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Orthokeratology, also known as Ortho-K or corneal refractive therapy, describes the gentle reshaping of the cornea (the clear structure at the front of the eye) while you sleep.When you wake up, the re-shaped cornea allows clear and natural vision without the assistance of prescription glasses or contact lenses. The reshaping is done using special contact lenses which are removed upon waking. This is a safe, convenient and non-surgical alternative to the traditional methods of vision correction. At this stage, Ortho-K is only available to myopic (short-sighted) individuals.
Controlled clinical trials have shown that the use of Ortho-K in myopic children have significantly reduced the progression of myopia in school-aged children and teenagers. Of all the methods that have been studied, Ortho-K has been the most effective at slowing myopia progression. This reduction is enabled by the lenses simulating something called peripheral myopia. The clinical trials have reported slowing myopia by 55% to 100%. Wearing Ortho-K lenses can help stabilise your child’s short-sightedness and potentially prevent the eyes from getting worse.
Who can have Orthokeratology?
Most people with mild to moderate myopia (with or without mild astigmatism) are good candidates for Ortho-K. A detailed assessment is necessary to determine the suitability of individual patients. Teenagers or children who have progressing myopia are usually good candidates for Ortho-K. Because the effect of the corneal reshaping is temporary you can stop wearing the lenses at any time and everything will return to how your eyes were before the therapy. Unfortunately, Ortho-K cannot be used to correct patients who are hyperopic (longsighted) or to correct reading problems due to presbyopia.
Children and young adults who want to be glasses-free but are unable to have LASIK are often good candidates for Ortho-K. People who play a lot of contact sports or work in dusty environments that affect contact lens wear can also be good candidates. Contact lens patients who suffer from allergies, dryness, irritation or are worried about losing their lenses during certain activities are also ideal candidates.
What does treatment with Ortho-K involve?
Firstly, one of our optometrists will carry out a comprehensive initial examination to assess vision and the condition & health of the eyes. Also at this visit precise measurements of your corneas are performed using a special computerised corneal mapping system (see topography).
Assuming that your prescription and corneal shape are suitable, the next step is the fitting. A pair of custom made lenses will be ordered for you to trial, which may take up to 1-2 weeks. Once these lenses arrive, we will go through how to insert, remove, and care for your Ortho-K lenses. The technique is slightly different to that of soft contact lenses, but we will cover that during your appointment with us.
The lenses are then worn overnight. The following morning your eyes will be assessed and any lens adjustments made.It may be necessary to have more than one trial to optimise the lens design. Your vision isn’t expected to be perfect after the very first night, in most people 70% of the reshaping is obtained during the first night and 100% within 10 days. It is possible that you may need to wear some temporary disposable lenses for the first few days until you reach the desired prescription.
You will need to return at regular intervals (1 week, 1 month and 3 months) in order for the optometrist to assess the lenses and ensure that the fit is still optimal. Regular ongoing review visits (6 monthly) are still necessary once the correct lens has been fitted, to ensure your corneas remain in good health and the best performance of your lenses. It is important that you come for these regular check-ups even if you have no concerns.
Is Ortho-K safe?
Ortho-K has been prescribed by contact lens specialists for many years and many thousands of people have been successfully treated. The rigid lenses that are used in Ortho-K are made from materials that allow sufficient oxygen permeability to make overnight wear safe.
Risks involved in this treatment are similar to those of regular contact lens wear, which includes eye infections and allergic responses to the contact lens. As with any type of contact lens wear, regular checkups and clean lenses on your eye minimise the risk of problems. If our instruction is followed, therisk of infection or adverse effects is very low. Also,parental supervision is recommended for young children in handling their lenses to lower the risk of adverse effects.
Does Ortho-K have any advantages over Laser Refractive Surgery (LASIK)?
Ortho-K is an easy, safe, non-permanent and reversible alternative to refractive laser surgery. It is available for children, teens and adults whose vision is still changing and also does not compromise the structural strength of your cornea. One of the biggest benefits is Ortho-K has been shown to slow down the progression of myopia, and in some cases even stop it.
What does Orthokeratology cost?
The orthokeratology treatment program costs $1399. This includes the first pair of lenses, all fitting and check-up visits for the first six months, and any lens modifications or remakes required during the fitting process. Routine checks are required every six months and lens replacement due to wear and tear every 12-18 months at $699/pair. Concessions are available to health care card holders and pensioners.
In the long-term, the cost of orthokeratology works out to be comparable to wearing regular disposable soft contact lenses and glasses, and of course the treatment costs are much less expensive than laser eye surgery (LASIK), without the risks of permanent eye surgery. If you’re in a private health fund with extras cover, you should be able to claim an annual rebate for the rigid gas permeable contact lenses used in orthokeratology.
Can any optometrist provide Ortho-K?
The process of fitting Ortho-K requires specialised equipment and training. As a result, most optometrists are not able to offer Ortho-K to their patients. At Insight Optometrists, we strive to work closely with our colleagues in order to try and provide this service to all patients who need it. Contact us anytime so we can answer any questions that you may have.