove?
No. We'll show you how it's done. Seven-year old children do it routinely.
How long will it take to achieve good vision after
I start OrthoK treatment?
Vision improvement starts immediately. You may notice it within a few minutes. It is very significant within two hours. Some patients see clearly in as little as one night of wearing OrthoK retainer lenses. Vision is normally good during all waking hours within the first week. In some patients with higher prescriptions, it can take two to four weeks to achieve good vision. Because children's eyes are more easily molded, vision improvement generally takes effect more rapidly than it does for adults. At times the eye will not respond to the original design as expected and your doctor will need to change the design to achieve optimal results.
Is that it?
There are too many questions to answer without knowing your specific history. Contact the office for an appointment. There are no guarantees in health care and we can not know with absolute certainty how your eyes will respond. However, by choosing a doctor who has experience fitting these specialized lenses, you increase your odds for a successful outcome.
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