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A Traveler’s Dream: Orthokeratology for the Modern Explorer

For modern explorers and avid travelers, the allure of new destinations and exhilarating experiences knows no bounds. The enchanting landscapes, architecture, culture, and excitement surrounding every corner fuel the desire for adventure and discovery. However, for those with vision correction needs, glasses, and contact lenses can sometimes pose limitations and discomfort that detract from the full travel experience. Orthokeratology, an innovative form of vision correction involving custom-designed overnight contact lenses, offers a liberating alternative that empowers travelers to explore unencumbered by traditional eyewear.

Our specially curated blog series will unveil the myriad ways orthokeratology caters to the unique demands of the travel-savvy individual at every step of their journey. We will discuss ortho-k’s advantages and considerations across different travel experiences, from sightseeing and urban exploration to coastal escapes, mountainous expeditions, and nature-filled adventures. Additionally, we will cover essential pre-travel tips, ortho-k maintenance during trips, and essential safety guidelines for international explorers.

Through a blend of insightful articles, our goal is to guide you to limitless exploration, providing valuable insights into the versatility and potential orthokeratology offers for the modern traveler. By showcasing and dissecting the unparalleled benefits of ortho-k, we aim to create a comprehensive resource for globetrotters seeking the ultimate in travel freedom and visual clarity.

Traveling Light: The Convenience of Orthokeratology for the Frequent Traveler

Being ready to explore the world at a moment’s notice is important as a modern adventurer. For those burdened with vision correction needs, glasses and contact lenses can sometimes feel like cumbersome necessities that prevent spontaneous exploration. Orthokeratology is revolutionizing people’s travel, offering lens-free days full of adventure and unforgettable experiences. Let’s dive into the numerous ways ortho-k provides convenience for frequent travelers.

No Need for Bulky Eyewear and Contact Lens Accessories

Orthokeratology eliminates the need for extra baggage dedicated to glasses and contact lens care. Traveling light becomes a breeze as ortho-k wearers are free from carrying contact lens solution, spare glasses, and cleaning supplies. With less to pack and keep track of, you can fully immerse yourself in the adventure.

Reduced Dependency on Daytime Contacts and Glasses

Frequent travelers know anything can happen during a trip, including losing or damaging glasses or contact lenses. Orthokeratology users enjoy the peace of mind of having clear vision throughout the day without worrying about such mishaps.

Visually Uninterrupted: Ortho-K’s Impact on Sightseeing and Adventure Experiences

A visually stunning destination deserves a clear, unhindered view to appreciate its full beauty. With orthokeratology, travelers can enjoy breathtaking sights without adjusting glasses or worrying about contact lens discomfort.

Uninterrupted Sightseeing Pleasures

Ortho-K allows adventurers to take in the wonders of their surroundings without being restricted by the glare or discomfort often associated with glasses and contact lenses. With clear vision, you can focus on capturing awe-inspiring moments and indulge in the magic of your surroundings.

Increased Comfort for Active Pursuits

Whether you enjoy hiking, swimming, or anything in between, orthokeratology ensures comfortable, unobstructed vision for all your favorite activities. Your eyes can experience new surroundings and landscapes lens-free, allowing you to embrace thrilling adventures with zero limitations.

Altitude and Orthokeratology: How Ortho-K Can Elevate Your Mountainous Expeditions

Mountain destinations present unique visual challenges for those reliant on traditional eyewear. With changing environmental conditions and variable light levels, orthokeratology can be the perfect solution for adventurers seeking to conquer the peaks.

Ideal Vision in Varying Light Conditions

When traversing mountain terrain, it’s common to experience rapidly changing light conditions, requiring adaptive vision. Ortho-K users are free to focus on their expeditions without the need to adjust glasses or worry about contact lens irritation, even as daylight fluctuates.

Minimal Fogging and Debris Concerns

Altitude travelers often experience lens fogging and debris issues, which can impact their overall experience. Orthokeratology eliminates these concerns, allowing adventurers to revel in the magnificent mountain views without unnecessary distractions.

