Is Ortho K Safe?

A question on parents' minds when considering Orthokeratology treatment for their children is the aspect of safety. Is Ortho K safe?

In short, yes. Parents can be assured that Ortho K treatment is a safe form of vision treatment for their children.

There are some risks, as with any other kinds of contact lens wear. The main risk factor of concern is the possibility of eye infection, or microbial keratitis (infection and inflammation of the cornea, the clear surface of the eye).

​But Ortho K lenses, which are custom-shaped rigid lenses worn overnight, are not statistically more risky to wear than regular, monthly-disposable soft contact lenses. As Ortho K treatment occurs at home during sleep, in a controlled safe environment, the lenses are also not exposed to outdoor environments or water elements (swimming, showering) during the day time.

The risk of microbial keratitis for an Ortho K lens wearer is estimated at only 13 per 10,000 wearers, per year. That's a statistical risk of just 0.0013% per year.

​So a serious infection event with Ortho K treatment is actually extremely rare, when OK lenses are professionally fitted by a reputable practitioner, and worn with due care. In Australia, eye care practitioners are highly regulated. As such, the vast majority of Ortho K lens wearers in Australia never encounter any significant problems even after many years of using Ortho K.
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Studies show Ortho K to be as safe for children as regular day-time contact lenses.

MINIMISING RISKS

The key to safe Ortho K wear is to be vigilant and minimise risks, by maintaining high levels of hygiene standards, every single day. No shortcuts. No being complacent. We ensure that all our paediatric patients and their parents understand this.

This means thorough hand washing with anti-bacterial liquid soap each time before touching the eyes or the Ortho K lenses. Daily cleaning and sterilising the lenses and lens case every morning after removing the lenses, using new solution. The cleaning solution we recommend is AO Sept hydrogen peroxide.

Younger children wearing Ortho K lenses are not at any higher risk than teenagers or adults. Children are generally good at following instructions. In fact, adult wearers of regular soft contact lenses who have become complacent and do the wrong things (eg. sleeping in their regular contact lenses when not supposed to, or go swimming with their lenses, or not replacing their lenses regularly) are those at highest risk of microbial keratitis.

​Successful, safe fitting of Ortho K also depends on the practitioner's skills and experience. Ortho K fitting is complex and unfortunately not every practitioner does it equally well. OK lenses that are fitted poorly can cause problems such as corneal staining and lens binding — while these are not serious problems they can increase the risks of Ortho K wear in the long term.

Ortho K lenses when fitted and used properly with care are safe, even for younger children.

BE CAUTIOUS. IF IN DOUBT, ASK THE OPTOMETRIST
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We ask our patients to have a close look at their eyes in the mirror each morning, ensuring the eyes appear white and feel comfortable.

​Our patients understand that whenever they have any concerns, however minor, to notify our optometrist right away. This includes any unusual redness or eye irritation. Our optometrist Dr Philip Cheng is qualified in ocular therapeutics, which means if there is a potential concern he can prescribe medical treatment right away to keep complications at bay. As part of our Ortho K service, we provide 24/7 support for our patients, with a direct line to our optometrist at all times.

From time to time, a minor case of viral or bacterial conjunctivitis (pink eye) is something that can happen to anyone, adult or child. It is not typically caused by Ortho K wear but rather it passes easily between people. Like a common cold. In the event of conjunctivitis we recommend taking a brief break from Ortho K wear until the redness subsides, usually after a few days, to minimise the risks.
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Here at the Melbourne Myopia Clinic, your eye health is our priority. We maintain a 100% safety record with no incidence of microbial keratitis with any of our patients fitted with Ortho K lenses here.

How to ensure safe Ortho K wear:

1. ​See an expert Orthokeratology practitioner with the right experience, equipment and skills to fit OK lenses well for all ages. For younger children, a paediatric Ortho K optometrist can provide the care your child needs.
2. Choose a therapeutically-endorsed practitioner, who is highly trained in eye health and can prescribe scheduled medicines for the eyes, if ever needed to treat an adverse event promptly.
3. Good fitting lenses are essential for good vision, comfort and minimising the risks. Quality Ortho K lenses made with high oxygen materials are essential to good eye health during sleep.​
4. Always attend your scheduled Ortho K reviews to check the health of your eyes and treatment effect.​
5. Follow your practitioner's instructions and maintain good practices of hygiene and lens disinfection, each and every day. Do not form lazy habits!
6. Check your eyes are white and clear each morning. If in doubt, call your practitioner immediately.

​References:
​https://journals.lww.com/optvissci/Abstract/2013/09000/The_Risk_of_Microbial_Keratitis_With_Overnight.6.aspx
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4697954/pdf/ecl-42-35.pdf​
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