Dr. Low has successfully completed the Orthokeratology Emerald Certification course, as required by the FDA, to ensure knowledge of the Emerald corneal reshaping and fitting process.
Slow the progression
of your child's nearsightedness
while they sleep, with Ortho-k lenses
Orthokeratology (Ortho-k) lenses are also commonly known as:
- Corneal Refractive Therapy (CRT)
- Gentle Vision Shaping System (GVSS)
- Vision Shaping Therapy (VST)
Ortho-k lenses offer benefits beyond vision correction. Children often feel better about their appearance than if they were wearing glasses, and Ortho-k lenses are more convenient when playing sports or just running around with friends. These factors also make children feel better about their interactions with peers.
What is Ortho-k?
Orthokeratology, commonly called ortho-k, is a method used in Duvall, WA to correct myopia (nearsightedness) by wearing rigid gas permeable contact lenses overnight, so that no vision correction is needed during daytime hours.
Gas permeable (GP) lenses specialized for ortho-k are inserted at bedtime and worn as you sleep. Throughout the night, the lenses reshape your cornea gently so that your vision becomes clear on the following morning. The correction is temporary, and ideally no eyeglasses or contact lenses will be needed on the next day or two. In order to maintain sharp visual acuity on a daily basis, you need to wear the ortho-k reshaping lenses every night.
FAQ's about Ortho-k:
“Why think about Ortho-k? Why not just wear eyeglasses or contact lenses?”
The main purpose of Ortho-k is to be free from both contact lenses and eyeglasses during waking hours. While this is ideal for sports enthusiasts or those who work in dusty or dirty environments, for others Ortho-k offers the appeal of being free from corrective lenses during the day. In Duvall, Ortho-k also offers relief from the problems sometimes associated with full time contact lens wear like drying and debris getting under the lenses.
Additionally, ongoing research shows that for many patients, the progression of nearsightedness can be stopped or significantly slowed down by using Ortho-k retainers. This makes it a great alternative for children, particularly those with nearsighted parents. Neither eyeglasses nor conventional contact lenses have been shown to have as strong a tendency towards controlling myopia as Ortho-k.
"What are the success rates of Ortho-k?"
The cornea experiences a significant degree of adaptation within hours to days, although full adaptation often requiring 2 – 3 weeks. During this initial period vision may be affected for some people. Once adapted, FDA trials showed over 65% of patients achieved 20/20 eyesight and over 90% achieved 20/40 or better (the typical US requirement for driving without glasses).
The corrective effect is stable but not permanent. Left to itself, the eye will slowly lose its adjusted shape, taking around 3 days to return to its former vision. The Ortho-k lenses must therefore be worn regularly so the corrected corneal shape is preserved and maintained. Usually they are worn only for part of the day (typically only when asleep at night); some users may only need to use them one night out of every two or three nights.
“Does Ortho-k have any advantages over Laser Surgery?”
There are several. Ortho-k is about half the cost of Refractive Laser Surgery (LASIK). It does not involve any post-operative discomfort. Ortho-k is very suitable for children and adults whose eyes are still changing, while LASIK is done only on adults with stable prescriptions. Both eyes can easily be treated at the same time with Ortho-k. Also, prescription changes are easy to deal with using Ortho-k. There are no strong steroid or antibiotic drugs needed with Ortho-k as there are during the post-operative period for laser surgery. Lastly, and perhaps most importantly, Ortho-k is reversible. Laser surgery is not.
“Is everyone a candidate for Ortho-k and can any doctor perform it?”
The answer to both questions is no. It does not work on every patient and needs to be performed in a very exact and meticulous manner. We have received special training and have the necessary diagnostic equipment, computer software and expertise to perform Orthokeratology.
The procedure works best on mild to moderate amounts of nearsightedness or astigmatism. More severe cases can have their vision improved, but will still need some additional vision correction. The procedure also does not work well on certain shaped corneas. Also, there are several incalculable factors for each patient - most notably the cornea’s rigidity. Thus the speed of Ortho-k correction varies with each patient. Generally, but not always, less nearsighted patients respond faster than more nearsighted ones. There are no age barriers for Ortho-k. It is safe for children and adults and is an excellent alternative for children who are just first becoming nearsighted, because as mentioned above, Ortho-k may prevent any further nearsightedness from occurring! Also, while success rates are very high, success cannot be guaranteed due to factors like the inability to wear the vision retainer for physiological reasons or other general health problems that may reduce wearing time.
“What does the Ortho-k procedure involve?”
A comprehensive eye health examination is performed first. Then, a corneal topographer is used to obtain a very precise computerized “map” of the cornea’s shape. This information is placed into the Ortho-k computer software and a diagnostic retainer is custom designed. At that time, if it is determined that you are a good candidate for Ortho-k, your own vision retainers will be ordered. It takes about one week for the retainers to be made and delivered.