Beach Getaways Simplified: Orthokeratology’s Role in Enhancing Your Coastal Escapes

Beach vacations and water adventures can be frustrating for those who rely on glasses or contact lenses to see clearly. With orthokeratology, you can simplify your beach getaways and enjoy every aspect of your trip to the fullest.

No More Lost or Damaged Contacts in the Water

Ortho-K users can indulge in beach activities, being carefree about losing or damaging contacts while swimming or participating in water sports. The freedom to enjoy the ocean through clear, lens-free vision is nothing short of transformative.

Maximize Your Beach Time with Convenient Vision Correction

Orthokeratology’s overnight lens wear means you can wake up with a clear vision, ready to hit the beach immediately. There’s no need to waste precious vacation time inserting and removing contact lenses or cleaning glasses.

Exploring Boundless Adventures with Orthokeratology

As seen throughout this blog article, orthokeratology transforms how people travel and explore the world around them. With greater freedom, comfort, and convenience, ortho-k users can embrace limitless exploration, unburdened by traditional eyewear.

Experience the life-altering power of orthokeratology by unlocking your potential for boundless adventure and crystal-clear vision wherever your journey leads. Schedule a consultation with Fenton Family Eyecare’s experienced eye care professionals to discover how ortho-k can reshape your travel experiences and empower you to embrace your wanderlust with unparalleled excitement and clarity.

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How to Care for Your Ortho-K Lenses

Approximately 45 million people in the United States wear contact lenses, and a portion of these users are turning to ortho-K lenses to correct issues with myopia and astigmatism.

If you’ve opted for ortho-K lenses for you or your child, taking good care of them is paramount, which is why Dr. Curtis Frank and our team at Vision and Ortho-K Center pulled together the following tips.

Your ortho-k starter kit

As with all contact lenses, you’re placing your ortho-K lenses directly onto your eyes each night, so keeping them clean and free of debris is very important as your eyes are quite delicate.

When we give you your ortho-K lenses, we also supply you with:

A case to store them in
Cleaning solution
A soaking liquid

This starter kit has all of the essentials you need for keeping your ortho-K lenses clean and properly stored. If you run out of supplies, most pharmacies carry these items.

Before you put your ortho-K lenses in

Before you go to bed, you should thoroughly wash your hands and, once clean, you should take each lens out and massage a few drops of the cleaning solution into the lens, making sure to address the entire lens.

Once your lens is cleaned, use the rinsing solution to clear away the cleaning fluid, which can sting your eyes. Then place the lens on your eye.

Run your hands under some water again and then clean and rinse the other lens as we describe above.

Once your lenses are in place, we may have you use eye drops to remoisturize the lenses so that they work smoothly through the night.

In the morning

When you wake in the morning, you should follow the same steps as above, except you’ll be removing the lenses rather than putting them in. This means washing your hands; removing, cleaning, and rinsing the ortho-k lenses; and then placing them in the storage case.

A word about storage cases

Since you’re taking such great care to ensure that your ortho-k lenses are properly cleaned, it makes sense that you should devote the same amount of attention to your storage case.

Always check to make sure the case is clean and spend a few minutes each week cleaning out the case (perhaps at night after you’ve placed the lenses onto your eyes). We recommend that you use a saline solution to rinse the storage case and avoid using tap water. Once the case is clean, you can fill it with the storage solution again.

If you follow these tips, your ortho-k lenses can last up to a year or two, but you do need to come back to see us more frequently to ensure the lenses are reshaping your corneas properly and your vision is improving.

If you have more questions about caring for your ortho-k lenses, contact one of our offices in Boston or Newton Upper Falls, Massachusetts, to schedule an appointment.

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Ortho-K: Top 10 FAQs

Orthokeratology (ortho-k) is quickly becoming the gold standard for myopia management in children.

We have provided the top 10 most frequently asked questions about ortho-k to help you decide if this myopia management technique is right for you.

1. What is ortho-k?

A: Ortho-k lenses are rigid gas-permeable (RGP) contact lenses that are designed to be worn overnight and removed in the morning.

Ortho-k lenses gently reshape the curvature of the eye to improve vision and control myopia progression . Ortho-k lenses are designed to float on top of the eye’s tear film and apply gentle water-based (hydraulic) pressure to the front layer of the cornea , called the epithelium.

