FREQUENTLY ASKED QUESTIONS
I've heard different names for orthokeratology, are they all the same?
Dream lenses, sleep lenses, night lenses, Ortho-K, OK lenses, eye braces, Paragon CRT (corneal refractive therapy), VST (vision shaping treatment) — you may have come across different terms, marketing and brand names for orthokeratology lenses. While there are different orthokeratology lens fitting systems and designs, the main principles behind them are very similar.
Which Ortho-K lenses do we use?
At Eyecare Concepts we use the EyeSpace orthokeratology fitting system. This uses sophisticated computer-aided modelling technology for the design of your lenses to your individual eye shape and parameters, as measured with our Medmont corneal topographer with a precision level measured in microns.
Unlike older Ortho-K fitting systems based on standardised fitting sets, such as Paragon CRT, our lenses are fully customisable to optimise myopia control effects for children, and to enhance vision clarity for adults. Our optometrist tailors each lens design to every individual's own vision needs to ensure the best possible result can be achieved. A wider range of prescriptions, including high myopia (short-sightedness) and astigmatism can also be corrected with our advanced Ortho-K lens designs.
Our Ortho-K lenses are made in Australia by a specialty contact lens laboratory based in Adelaide. We do not use inferior lenses from Asia that some other practitioners may use. The safety and satisfaction of our patients is our priority.
Is Ortho-K safe?
All contact lenses carry the potential for complications and Ortho-K lenses are no exception. Ortho-K is a safe form of vision correction when properly prescribed by a trained practitioner and worn as instructed with due care by an individual. Although Ortho-K lenses are rigid, they are made from breathable, oxygen-permeable materials specific for night-time wear.
People who are non-compliant wearers of regular, low-oxygen soft lenses and cosmetic contact lenses are at higher risk than a diligent Ortho-K lens wearer. Cases of eye infections across all contact lens use are largely associated with poor hygiene and poor compliance such as not washing hands prior to lens handling, using tap water to rinse lenses, showering, swimming with lenses (which does not happen with Ortho-K), improper lens disinfection and re-using cleaning solutions.
What are the risks of Ortho-K?
Infection is the main risk of all types of contact lenses, including Ortho-K. The risk of microbial keratitis in an Ortho-K wearer is extremely low (approximately 7 in 10,000 wearers, or just 0.07%), which is actually comparative far less than overnight extended-wear of soft lenses (0.52%). Even a daily-disposable soft lens wearer can be at risk if he or she doesn't do the right thing. So the key to minimising risk is to always follow the proper handling, hygiene and disinfection procedures for your lenses as recommended by your optometrist. There is no additional risk for a child wearing Ortho-K lenses compared to an adult.
Who is Ortho-K suitable for?
Anyone who wants the freedom of clear vision without having to wear glasses or contact lenses during the day. People work in environments that may cause issues with regular day-time contact lenses — eg. eye irritation and dryness from computer screens, air-conditioning, smoky areas and dusty outdoor work sites. People with sensitive eyes and prone to allergies. Those with active lifestyles, fitness fanatics and keen swimmers. Adults considering laser eye correction but whose prescription hasn't quite stabilised enough for surgery, or are wary of the risks of permanent laser surgery. Kids are particularly good candidates for Ortho-K lenses — they can see clearly for school and all their sports and activities without the risk of breaking or losing their glasses or daytime contacts.
What prescriptions are suitable for Ortho-K?
Ortho-K can correct most prescriptions — myopia (short-sighted), astigmatism (uneven eye surface curvature), hyperopia (long-sighted) and even presbyopia (difficulty focusing with age). With correction for short-sightedness, Ortho-K typically works best for prescriptions between -1.00 and -6.00. Higher corrections are sometimes possible depending on the individual's eye parameters and vision expectations, and partial corrections are also a possibility for people with high degrees of myopia. With the latest, more complex lens designs, even a moderate amount of astigmatism can be treated. Our experienced orthokeratology practitioner has successfully fitted Ortho-K lenses for prescriptions as high as -10.00.
Who can wear Ortho-K lenses?
