OrthoK: What to Expect

Published on
December 4, 2023
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Still curious about ortho-K? We've made a list of common experiences on the ortho-K program and frequently asked questions on this page that may answer some of your questions. If you would like to know more or you have a specific query, feel free to contact us and a member of our staff can give you more information.

Follow-up appointments

Initial check

During this appointment we will check suitability for ortho-K wear. At Innovative Eye Care, we have a range of state-of-the-art technology to assist us. This includes slit lamp imaging to determine whether the surface of the eye is healthy, checking your prescription with subjective and objective refraction and therefore determine the amount of correction needed, mapping the cornea with corneal topography and tomography to design the lens, and in the case of myopia control, analysing the length of the eye with ocular biometry to see if ortho-K is required to slow down growth.

Delivery and teach

If you have never worn contact lenses, it can be helpful to practice some eye touching techniques prior to your appointment. This might include following the lens insertion guides on our website (www.innovativeeyecare.com.au) or practicing putting lubricating eye drops on the eye. At your appointment, the fit of the lens on the eye is checked and our team will take as many times is needed to teach insertion, removal and maintenance of the lenses.

First morning

Vision will be often not completely corrected, so you may need someone to drive you to your appointment. Try to take the lenses out as soon as you wake up, which will both improve any sensitivity you might feel and remove the ‘sleep’ that builds up overnight. Your optometrist will check how much your prescription has changed and can provide you with disposable soft lenses while your ortho-K lenses continue to further reshape your eyes.

One week

For most people, the clarity of vision will be nearing 100%. Your optometrist will measure how well the ortho-K lenses are performing and check your eyes are tolerating them well. If the visual result needs improving, lenses can be fine-tuned and a replacement covered under warranty can be ordered.

Ongoing follow-ups

After the one-week appointment, a follow-up is required for a month’s time, then for three months, then for six months, then finally only yearly reviews are needed. If any trouble with the lenses is experienced, please contact us to book an appointment. Follow-ups are vital for monitoring ongoing success of the procedure and the health of the eye. These appointments incur no extra cost under the ortho-K program for the first 12months.

Frequently Asked Questions

How new is ortho-K vision correction?

The idea of corneal moulding to correct myopia may have originated millennia ago when the Chinese placed bags of sand over their eyelids to improve vision. Ortho-K as we know it today has been around since the 1940s and has been continuously refined over the decades to a point where it is now produces reliably safe and predictable correction.1

Are there age restrictions for ortho-K?

There is no age limit for ortho-K: children as young as six have been successfully and safely treated with ortho-K lenses. As ortho-K has been shown to reduce or halt the progression of myopia(short-sightedness), it is one of the most common methods of vision correction in teenagers and pre-teens in our practice.2,3

Can the ortho-K contact lenses damage my eyes?

Any contact lenses have the potential to damage your eyes or cause an infection; however, research shows that the rate of infection when using ortho-K lenses is less than half as frequent as overnight wear of soft contact lenses.4 Correct hygiene, lens care regimes and replacement of lenses every 1-2 years minimises the chance of any complications with ortho-K lens wear. If the lenses are fitting poorly there is a chance long-term wear may harm your cornea. Our lenses are designed with computer software, rather than just taken out of a case and fitted with trial-and-error, making them much more likely to fit safely from the first lens.

How different are the ortho-K contact lenses from soft disposable lenses?

Ortho-K contact lenses are made from a specially designed highly oxygen-permeable material different to soft contact lenses, making handling quite different. Although they appear like RGP hard contact lenses, the design is quite different on the back surface of the lens to enable reshaping of the corneal tissue.

Can I see with my ortho-K contact lenses in?

Yes. One of the great features of ortho-Kis that if you get up in the night, you will be able to still see reasonablywell. We do not recommend extended day-wear, however, as this may compromise corneal health over time.

Do I need to wear my ortho-K lenses every night?

