I Hate Reading Glasses

Ortho-K lenses are worn only when you sleep.  They are removed to reveal clear, comfortable vision without glasses or contact lenses. When I chat with people who are not currently Ortho-K patients, one question seems to come up over and over again.  "Can you fix my eyes so that I do not have to wear reading glasses?"  When I answer "Yes", they often shoot back with; "you mean that Monovision stuff?"  Many times they have never worn contacts so I wonder where they get the terminology from.  One day my question was answered.  They read about it on Lasik sites because that is all Lasik has to offer.

Let me be clear.  I design Multifocal Ortho-k retainers that allow you to focus distance, intermediate and near without Monovision.  I can design Multifocal Ortho-k for Nearsightness, Farsightedness and Astigmatism. So go ahead, throw away those reading glasses! 

Am I a candidate?

Patients often ask the question as to whether they are a 'candidate' for Ortho-k.  I believe it comes from glossy advertisements which seek to suggest that it is a 'privledge' to have good corrected eyesight.  People are excited to be 'picked' and are relieved to be 'candidates'.  Now that is good salesmanship!

But that is just hype. Not my cup of tea really.

Ortho-k has reached the level where I can correct nearly any eye and nearly any prescription.  Some patience is needed when you are no longer a teenager.  It might take some practice before you become a pro at placing the lenses on and off the eye.  You may have dry eye problems or other contact lens induced issues that have to be addressed along with the goal of ortho-k.  We may be designing bifocal ortho-k for you which will require some adaptation for you to be comfortable in your 'new' eyes.  Be patient and Ortho-k retainers can be a life changing experience.

Long Distance

We regularly have patients that come a significant distance to be fit.  It is important if you do so, to understand the process and what to expect.  First, it is critical that we get very clean measurements on the day of your initial visit.  You should be out of any lenses made of gas permeable materials for a month prior to your visit.  It is too your advantage to be out of soft contacts for one week.  Are these rules set  in stone?  No, but you invite disappointment if you don't follow them.

At the initial visit, we will make all the measurements necessary to design and manufacture the ortho-k retainer lenses.  You can expect to return for a dispense visit in approximately three days when we receive the lenses.  A one week follow-up is usually planned.  At that visit, if your case is straightforward, you will be released.  More and more however, I am seeing patients who travel a long ways to see us precisely because they are NOT straightforward cases.  In those cases where the initial lenses may not have performed to expectations, we will usually have the new lenses shipped to you where you live, with another followup scheduled to monitor the design changes.

How does Ortho-k compare to Lasik?

When the cornea is reshaped, either by Ortho-k or LASIK, the results are very similar.  For example, if you are very nearsighted, both techniques will result in some starbursting around lights at night.  The difference is that any side effects of LASIK will not be reversible, but with Ortho-k the eyes will return completely to their original shape in 30 days.  LASIK will only have to be applied every 10 yrs or so as the eyes change, where as in Ortho-k usually (but not always) your retainer lenses will need to be worn nightly.  With LASIK, tissue is permanently altered so measuring IOP (for glaucoma) can no longer be done accurately and neither can the eyes be measured precisely enough to achieve a reliable outcome for cataract surgery.  Neither of these problems apply to Ortho-k.

Ortho-k is Safe

That should be the headline for patients and parents who are attracted to the vision problem solving technique we refer to as Ortho-k. Many people I interact with on a daily basis seem to have doubts about that statement. Let me put those concerns to rest!

ALL contact lenses reshape the surface of the eye to some extent. Rigid Gas Permeable lenses being less flexible than the eye itself, cause the greatest shape changes. All Eye Doctors intuitively know this because they refine their eyeglass prescriptions based on whether the patient will wear their glasses primarily prior to lens insertion or after lens removal. But most Eye Doctors do not own the equipment to visualize those changes.

And why should they? We have been fitting rigid lenses for over five decades, all without the equipment to visualize those unintended changes, and all without even the problems so common with soft contact lens wear.

An Ortho-k lens merely creates a preplanned, preprogrammed, and closely monitored shape change as opposed to the unplanned, unintended and unobserved changes of the past. In fact, since Ortho-k lenses are mostly prescribed for sleep wear only, they are usually worn less than 8 hours a day as opposed to the 14-18 hours a day for daytime wear lenses.

So whether you are considering being fit into Ortho-k lenses for distance correction, to eliminate your reading glasses, as an alternative to LASIK surgery or for the prevention of nearsightedness. You owe it to yourself to consider what is, in my opinion, one of the safest vision correction options available.

Why have I not heard about this before?

That is the number one question I get from people I talk with.  The answer is complex.  Part of the answer is that a doctor has to invest a tremendous amount of time and money to develop new skills.  Both of those commodities are in short supply.  Additionally, meeting patient expectations demands that the doctor have the skills to design from a CAD/CAM system.  Computers may be second nature to many young people but those skills are in short supply among Doctors.  The third reason is that Ortho-k is not yet mainstream in the schools where new doctors are trained.  It will be.  But not yet.  A fourth reason is that modalities such as surgery, have huge budgets for advertising making alternate options much less visible.  I have fitted ortho-k lenses for over twenty years.  Yet I speak to people who have been patients of mine for years that 'have never heard of them'.

One final note.  Thirty years ago, doctors were not taught to be 'competitive' in the business world.  That has all changed, so it is common for doctors these days not to mention options which you cannot obtain unless you leave their office.

Myopia Control

Various studies addressing the control of nearsightedness and astigmatism in children and young adults (eg the recently published CANDY study) have been making the rounds of various vision journals of late. The studies originate in the observation by this author and many others that patients who have been fit into ortho-k lenses (orthokeratology) usually never require a change in their lens design or prescription.

I have fit lenses of this type for over 20 years and became convinced of their power to prevent change many years before any formal studies were initiated. Doctors who spoke of this were considered 'nuts' of course and when I put my then 7yo daughter into them four years ago, I could only share those ideas with a few. I fit her into overnight ortho-k retainer lenses to be worn two nights a week, to correct her 1/2 diopter of myopia (nearsighted). Four years later, her eyes have not changed. Her mother and I are 7+ diopters nearsighted and are thrilled that she has the opportunity to dodge that bullet.

As studies are published, you are starting to see an interest by the ophthalmic community in this modality and I hope more doctors will learn the skills necessary to perhaps eliminate nearsightedness in our lifetime. Many have monetary interests in making sure this does not happen and I expect there to be many smear campaigns mounted. But my kids at least will perhaps never know what it is like to face the awful decision of whether or not to have surgery on their eyes just to correct a very annoying, but ultimately harmless thing, like nearsightedness.