What is Orthokeratology
Orthokeratology, or ortho-k, is the use of contact lenses to temporarily reshape the eye's surface, according to the American Academy of Ophthalmology. People get ortho-k lenses to improve near-sightedness (myopia), which is when people can see things close to them but have trouble seeing things far at a distance.
Myopia occurs when the surface of the eye refracts light improperly. Though wearing glasses and getting LASIK surgery can address it, orthokeratology aims to flatten the cornea (or the clear bubble on the front of the eye that bends light in such a way that helps you see), says Molly King, OD FAAO, an ophthalmologist. "The cornea is responsible for the majority of blurriness in myopia," Dr. King explains. Essentially, these "eye braces" work by fixing the altered shape of the eye that causes hazy vision.
It is not ideal for patients with far-sightedness (hyperopia). This happens when the surface of the eye is too flat. Ortho-k helps flatten a too-steep curve, according to Dr. King, so because far-sightedness is from a too-flat curve, the curve-flattening assistance that these lenses offer wouldn't help.
Additionally, it might not be helpful for people with astigmatism because those vision issues stem from internal alterations of the eye that are unrelated to cornea curvature. And if someone has significant amounts of near-sightedness, ortho-k may not be a fit. The lenses can only correct for so much myopia, and sometimes the cornea can be too flat, resulting in not enough "meat" for the lenses to flatten.
Ortho-k might be "a good option for those who live more active lifestyles and do not want to deal with the hassle of contact lenses throughout the day," Dr. King says. For example, if there are people who lose, break, or generally find glasses annoying, this option can offer some freedom. She also says it’s a popular choice for children who have inherited vision issues that will likely be progressive (based on their parent’s eyesight history).
What is it like to use ortho-k lenses
Although ortho-k lenses were developed in 1990 and have been utilized widely in the UK since 2002, acquiring them in the US is not easy. There are a few hoops to jump through to make sure you’re getting the right fit that will truly help your vision. Most US insurance plans consider these lenses elective and don’t offer coverage. And orthokeratology can be expensive, with costs ranging from 1,000 to 4,000, according to VisionCenter.org. In most cases, it is not covered by insurance and is an out-of-pocket expense for most people and insurance plans, Dr. King says. However, talk with your provider to see if there are any requests or approval processes you could pursue.
To get these lenses, you start by finding an ortho-k lens specialist that can assess your eyes and find you the correct lenses. It takes a few visits over a few weeks to get the right lenses. Then you replace them at various frequencies based on whatever program and lens brand your specialist uses.
"At night time, you put a rigid contact lens in the eye to flatten the cornea. When you wake up, you take the contacts out and have clear vision," Dr. King says. It's not permanent and can take a few weeks to take full effect, and offer glasses-free clear vision during the daytime. Most of the time, people can enjoy one to two days of corrected vision after wearing them at night. It is a lot like Invisalign braces in that way: You need to wear them nightly to see results. If you stop, your vision impairments will return.
One more thing to note: These lenses can be uncomfortable as you get used to them. They are firmer than regular contact lenses and can be slightly stiff. However, Dr. King says that people can often get used to them and feel the pros outweigh the cons.
There is some increased risk of infection
Your risk of bacterial infections does increase slightly with this form of eye therapy. This can result from persistent eye irritation, improperly fitting lenses, or bacteria introduced when inserting the lenses. The main way to prevent this, Dr. King adds, is to stay in touch with your provider and inform them of any redness, irritation, pain, or discoloration at any point during your treatment. Additionally, the bacterial infection risk that comes with using contacts can be mitigated by using clean hands (including clean fingernail beds) when applying the lenses and following all hygiene-related instructions from your lenses and doctor.
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