There are no lower and upper age limits for Ortho-K treatment. Children as young as 5 have been successfully fitted with Ortho-K lenses. One key advantage of Ortho-K lenses for kids is that they can effectively slow down, or even stop, their eyes from worsening as they grow up. Reducing a child's myopia (short-sighted) progression is highly beneficial for their long-term eye health — lowering the risk of developing glaucoma, retinal detachment and myopic macular degeneration associated with high degrees of myopia. We assess your suitability for Ortho-K based on many factors — to best way to know if you're a suitable candidate is to visit us for a detailed Ortho-K assessment.
How effective is Ortho-K for myopia control?
Ortho-K is the most effective optical treatment for myopia control, and this is backed by numerous international research papers studying the effects of Ortho-K lenses on children's myopia progression. We can expect Ortho-K treatment to slow a child's myopia progression by around 50% (halving the rate of progression), and in many cases better results have been achieved and some children even stop progressing altogether. Even at 50% progression reduction, a child who may have ended up with short-sightedness of -8.00 untreated is now around -4.00 after Ortho-K treatment, which is a substantially better outcome for the child's functional vision and long-term eye health. And the earlier Ortho-K treatment is started, the greater the benefits for your child's visual outcome.
How does Ortho-K slow myopia progression?
During sleep, Ortho-K lenses put gentle pressure on the front surface of the eye, the cornea, gradually changing its shape over time and redistributing the cells within the tissue. As the centre of the cornea becomes flatter — which is what corrects vision in short-sighted prescriptions — the mid-peripheral parts of the cornea become thicker. This change in peripheral corneal shape changes the focusing of light onto the peripheral parts of the retina, at the back of the eye. This process — known technically as reducing 'peripheral retinal hyperopic defocus' — helps modulate the growth of the eyeball, slowing the elongation that comes with progressive childhood myopia. See here for a more detailed explanation.
How does Ortho-K compare to other methods of myopia control?
Ortho-K lenses are considered the gold standard in optical treatment for myopia control, while atropine eye drops is a medical treatment that is also very effective in many children. These two methods work on different pathways on the eye. As every child is different, one child may respond well to one method of treatment while another doesn't. The different methods give us more options in managing your child's myopia. Soft contact lenses for myopia control are also available — these do not correct astigmatism as well as Ortho-K lenses and their studied effectiveness is generally slightly less — but are still an excellent option for many kids. Children with more aggressive progression may benefit from combined treatment with both contact lenses and atropine eye drops.
Can I wear Ortho-K if I have dry eyes?
As part of our detailed assessment of your suitability for Ortho-K we will assess your eyes for dry eyes. Yes, most people can wear Ortho-K lenses even if they have dry eyes. In fact, rigid contact lenses can be more suitable than soft lenses for people with dry eyes as soft lenses draw moisture from the eyes throughout the day. Many dry eye symptoms are also caused by the environment — air conditioning and looking at a computer screen — which won't be an issue during sleep with the eyes closed.
How quickly can I expect my vision to improve with Ortho-K?
You will notice an improvement in your vision after the first night of Ortho-K wear, and further improvement and stability over the next two weeks as your eye shape settles with treatment. Higher degrees of myopia and astigmatism can take longer to reach the optimum result. Most of our patients are amazed by how much clearer they can see after just 1-2 nights of treatment. As part of our Orthokeratology Fitting Package we can provide you with a pair of low-strength glasses or supplementary soft contact lenses to give you good functional daytime vision during the initial adaptation period.
Are Ortho-K lenses comfortable to wear?
During the first few nights as your eyes are becoming accustomed to the lenses, you may feel a slight irritation after lens insertion and before going to sleep. This is normal and nothing to worry about. Most of the sensation comes from your eyelid moving over the lens as you blink. When you go to bed and close your eyes you won't feel anything and the lenses won't affect your sleep. After one week you will find that the lenses are quite comfortable to wear.
Can I see while wearing the lenses?
Yes, you can see while you are wearing your lenses. We recommend that you insert your Ortho-K lenses about 15 minutes prior to bedtime to allow them to settle in your eyes. You can watch TV with the lenses in, and if you woke up the middle of the night to go the bathroom you can still see.
How long do I need to wear my Ortho-K lenses for each night?
The recommended wearing time each night is at least 6 hours, and optimally 8 hours, for maximum vision correction and best results.