The hydraulic pressure causes the cells of the epithelium to move from the center of the cornea to the periphery. This migration of corneal cells leads to a temporary reshaping of the cornea and correction of the refractive error.

2. Is ortho-k safe?

A: Studies have compared the safety of regular contact lenses to ortho-k lenses and have concluded that ortho-k lenses do NOT increase your risk of contact lens complications.

Some of the most common contact lens complications include eye infections, hypoxia, corneal abrasions and corneal staining— all of which can lead to more serious conditions that can even threaten permanent vision loss.

To prevent contact lens complications that can occur with any type of contact lens, always follow your eye doctor’s instructions on how to properly handle and care for your ortho-k lenses, as well as when to wear them and how often to replace them.

3. How long do the effects of ortho-k last?

A: After the ortho-k lenses are removed each morning, improved vision is generally noticed for 24 to 72 hours.

For optimal results, follow your eye doctor’s instructions on how often to wear your ortho-k lenses— some patients require nightly wear, while others may be able to wear their lenses every other night.

4. How does ortho-k control myopia progression?

A: Ortho-k has been proven to reduce the rate of myopia progression in children by up to 50 percent.

Conventional methods to correct myopia and improve distance vision include eyeglasses and contact lenses— though over time, many patients experience a gradual increase in their optical prescriptions with these traditional methods.

By reshaping the cornea for vision correction, ortho-k can help to reduce the rate of myopia progression.

As a result of its safety, efficacy, and convenience, ortho-k has become one of the most recommended methods for myopia management and vision correction.

If your child has myopia, contact an eye doctor near you, who can discuss the best options for myopia management.

SEE RELATED: Why Do Adults Choose Ortho-K?

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5. who can benefit from ortho-k.

A: Ortho-k can be prescribed for children, teens, and adults.

Children as young as eight years old can benefit from ortho-k for myopia management .

Ortho-k is also a great solution for patients who are not eligible for LASIK surgery due to thin or irregular corneas, high refractive errors, unstable vision or severe dry eyes .

Ortho-k is especially convenient for athletes, as well as for patients who live in dusty, windy, dry environments or extremely hot or cold climates.

6. Do all optometrists fit ortho-k lenses?

A: Ortho-k lenses require a specialized contact lens fitting, and not all optometrists who fit regular contact lenses also fit ortho-k lenses.

Optometrists and eye doctors who provide myopia management and prescribe ortho-k lenses have undergone specific extensive post-graduate training.

During your ortho-k lens fitting, your optometrist will measure and map out the surface of your cornea using a digital corneal topographer . This device allows your optometrist to accurately fit your child’s ortho-k lenses to the shape of their eye.

If you are interested in ortho-k, it is a good idea to check that your eye doctor has experience in ortho-k and myopia management before scheduling an appointment.

7. W hat can you expect when you first begin wearing ortho-k lenses?

A: When you receive your lenses, your optometrist will provide detailed instructions on proper care and handling, as well as how often to wear your ortho-k lenses.

It is not uncommon to feel the ortho-k lenses in your eyes until you get used to wearing them— this may take a few days. Don’t be discouraged, ortho-k lenses become more comfortable over time.

Additionally, you may notice blurred vision, halos around lights and increased sensitivity to glare until your eyes adjust to the new lenses and reach full correction.

8. How much will your vision improve with ortho-k?

A: Many ortho-k patients are able to achieve 20/20 vision without needing any daytime optical correction.

According to a nine month FDA clinical study:

95% of patients achieved 20/40 vision or better
73% achieved 20/20 vision or better

9. How long does it take to notice maximum results from ortho-k?

A: The amount of time it takes to notice maximum results from ortho-k depends on the severity of your myopia when you begin wearing your ortho-k lenses.

For mild myopia, improved vision may be noticed after one or two days of wearing your lenses. Though, for higher optical prescriptions, it can sometimes take around two weeks to notice for maximum results.

Your eye doctor may recommend wearing glasses during the day with a low prescription until you are able to reach your desired results.

10. Can I have LASIK surgery after ortho-k?

A: Yes. If you would like to permanently correct your vision, LASIK surgery can still be an option, even if you have been wearing ortho-k lenses.