When you pick up your retainers, you will be instructed on how to use and care for them. Proper care of the retainers is very important for continued comfort and good vision. If the retainers fit properly, you will wear them that first night. Your vision should be clear with the retainers on.
We will see you the next morning. You should come to the office wearing your vision retainers. We will remove them for you. Of course, should you experience any problems while at home with your retainers, simply remove them.
Most of the visual changes occur rapidly over the first few days. As the cornea changes shape and vision improves, we will supply you with (no-charge) any needed contact lenses to be worn during these first few days.
The majority of patients achieve excellent vision in only a few days. Even after you are seeing well, we will continue to monitor your eyes to ensure your cornea is adapting to the retainers. Most patients complete their follow up care in one month although some may take more or less time. When the treatment is completed, the retainer will continue to be used on a nightly basis. Eventually some patients are able to use the retainers every other night.
“Are there age restrictions for Ortho-k?”
No, there are no age restrictions. Ortho-k has been successful in children as young as 6 years old. It is great alternative for active children and teens, especially those involved in sports and activities where glasses may get in the way.
Those who are older are also candidates for Ortho-k. Patients who require bifocals or reading glasses can have the distance vision corrected with Orthokeratology and wear reading glasses for near work. The doctor may also recommend a monovision correction, with one eye focused for distance and the other eye corrected for near vision.
“How much does Ortho-k™ in Duvall cost?”
Ortho-k is a significantly longer process than a regular contact lens fitting. It requires a series of visits to our Duvall Vision Center and potentially multiple pairs of lenses. Also, GP lenses used for ortho-k are more costly than most regular contact lenses. Therefore, fees for orthokeratology are higher than fees for regular contact lens fittings. The Ortho-k process includes all of the professional visits, retainer lenses needed to achieve optimal vision, and any needed interim soft contact lenses. Lost, broken or spare retainers are also available.
“Does my insurance cover Orthokeratology?”
This is an elective treatment and is not usually covered by insurance or vision benefit programs. Flex spending and Health Savings accounts can be used, if available. If contact lenses are covered under your vision plan, that benefit may be applied towards the overnight retainers.
“What are the disadvantages of Ortho-k?”
You must be prepared to allow 3-4 visits over about a two-month period. Should you stop wearing your retainers, your vision will return to its original state. While the degree of success is very high, it cannot be guaranteed. However, when the corneal topography and computer software indicate a patient will be successful, it is rare that patients don’t do well with Ortho-k. The amount of improvement and length of time to improve vary from one person to the next.
“Are there any risks associated with Ortho-k?”
All contact lenses are medical devices and all are associated with risk of injury or infection. Ortho-k retainers are no exception. The lens material is FDA approved for overnight wear and has been shown to be quite safe when fit and worn according to instructions. There have been isolated reports of superficial injury and of infections when wearing overnight vision retainers. These have been rare occurrences. Ortho-k is considered to be safe and effective.
“I’ve never heard of Ortho-k. Is it new?”
Attempts to re-shape the cornea have been tried since contact lenses were first fit. The scientific name for Ortho-k is Orthokeratology. When Orthokeratology was first attempted in the 1960’s, it would often take over a year to complete and the results were not nearly as favorable as Ortho-k. With the newer diagnostic technology used to measure the corneal shape and the newer materials being used for vision retainers, Ortho-k is now a viable alternative for many nearsighted or astigmatism patients.
“Can I see with my Vision Retainers in?”
Yes. Vision is good with the retainers on your eyes. If you have to get up in the middle of the night, your vision will be satisfactory.
“What happens if I lose a retainer?”
Vision will start to blur after a night or two of not wearing the retainers. Your previous glasses and contacts may not help. Having a spare pair of retainers available is highly recommended for any contact lens wearer, but is particularly important for Ortho-k patients.
“Are the changes in my vision reversible?”
Yes, unlike laser vision correction, the Orthokeratology effect is temporary. If you stop wearing the retainers your vision will return to your previous level, usually within a week.
“Is Ortho-k painful?”
Although rigid lenses are generally considered to be not as comfortable as soft lenses, overnight Ortho-k is generally very well accepted, since the main cause of rigid lens discomfort during waking hours is the feeling of the eyelids moving over the lens edges while blinking. Since Ortho-k lenses are worn when the eyes are closed for sleep, so there is no blinking and therefore generally no residual feeling of the lens after the adaptation period.
“I stopped wearing contact lenses due to discomfort. Am I a candidate for Ortho-k in Duvall, WA?”
Retainers are worn only while sleeping. This greatly reduces any discomfort normally associated with wearing contact lenses during the day.