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Orthokeratology is also referred to as ortho-k and CRT (corneal reshaping therapy). It uses specially designed and shaped contact lenses to reshape the cornea and provide clearer vision when not wearing the contacts. Most ortho-k lenses are worn at night to reshape the front surface of the eye while you sleep. Vision improvement is reversible but can be maintained if you keep wearing the lenses as directed.
Ortho-k is mainly used to correct nearsightedness (myopia) and low levels of astigmatism, but some hyperopia (farsightedness) can also be corrected. These vision problems can also usually be corrected by eyeglasses, regular contact lenses, LASIK or PRK. Orthokeratology is a surgery-free way for some people to leave their glasses behind and not have to wear contact lenses all the time. All of our ortho-k patients have been able to see well enough to pass their driver’s license testing without glasses!
Ortho-k is sometimes recommended to correct children’s vision, mainly because it can slow down their increasing myopia. Vision can continue to change for some children into adulthood. Vision correction surgeries like LASIK are not an option for children and recommended until vision is stable.
The cornea is a clear, dome-shaped window in the front of your eye that focuses light onto the retina and is responsible for most of the eye’s focus. Its tissue is very flexible.
Dr. Rebuck will map and measure the surface of your cornea using our corneal topographer and then design lenses especially for your eye. The cornea map is created by reflecting light off the surface of the eye. The machine doesn’t touch your eye, and there is no pain. The corneal topography map shows the shape and curves of your cornea.
The lenses work by temporarily reshaping the center of the cornea, changing how light is focused by the eye. Most orthokeratology lenses are worn overnight, then removed during the day although you can still see rather clearly while wearing them. These overnight lenses are rigid, gas-permeable lenses that are sturdy enough to reshape the cornea, but also allow oxygen transmission, so your eye stays healthy.
When ortho-k lenses are removed, the cornea stays reshaped for a while and vision is corrected without the need for glasses. If you stop wearing the lenses at night, your eyes will return to their original shape and the refractive error will return. You have to keep wearing the lenses regularly to keep the vision correction.
It can take up to two weeks to attain the maximum vision correction from orthokeratology, although most people experience significant vision improvement in days.
You may need to have your ortho-k lenses adjusted to see properly until you reach the desired prescription. Typically, up to two pairs of orthokeratology lenses are used, one after the other, to achieve the best vision correction. Once you’ve reached the desired prescription, you’ll use the same shape of lens each night to maintain the correction.
Until you get used to them, you will probably notice the lenses on your eyes until you fall asleep. With time, they usually become more comfortable. Once your corneas have achieved the final desired configuration, you will wear the lens while sleeping to maintain your vision.
Ortho-k is associated with a slightly increased risk of infection (microbial/bacterial keratitis). This risk is more concerning for children and adolescents, who may be less able than adults to maintain good hand and contact lens hygiene.
There is no limit to how long you can use orthokeratology lenses. You must see your optometrist for regular check-ups. But if your eyes stay healthy and comfortable, ortho-k could be used for years.
In most cases, orthokeratology would be an elective treatment, so it isn’t covered by vision plans or medical insurance. The initial fitting is more expensive, because you’ll have more office visits in that first year. Subsequent years of treatment will cost less, but the lenses should be replaced every year because they get damaged and can warp over time.
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