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.