Many people have heard of Lasik, which is a surgical laser procedure to correct vision. It works by reshaping the cornea, which is the clear “window” in front of the colored iris, and is an excellent surgical option for those who want freedom from glasses and/or contact lenses. While many people desire this type of permanent vision correction, there is another non-surgical option to consider for some to consider: ortho-keratology.
Freedom from glasses and daytime contact lenses without surgical intervention is possible today for most patients. This method of vision correction is called Ortho-K and involves wearing custom-designed contact lenses overnight. The lenses reshape the cornea while one sleeps and the lenses are removed upon waking in the morning. This corneal reshaping corrects vision in a non-permanent fashion, unlike most surgical procedures which cannot be reversed. Most patients require nightly to every-other-night wear of their Ortho-K lenses to maintain vision correction.
Ortho-K lenses are gas-permeable, sometimes referred to as “rigid” lenses, which are a different material than standard soft contact lenses. They are typically smaller in size than standard soft contact lenses as well. As with any change to contact lenses, it can take time to get used to handling and caring for lenses. Typically, a sensation of initial lens awareness is experienced due to slight movement upon blinking — of course, when asleep, this does not occur.
So, who is a good candidate from Ortho-K? Those who require or would benefit from freedom from corrective lenses during the daytime — athletes such as swimmers are a prime example. Wearing contact lenses while swimming increases risk for serious eye infections, and having goggles made with the glasses prescription is not always feasible. Children, whether avid athletes or not, are often excellent candidates for Ortho-K because Lasik and other surgeries are simply not Food and Drug Administration-approved for kids. Adults wary of the cost or permanency of Lasik are also good candidates for Ortho-K lenses. Ortho-K corrects myopia (nearsighted vision) best, but can also be used for astigmatism and hyperopia (farsighted vision). Routine tests at an annual eye exam often determine if someone is a good candidate for Ortho-K.
One exciting benefit we see with Ortho-K use in children is the potential to slow down the progressive form of myopia. (Progressive myopia is defined as worsening nearsightnedness on annual eye exams, requiring stronger glasses prescriptions.) The ability to slow this change also implies a decrease in retinal thinning and a larger range of clear vision. This means that when using Ortho-K contact lenses, a child may not need to continue to increase their glasses prescription year after year. While Ortho-K has been around for more than three decades, understanding this aspect is relatively novel, and studies continue to show positive results.
Abigail G. Harsch, O.D., F.A.A.O., F.S.L.S., is the director of specialty contact lenses at Nittany Eye Associates.