Corneal Molding, Orthokeratology, Ortho-K and Vision Shaping Treatment
Vision Correction Without Surgery
Orthokeratology, also commonly known as corneal refractive therapy, vision shaping treatment, corneal molding and Ortho-K is the gentle reshaping of the corneal to correct myopia (nearsightedness).
History of Ortho-K
Orthokeratology is known by numerous names and the technique has change greatly over the years. Various forms of Ortho-k have been practiced for about 40 years. The technique first involved using progressively flatter lenses to flatten the cornea causing the patient to become less nearsighted. This early method required months to show results and the patients had to wear their lenses during part of each day or wore them on alternating days.
Corneal Molding has evolved into a method where over 80% of the patients achieve success with the first lens. Good results typically take less than a week. The process is accomplished while you sleep using a computer designed reverse geometry contact lens. The lenses are inserted at bedtime and removed in the morning. The lenses safely and gently reshape the cornea changing the eye's focus. Most patients will have good vision throughout the day. Some patients may only need to wear their lenses on alternate nights to maintain good vision.
Recent studies have shown that orthokeratology lenses can prevent the progression of myopia (nearsightedness) in children (opens in new window).
How Does it Work?
Orthokeratology is accomplished by using a reverse geometry contact lens that gently flattens the cornea by pushing the outermost layer of the cornea towards the periphery as shown by the corneal topography images below.
The image on the
left is a normal cornea before wearing the lenses. The middle
image is the same patient after wearing the Bausch & Lomb DreamLens™ that employs
the
Vision Shaping Treatment™
Process. The image to the right shows how the corneal
topography looks after LASIK (different patient).
Before Ortho-K After Ortho-K After LASIK
The traditional methods of fitting the reverse geometry lenses used in modern ortho-k do not follow traditional contact lens fitting methods. Because of this difference the FDA restricts the use of these lenses to only those doctors that have been specially trained in their use. This is an additional requirement that has never been used for contact lenses, however, it is much like the requirement for the additional training required of physicians that use the excimer laser for LASIK and PRK.
This special provision has never been used for contact lenses, although it has been used for other ophthalmic devices such as excimer lasers for refractive surgery procedures.
What are My Options?
At Total Eye Care we consult with the patient as to which option best fulfills their visual needs. We can provide any of these options for our patients.
Glasses
This is the most common, safest and simplest option. All contact lens wearers should have a pair of glasses that they can fall back on when they can't or should not be wearing their contact lenses.
Refractive surgery
Refractive surgery is one of the options that we have available, however, not everyone is a candidate for refractive surgery There are a number of reasons why a person may not be a candidate for LASIK or PRK.
Why Not Have LASIK?
The most common contraindications to refractive surgery are large pupil size, thin corneas, occupation, refractive error, surgical expectations and age. Some patients simply are not comfortable with having surgery on their eyes or hesitant to undertake something that is permanent. For more information on refractive surgery our refractive surgery FAQ.
Traditional Contact Lenses
Traditional contact lenses provide a number of options from soft contact lenses that are discarded daily, every two weeks or monthly. There are also contact lenses that can be safely worn overnight from 6 nights to as many as 30 consecutive nights.
What Should I Expect
Patients interested in Ortho-K start with either an eye exam or a Free Ortho-K Screening. After a comprehensive eye exam, including an Ortho-K consultation, corneal topography is done. These are topographical maps of the cornea. Everyone's topographical map is different, much like our fingerprints.
Corneal topography shows us irregularities in the cornea and is essential to designing contact lenses that will mold your cornea. Corneal topography also allows us to diagnose corneal diseases such as keratoconus. Specular microscopy is also performed which allows us to see that the corneal cells are healthy.
The corneal topography data is then used with the refractive data to design a gas permeable contact lens that will flatten the cornea, resulting in clear vision.
When we receive your contact lenses we verify the lens order and call you to schedule a time to dispense you contacts and teach you how to insert, remove and care for them.
When you pick up the lenses your doctor will verify that they fit as expected and determine when you will be seen next.
Most patients wear their lenses at night, while sleeping, and remove them in the morning. Some patients wear them every night and some wear them every other night.
Schedule a Free Consultation and See What Option is Best for You
Related Articles You May be Interested in
Myopia Prevention with Ortho-K The CANDY Study (pdf) opens a new window
Can a Contact Lens Cure Nearsightedness? Five-Year FDA Study Testing Corneal Reshaping Therapy as Possible Method to Arrest Myopia
Incidence of myopia in the US population increased by 66% in the last 30 years
Listen to the NPR Medical Detectives interview of the Author of the Increased Myopia Study