Unlike LASIK surgery, ortho-k is temporary and the results only last as long as you continue to wear your lenses.

Several months prior to your scheduled LASIK surgery, your eye doctor will instruct you to stop wearing your ortho-k lenses. This will allow your corneas to revert back to their original shape and ensure optimal LASIK surgery results.

LEARN MORE: Guide to Myopia Management

Schedule an appointment with an optometrist experienced in myopia management to find out if ortho-k lenses are right for you or your child.

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How to Add Ortho-K to Your Toolkit

This valuable service may require thorough education but will provide enormous benefits to your patients and practice..

By Dan Fuller, OD

Practitioners have been called upon to adopt an unprecedented amount of flexibility due to the uncertainties caused by the COVID-19 pandemic. Business plans that were forward-looking into one-, three- or even five-year periods must now require significant revision. It may seem odd to discuss adding new services to your practice while trying to recover losses to your core business, but it is essential to address both the immediate needs and the growth of your practice. Looking for ways to capture new patients, offer new services to existing patients and grow your practice remain crucial aspects of your business even during a crisis.

In his venerable work Out of the Crisis , W. Edwards Deming presented 14 key management points. 1 The first of which is, “Create constancy of purpose toward improvement of product and service, with the aim to become competitive, to stay in business and to provide jobs.” You can leverage existing resources to add orthokeratology (ortho-K) to your practice without a large capital investment. This article offers both strategic and practical ideas on how to incorporate ortho-K into your business plan.

Setting up a comprehensive myopia management program includes considerations of behavioral changes (e.g., more outdoor time), anti-muscarinic agents (primarily low-dose atropine), soft multifocal contact lens and overnight ortho-K interventions. 2,3

Ortho-K lenses are sometimes, although rarely, prescribed for use during the day. Our colleagues outside the United States have access to other options, including novel spectacle lens designs, which are projected to become available in the United States in 2022. 4-6 Even if you do not have access to, or choose not to offer, pharmacological or spectacle interventions, you can offer the contact lens options. Regardless, remain informed of approved and off-label technologies and future developments. If you don’t, your patients or their parents will.

Program Administration

When dealing with special populations such as pediatric patients, you must obtain informed consent from the parents and assent from the patient, if possible. This process varies across the globe, but informed consent must be provided verbally and in writing with signatures from the responsible parties. 7,8 Copies of these documents should be retained in the patient’s file.

Provide the parent a packet of materials that includes the informed consent document, discussion of the procedure and device prescribed, schedule of visits, discussion of fees and what they cover, payment plans, warranties, how lost or damaged lenses will be replaced and cancellation policies. Also include training materials, a care kit, instructions for lens care and the handling and wearing schedule. Provide clear guidance on what to do if they experience an adverse event and provide your after-hours contact information.

Indications

Ortho-K lenses are enjoying a resurgence due to the worldwide myopia epidemic. They represent approximately 8% of the rigid contact lens market (0.7% of all contact lens fits) in the United States and 3% of all lens fits worldwide (range <1% to 30%). 9,10 The FDA requires optometrists to complete a certification course for each design before they can offer them in their practice ( Table 1 ). 11 The indications for ortho-K include the temporary reduction of myopia, slowing of myopia progression and as an alternative for soft contact lens wearers experiencing dry eye. 1,11,12

(*VST includes a family of 15 different designs)

Ortho-K Candidates

Above all else, the patient and/or parent needs to be motivated to partner with you in their care over an extended period of time.Ortho-K does not permanently correct myopia, and clinicians must carefully assesss patient and parent expectations. Also, the effects regress after cessation of wear at variable rates for individual patients. Elimination or even slowing of myopia progression cannot be guaranteed, and adverse events (though uncommon) do happen. Patients with histories of non-compliance, allergies, preexisting lid or corneal disease may need to be treated to resolution prior to considering a fit. 13-19 The ability of the patient or family to comply with care, hygiene, handling and return visits, requires special consideration prior to embarking on any overnight wear of a contact lens.

