Orthokeratology

Orthokerotology (Ortho-k)

Othokeratology (Ortho-K) is a non-surgical treatment to reshape the cornea of the eye to
reduce nearsightedness (myopia) and astigmatism. The successful treatment is achieved
by wearing a customized retainer lens to gently flatten the cornea during sleep. After the
retainer lens is removed upon wakening, the cornea retains its flattened shape and allows
clear eyesight without glasses or contact lens throughout the day. It works similarly
to how the braces correct deformed teeth. It is necessary to wear these retainer lenses
consistently to maintain the desirable corneal form for optimal vision.

Orthokeratology (Ortho-K) is also known as corneal refractive therapy (CRT), corneal
reshaping or corneal molding. Many optometrists have practiced this technology since
1960’s. With new technology in better lens design and lens material, FDA has granted
the approval in 2002 for treating nearsightedness and astigmatism for patients of any
age. It is especially appealing for individuals with active life styles such as athletes and
swimmers because of the freedom from glasses or day-time contact lenses.

The most exciting news in the Ortho-K world is the growing evidence for myopia control
in developing youth. Many longitudinal studies conducted around the world have shown
the promising role of Ortho-K in control myopia progression in kids. In the effort to
prevent myopia progression, we highly recommend Ortho-K for any children with rapid
progression in nearsightedness and emerging myopia with high nearsighted parents.

If you are nearsighted and would like to be functional without glasses or contact lenses,
but do not qualify or not favor for laser treatment, Ortho-K may be the perfect alternative.
Schedule an appointment with Dr. Chang to determine if you are a good candidate.

What is the advantage of Ortho-K?

FDA approved safe treatment
Convenient – clear vision without glasses or contact lenses
Non-surgical – no surgical risk involved, painless
Reversible – no permanent change in corneal tissue
Safe for all ages – both kids and adults can be good candidates; no more worries
about kids losing or breaking glasses
Myopia control – great potential for myopia control in school age children

Is Ortho-K safe?

It is FDA approved for all ages. All recent studies have shown safety and efficacy
of this treatment. The risk of wearing retainer lenses at night is similar to the risk
of contact lens overnight wearers. It is important to follow our instruction regarding
wearing, cleaning and follow-up schedule to ensure the successful treatment without
complication.

How do you compare Ortho-K with LASIK to correct myopia?

Unlike LASIK procedure, Ortho-K is non-surgical and reversible. Both treatment
target for “reshaping the cornea” to achieve clear unaided vision, one is permanent with
surgery; one is maintained by wearing customized retainer lenses. In general, children
are not good candidates for LASIK because their eyes are still developing. People who
have worn Ortho-K in their youth years can still choose LASIK surgery later. People
who are not qualified for LASIK due to thin cornea can be good candidates for Ortho-K.
In addition to be independent from glasses, the most important benefit for children is the
potential of Ortho-K in myopia control in developing youth.

Am I a candidate?

FDA approved Ortho-k to correct up to -6 D of myopia and mild astigmatism. However,
many recent new designs will allow correction for higher myopia, astigmatism and
hyperopia. In addition to the refractive error, many other ocular conditions might affect
the process, such as severe dry eye. Adult patients might have different visual demands,
and need to be further investigated to determine candidacy. Dr. Chang will measure your
eyes with a corneal topographer to rule out any corneal irregularity. Only after careful
clinical examination, we will be able to discuss with you.

How soon should I see well? How often do I need to wear Ortho-K
lenses?

All retainer lenses are designed for you to wear 6-8 hours every night during sleep to
achieve successful treatment. Most of people notice improvement right after the first
night. Depending on the pre-treatment prescription and corneal shape, each patient might

need different length of time to reach fully stable vision throughout the waking hours,
up to a few weeks. For low myopia prescription, you might be able to skip one or two
nights of lens wear after you have reached stability. Dr. Chang will follow your corneal
changes and vision to through the treatment.

Will my insurance cover the treatment?

Unfortunately, Ortho-k treatment, along with laser vision correction, is considered as
elective procedures, so your insurance carriers will NOT cover this treatment. However,
most of the employer sponsored medical spending will be able to cover.

How much is the exam fee? Do I expect to pay this every year?

Ortho-k requires practitioner’s expertise, significant longer chair time, multiple office
visits and potentially multiple retainer lenses. Since these lenses are custom made, the
cost is higher than regular contact lenses. Therefore, the fee for Ortho-K is higher than
regular contact lens exam.
The cost for Ortho-K program is a global-fee which includes all of the professional visits
for one year and one set of retainer lenses (not included regular eye exam, which your
insurance will most likely cover). Regular follow-up visits are crucial to ensure the
success. Periodic office lens cleaning is also included.
Once the program is completed, you will continue annual eye examinations and annual
maintenance checkups. The maintenance program usually costs 20% of the initial fee
and it also covers all visits within one-year period.

Will Ortho-K stop my child’s eyesight from getting worse?

Recent researches have shown that Ortho-K is the most promising and safe procedure
to slow down myopia progression in pediatric population. Though Ortho-K holds high
hope, the “cause” of myopia is complicated and most likely multi-factorial. Before a
better treatment comes along, we do highly recommend this safe procedure for your
children. In addition to Ortho-K, encourage your child to spend more time outdoors, read
with good with proper posture/lighting and eat low-carbohydrate diet have been shown
helpful in preventing myopia progression.
For adult-onset myopia, it is still not clear about the role of Ortho-k has in myopia
progressing.

Ortho-K on the news

http://www.crtvision.com/CRT_In_The_News.html

Ortho-K Lens care
Insertion and removal videos:

GP Lens Care and Handling

Related links

http://www.ortho-k.net/
http://okglobal.org/