In the initial period of therapy, you will need to wear your lenses every night to ensure you have clear vision during the day. As your correction stabilises you may be lucky enough to find that you may still get great day time vision by wearing the lenses only every second night! Patients with higher prescriptions before Ortho-K will most likely need to wear the lenses every night for optimum treatment.

What will happen if I forget to wear my lenses for anight?

Because the cornea slowly starts to change back to its pre-ortho-K shape after the lenses are removed you are likely to find your vision is a little blurrier after a night without lens wear. For most patients with high prescriptions, they may require low-powered spectacles or soft contact lenses for day-time wear if this is a regular occurrence.

How long does it take to reach good vision?

Most patients have rapid improvement in the first few days of therapy. Generally, 50-70% of the required correction is achieved after only the first night’s wear. Optimum, stable vision will generally require up to 10-14 days of treatment depending on the prescription.

How often will I have to replace my ortho-K Contactlenses?

We recommend replacing an ortho-K lens every 1-2 years depending on its condition. This is to maximise the quality of the corneal moulding, as wear and tear on the back surface of the lens compromises its effect over time, and to decrease the chance of infection or inflammatory events from using a scratched or dirty lens. You should bring your ortho-K lenses to each 6-month follow-up appointment so that your optometrist can examine them under the microscope to check their condition.

What if my driver’s license says I must wear glasses fordriving?

Your driver’s licence may state that corrective lenses are required for driving. Your optometrist can write a letter explaining that you are treated with a vision therapy program that eliminates the need for corrective lenses while you are operating a motor vehicle. If driving, you should ensure that you use your ortho-K lenses the night before. See Driving and Vision.

I live a long distance away and will struggle to make allrequired appointments. Can I still have ortho-K?

Regular appointments are very important when starting ortho-K to ensure the best vision and eye health. We can, however, accommodate for long-distance patients in a number of ways, including extended appointments with in-office wear time rather than a following-morning appointment. This is assessed case-by-case.

Why should I not just get laser vision correction?

The cost of ortho-K vision correction is roughly a third of the cost of laser vision correction. It also is completely reversible and does not have the potential to worsen your dry eyes to the same extent as laser correction. As patients reach their mid-forties and start needing help for their near vision (see presbyopia), ortho-K therapy can be modified to give clear vision at all distances without a pair of glasses, unlike a one-off laser procedure.

How long does the myopia control effect of ortho-K last?

There should be a myopia control effect long as your use your ortho-K lenses. There is no research or anecdotal reports of patients ‘rebounding’ after ceasing ortho-K contact lenses. It is expected that patients who start ortho-K contact lens wear for myopia control continue to use these until their late teens when myopia tends to stabilise. The decision to stop ortho-K should be made with your optometrist, with your prescription and eye length closely monitored for possible regression. Of course, most patients are so happy with their ortho-K lenses that they continue to wear them well into adulthood!

How do I get started?

A full eye exam at Innovative Eye Care is necessary prior to starting ortho-K, even if you have had a recent eye examination at another optometrist. Several aspects of your eyes including health, vision and corneal shape will have to be assessed to establish if your eyes are suitable. If in the last 12 months you have had a full eye exam with us, you may just need a corneal topography and a quick discussion with your optometrist to see if ortho-K is right for you.

For instructions on the handling and care of ortho-K lenses, see our care of orthokeratology lenses page.

References

1) Mountford, J., Ruston, D., Dave, T. (2004)“Orthokeratology.” 1st ed. Edinburgh: Butterworth-Heinemann.

2) Hiraoka, T., et al., 2018. Safety and efficacy following 10-years of overnight orthokeratology for myopia control. Ophthalmic Physiol Opt 38(3): 281-289.

3) Bullimore, M. A., et al., 2013. The risk of microbial keratitis with overnight corneal reshaping lenses. Optometry and Vision Science 90(9): 937-944.

4) Efron, N. (2012). “Corneal Warpage. Contact Lens Complications. 3rd ed. Sydney: Elsevier.

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