None of the currently FDA-approved designs have an age restriction. None of the designs approved in the United States possess an indication for myopia control. Outside the United States, the Bloom lens (Menicon) carries this indication. 20 Both adult and pediatric patients who have never worn a lens before may adapt faster than previous soft lens wearers who may be inclined to compare ortho-K designs with their habitual soft lenses.

Patients who have reduced their wearing time due to dryness or discomfort as well as those who wish to temporarily reduce their myopia make great candidates. If the intent is to slow myopia progression, then the earlier you identify onset and progression of myopia, the earlier you can intervene. Research has found a more rapid progression of their myopia in the year prior to onset and a slower rate after onset in children between six and 14 years old. 21

Evidence for Efficacy

The Blue Mountains Eye Study from Australia found myopic maculopathy increases with the amount of myopia, with 43% of cases occurring in myopes less than 5.00D. 22 This has led to the often-quoted statement that there is “no safe amount of myopia.” 23 Any amount of myopia reduction is important, with a 40% decrease in risk of maculopathy for each 1.00D reduction in progression. 24

Clinicians must monitor axial length changes to accurately track progression since orthokeratology reshapes the corneal surface. The corneal epithelium under the treatment zone thins while the midperipheral area in the reverse curves thickens to create the effect. 25 A change in axial length of 0.1mm roughly equates to 0.20D to 0.25D. 1

Comparisons of the safety and efficacy of ortho-K across studies is difficult because of variations in inclusion criteria, presence/absence of controls, lack of masking and methodological differences. Nonetheless, a summary of four representative meta-analyses reported remarkably consistent reductions in the progression of axial length in the range of -0.25mm to -0.27mm ( Table 2 ). 1,12,26-29

Evidence for Safety

The risks associated with ortho-K are less well understood but are likely similar to those of other designs. Risk factors include overnight wear, use of tap water, and topping off solutions. 12,26 The majority of published reports come from Asia and ortho-K is more widely used, where conditions of sanitation may vary, and suggest causative organisms encountered are overwhelmingly Pseudomonas aeruginosa or Acanthamoeba . 17,30-32

Incidence data on rates of microbial keratitis are elusive but may be similar to overnight soft lens wear—between 19.5 to 25.4 per 10,000 wearers. 12 Adverse events (corneal infiltrative events, including infection) in soft lenses appears to be comparable to adults and may be less in the eight- to 11-year-old age range. 33 It is not clear whether this is true of ortho-K. In a retrospective study of gas permeable (GP) lens wearers who experienced Acanthamoeba keratitis, 24% wore ortho-K lenses but no odds ratio could be calculated. 30 Research also shows that Pseudomonas aeruginosa binding to the corneal epithelium increases after overnight ortho-K wear. 34

Initial Examination

The initial exam deviates only slightly from your usual standard routine for a contact lens wearer. There are a few additional tests that are important to facilitate the fit and track individual success, such as cycloplegic refraction, axial length, topography or tomography, pupil size and corneal diameter measurements. 35 Many devices are capable of collecting this information, including a number of combination instruments. These contemporary devices can easily upload data to your lab to further assist in fitting. Be consistent when using these devices for each visit because agreement varies significantly between instruments. 36,37

Cycloplegic refraction decreases the likelihood of over-minusing the patient. Some consider this an optional step, but, since a baseline fundus evaluation is important, it can be easily incorporated into the first visit. Tracking changes in axial length over time is a more reliable measure than changes in refractive error that are influenced by the reshaping of the corneal surface. Assessing pupil size in both ambient and low light conditions helps ensure the treatment zone of the lens will be optimized to reduce risks of flare or glare. Assessing corneal diameter ensures the overall diameter of the lens will not exceed that of the cornea and improve lens centration.

Tomography, such as the Pentacam (Oculus), relies on a rotating Scheimpflug camera and not a reflection of a Placido disc. It is not subject to errors induced by an unstable tear film and measures true corneal height as well as elevation data. 38

Placido disc topographers generally do not cover as large a region of the cornea as a tomographer, but there are some devices that allow you to stitch or tile together images from different fields of gaze to cover a larger surface area, such as the Medmont E300 (Medmont). This can be important when evaluating whether corneal astigmatism is confined to the central cornea or extends out toward the limbus, improving parameter and design selection. The two types of devices may offer the ability to model contact lens fits without putting a lens on the eye and may even generate simulated fluorescein patterns from the height data.

