Accelerated Orthokeratology The Non-Surgical Procedure for Reducing Nearsightedness and Astigmatism

Question: What is Orthokeratology?
Answer: Orthokeratology is a procedure for decreasing nearsightedness using specially designed rigid contact lenses. The lenses correct vision while they are being worn, and the correction is maintained after the lenses are removed.

Question: How often must the lenses be worn?
Answer: How often the lenses must be worn varies from person to person. Some people only need to wear their lenses 3 to 4 nights a week to maintain optimum vision. Others must wear their lenses every night to maintain clear vision the following day.

Question: How can contact lenses decrease nearsightedness?
Answer: The lenses are fit flatly which causes the cornea on the front of the eyeball to flatten. This decreases nearsightedness much like Radial Keratotomy surgery or laser refractive surgery.

Question: Are the orthokeratology lenses comfortable?
Answer: Yes, even people who have never worn contact lenses are amazed at how comfortable the orthokeratology lenses are. The lenses are slightly scratchy in the beginning. This is because the lenses are not fit to your eye - we’re making your eye fit the lenses. Once the shape of your cornea begins to change, usually within the first 2 to 3 days, your eye fits the lens better which results in increased comfort.

Question: Is orthokeratology as effective as surgery?
Answer: Orthokeratology is limited to low and low-moderate degrees of nearsightedness, but it is as effective as surgery for these amounts of nersightedness.

Question: What do you mean “low to low-moderate degrees of nearsightedness?
Answer: Orthokeratology is effective for up to 4 1/2 prescription units of nearsightedness and 11/2 prescription units of astigmatism.

Question: Is orthokeratology new?
Answer: No. Orthokeratology has been around since the early 1960’s. It has been thoroughly researched. Many studies have been published in professional journals indicating its safety and effectiveness.

Question: Is orthokeratology permanent?
Answer: No. Orthokeratology is a reversible procedure. The contact lenses used to perform orthokeratology must be worn a limited number of hours every day (or at least several days each week) to maintain the improved vision. If the lenses are discontinued, the eyes will return to their pre-orthokeratology status over time.

Question: If it’s not permanent, why would I choose orthokeratology?
Answer: There are many reasons:

1. If you are under 19 years of age, you are too young to undergo refractive surgery. Orthokeratology may be able to provide you with vision that is independent of glasses or contact lenses until you are old enough to undergo refractive surgery.
2. If you have an extremely low degree of nearsightedness, refractive surgery may overcorrect your vision, making you farsighted rather than nearsighted.
3. If you are concerned about having eye surgery, orthokeratology offers the only non-surgical method of reducing nearsightedness.
4. If you would like to reduce your dependence on glasses or contact lenses, but having refractive surgery would disqualify you from your job, orthokeratology offers the only non-surgical method of nearsightedness reduction.
5. If you are a preteen or teenager whose glasses are getting stronger each year, orthokeratology offers a way for you to stop the progression of your nearsightedness, reduce it, and perhaps eliminate the need for glasses or contact lenses altogether.

Question: Can I see with the orthokeratology contact lenses while I am wearing them?
Answer: Yes. The orthokeratology contact lenses will provide proper vision correction just like standard contact lenses while they are being worn.

Question: I’ve heard sleeping in contact lenses isn’t safe. Why are orthokeratology lenses worn during sleep?
Answer: We do not recommend that our patients wear their contact lenses during sleep (extended wear) even if their lenses are approved by the government for such wear. In “extended wear,” the lenses are removed only once or twice a week for cleaning and disinfecting.
Orthokeratology lenses are worn during sleep and removed in the morning. The remainder of the day is spent without the lenses in. Therefore, the eyes are directly exposed to the air and the oxygen they need for many hours each and every day. This is much safer and quite different from “extended wear” where the eyes go without contact lenses for only a few hours a week.
As far as night vision is concerned, orthokeratology patients sometimes do notice a ring around lights (flare) at night. The orthokeratology lenses flatten the central 6 to 7 millimeters of the cornea. At the edge of this flattened area the cornea begins to rise to a steeper curvature. This edge is called the compression ring. During the day, the eye’s pupil is small (constricted) due to the bright sunlight. When the pupil is small, the edge of the compression ring is not inside the field of vision and is, therefore, not seen. At night the pupil is larger (dilated) to allow more light to enter. When the pupil dilates, the edge of the compression ring may become visible. Less than one percent of orthokeratology patients experience this phenomenon.

Question: If I have orthokeratology, will I need to have “updates” or lens changes?
Answer: Most people never require adjustments to their orthokeratology lenses. The lenses are very durable, lasting up to 3 years or more in many instances.

Question: Doesn’t it take a long time for orthokeratology to work?
Answer: Modern orthokeratology is known as accelerated orthokeratology. The majority of change takes place in the first one to four weeks of lens wear. Smaller, slower changes may occur up to several weeks thereafter. The original method of performing orthokeratology used standard contact lenses, was very limited in the amount of nearsightedness it could eliminate, and took up to 2 years to work. This outdated method of orthokeratology should not be confused with today’s modern procedure that utilizes highly technical, computer-generated, special contact lens designs.

Question: Are there any risks associated with orthokeratology?
Answer: As with any contact lens, there is a slightly greater risk of having an eye infection such as “pink eye.” Also, if proper care is not taken to follow the doctor’s instructions, or if follow-up appointments are not kept, the lenses could flatten the cornea off center. If the cornea is flattened off-center, your orthokeratology may be less effective and your eyes may develop temporary astigmatism. If it is impossible to get the orthokeratology lenses to center on your eyes, your doctor will tell you you are not a good candidate for the procedure.

Question: I’ve heard that after having refractive surgery (RK, Lasik, Lasek, PRK) vision fluctuates during the day. Also, I’ve heard that some people have complaints about their night vision after having refractive surgery. Are these problems also common to orthokeratology?
Answer: It is true that some people who have had refractive surgery experience fluctuations in their vision during the day. These changes are usually due to changes.

Home > Medical Info > Orthokeratology