Will my vision become blurry at the end of the day?
Depending on your pre-treatment prescription there may be a little fade in your vision towards the end of a long day, but for most people it's not a problem. During the design of your lenses we factor in a slight amount of expected daytime regression to ensure that good vision is maintained for most of your waking hours. For lower prescriptions you should enjoy clear, crisp vision lasting one full day after lens wear, and sometimes longer.
What if I forget to put my lenses in for one night?
Most people still have good functional vision the next day if they skipped a night of lens wear. Over time you will know how much your vision regresses if you skipped a night, or two nights of Ortho-K wear. Some of our patients are happy wearing their lenses every second night and still enjoy clear vision for their daily activities. If you were to take a short break from Ortho-K treatment, you can wear the low-strength glasses or soft contacts we provided you with to see clearer.
How do I look after my Ortho-K lenses?
Cleaning your Ortho-K lenses is easy. We recommend a no-rub, hydrogen-peroxide lens sterilisation system such as AOSept Plus for daily cleaning, and adding an intensive protein cleaning step with Menicare Progent once a month. A kit containing all the solutions and eye drops to get you started are included in your Ortho-K package.
How often do I need to replace my Ortho-K lenses?
Yearly replacement of lenses is our recommendation, for best vision results, comfort and safety. Microscopic deposits, minute lens surface scratches and lens shape changes can occur with normal use, gradually reducing the effectiveness of treatment over time.
How much does Ortho-K cost?
Our comprehensive Ortho-K Fitting Program starts from $1600, inclusive of all consultations in the first 6 months, a set of fully customised Ortho-K lenses for your first year of treatment, lens care starter kits and a spare pair of low-strength glasses or a supply of supplementary soft contact lenses. More complex prescriptions and eye shapes attract a higher fee. The cost of Ortho-K treatment is less than one-third of the cost of laser eye corrective surgery. Yearly replacement Ortho-K lenses start from $500 per pair. Some rebates are available through private health funds if you have extras optical cover.
For how long can I continue with Ortho-K vision treatment?
You can continue with Ortho-K treatment for as long as you wish. For children using Ortho-K for myopia control, they generally wear Ortho-K lenses until their myopia has stabilised, usually in their late teens or early adulthood, however many do choose to continue using Ortho-K for their vision correction instead of regular glasses and contact lenses. There are individuals who have happily worn Ortho-K lenses for over 20 years.
Would I still be able to have laser surgery later on if I wore Ortho-K?
Yes, of course. Ortho-K vision treatment is temporary and completely reversible. Your eyes will naturally return to their original shape if you stopped Ortho-K lens wear for a few weeks and there are no implications for laser surgery should you decide to have permanent vision correction later on.
Why is Ortho-K not as common in Australia?
Adults and children have been successfully treated with Ortho-K lenses for over 20 years in Asian countries such as Hong Kong, China and Singapore — the main reason being that South East Asia has long had a higher prevalence of myopia (short-sightedness) than the rest of the world, with greater public awareness of the importance of myopia prevention and myopia control. In the United States, overnight orthokeratology gained FDA approval 16 years ago, in 2002.
Ortho-K is fast gaining in popularity around the world with the rise of childhood myopia globally. There are now many Ortho-K practitioners in the US and the UK, while in Europe many ophthalmologists also prescribe Ortho-K lenses for their patients. In Australia, with increasing interest from parents understandably concerned about their children's worsening eyes, Ortho-K is expected to also become a more common choice for patients. We believe Ortho-K is the future of vision correction.
Why don't all optometrists fit Ortho-K?
Ortho-K fitting is complex and requires additional training, experience and technology. Not all optometrists are equipped with the necessary tools to fit Ortho-K successfully. As Ortho-K lenses are custom-designed individually for each eye and the corneal reshaping process is extremely precise, this demands additional time, expertise and experience for best results. Successful Ortho-K treatment also requires close aftercare monitoring and follow-up visits ideally with the same practitioner for continuity of care — this is often not possible in a retail optical store environment. For the best Ortho-K experience, choose an expert contact lens practitioner.
© 2019 The Myopia Clinic | Eyecare Concepts | Kew East Melbourne