Most of us have learned that there are only three ways to deal with nearsightedness: glasses, contact lenses, or LASIK surgery. But what if there was a fourth? What if you could go to bed at night and wake up in the morning with near-perfect vision?
Sounds like science fiction but it’s a solution that’s actually been around for more than 50 years. It’s called orthokeratology or ortho-k for short. In the last decade, ortho-k has been enjoying a renaissance and has undergone some fine-tuning that could make it an attractive choice for many people who are nearsighted.
Ortho-k is a vision correction treatment that involves wearing specially designed gas-permeable contact lenses overnight. While you sleep, the lenses reshape your corneas. When you awake, you remove the lenses, and your distance vision is improved. It may take weeks or just days, but eventually your vision can range from 20/40 to 20/20. Better vision can last from one to two days before you need to reinsert the lenses before going to bed.
Ortho-k has been used effectively in Latin America, the United States, and China, and is on the rise in Europe. Thanks to some improvements over the years, optometrists are taking a closer look at ortho-k, particularly for children. As reported in the February 2018 newsletter, myopia (nearsightedness) among children has grown at an alarming rate, and there is evidence that the treatment can forestall the progression of nearsightedness in children.
One study from the Centre for Myopia Research at Hong Kong Polytechnic University School of Optometry found that starting treatment for myopia at an early age halves the risk of progression in children whose myopia is progressing rapidly. Although the study’s authors recommended that the ideal age for orthokeratology is six to nine years old, we have had success in treating older children as well at Acuity Vision Optometry Boutique.
There are other reasons that ortho-k may be preferable for children to eyeglasses or regular contacts:
Children frequently break, scratch, or lose their glasses.
Kids and teens who wear contact lenses often have difficulty keeping them germ-free at school or on the go.
Children whose vision is corrected without the encumbrance of contacts or glasses may have an easier time playing sports, particularly for activities such as swimming.
Ortho-k could also be an alternative to refractive surgery, such as LASIK, when the person is younger than 18 or not a good candidate for other reasons. And if you’re environmentally conscious, you might consider the treatment as a way to reduce waste from contact lenses that need periodic replacement.
How does ortho-k work?
Although the first orthokeratology design emerged in the 1960s, it wasn’t practically implemented until the 1990s. During that time and since, lens materials have improved, along with computerized corneal topography, a mapping technique for measuring the curvature of the cornea that’s necessary for the correct fit.
The lenses work by flattening the center of the cornea, which controls how light is bent as it enters the eye. The lenses flatten and reshape the cornea by night, and when they’re removed in the morning the cornea stays flattened for a while, which corrects vision by day. If you stop wearing the lenses at night, your corneas will return to their original shape and your nearsightedness will return.
Are the lenses safe?
Generally, putting any contact lens in your eye carries a small risk of an infection called microbial keratitis. Although there have been instances of corneal abrasion with the lenses, studies have shown that the infection risks from ortho-k are no greater than the risks from using soft contact lenses.
What to do if you’re interested
Dr. Schmidt recommends that patients schedule an eye exam with her if they want to learn more about ortho-k for themselves or their child. If you decide on the treatment, she’ll design lenses specially for you. The cost of ortho-k varies, and although it is an elective procedure generally not covered by vision insurance, Dr. Schmidt can work out a fee structure with you at your next appointment.