The ability to create subtractive or comparative maps is an essential feature on both devices. Topographical findings that make ortho-K more challenging include irregular astigmatism, high astigmatism, limbus-to-limbus astigmatism, decentered corneal apex and asymmetries. 39 Topographical attributes that are positive indicators include well-centered apex near the geometrical center of the cornea, K values between 41.00D and 45.00D, with-the-rule astigmatism <1.50D and average corneal eccentricity between 0.25 and 0.80. 39 Axial maps are useful for comparing patients while obtaining a general overview, tangential maps provide more data on localized shape changes induced by ortho-K, and difference maps will allow you to track changes ( Figure 1 ). 39

The data you collect helps determine whether to select a diagnostic trial lens, employ a fitting nomogram, submit electronically to the lab or to empirically design the lens using software. 35 All are viable options ( Table 3 ). 40 As you gain more experience, you will likely want more control of the design process and may wish to use design software. Avoid using design software until you gain the deeper understanding of how to manipulate parameters to achieve a desired effect. Trial lenses can expedite the fitting process for anxious parents/patients, where empirically designed lenses can be more customized to topographical features.

You want a well-centered lens, with an aligned area of approximately 4mm in the treatment zone, pooling in the return zone where the reverse curves are 1mm to 2mm wide, then an alignment zone of similar width and finally enough edge lift to create a band of pooling of 0.5mm and ensure adequate tear exchange. The lens should move on the blink but not to the point it moves outside the corneal diameter ( Figure 2 ). 35

Once the amount of flattening for the myopia + Jessen factor have been incorporated into the base curve, you will seldom need to modify this parameter unless you determine undertreatment. In that case, you may flatten the base curve or increase the diameter of the treatment zone. More commonly, you will find you may need to modify the reverse curve, or the toricity of the reverse or alignment curves. The reverse curve contributes to decreasing the myopia slightly as you flatten this curve, thereby reducing the sagittal depth and eliminating a central island identified by topography. But mostly the reverse curve improves lens centration by manipulating the sagittal depth of the lens.

A low riding lens leaves a “frowny face” on your topography, and a high riding lens creates a “smiley face.” Modify the reverse curves and/or alignment curves by increasing or decreasing the sagittal depth, respectively. Smaller adjustments may be made by changing the landing zone angle on some lenses. In cases of corneal astigmatism that is limbus-to-limbus, these curves may need to be toric rather than spherical. 35

Ortho-K for hyperopia and presbyopia (monovision) is an option; however, it’s not as well studied as it is for myopia. Nonetheless, studies with GP designs with base curve radii fit 0.4mm to 0.7mm steeper than flat K have shown success and reversibility with up to 28 hours of wear. 40 The designs also have an impact on steepening of the treatment zone, flattening in the reverse zone and a positive shift in spherical aberration (as well as other HOAs). 40-43

Follow-up Scheduling

The timing of return visits after dispensing are dictated by the individual needs of the patient. A typical schedule would be the morning after the first overnight wear period, one week and then one, three and six months. 8 Once the desired effect is achieved, six-month intervals are fine. Assess the centration by topography and unaided visual acuities at every visit along with the ocular health, compliance and reinforce education. At one week, you will add a manifest refraction and you should be at or near your target of +0.50D to +0.75D of hyperopia. 37 At six months, include axial length measurements to assess progression.

Continue educating yourself and consider adding this valuable service to your practice. Understanding myopic progression and control should become part of every primary care practice. There are numerous opportunities to acquire the proper training on ortho-K through continuing education programs at major meetings, dedicated societies and manufacturer online certification courses.

Adding ortho-K to your practice is a win for both patients and the economic health of your practice. It is immensely satisfying to change lives and reduce the risk of future morbidities through early intervention. You will also see how highlighting this service will benefit your practices.

Dr. Fuller is a professor and founding supervisor of the Cornea & Contact Lens–Refractive Surgery residency at The Eye Center at Southern College of Optometry. He is also a Diplomate of Cornea, Contact Lenses and Refractive Technologies for the American Academy of Optometry.

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How Does Orthokeratology Improve Vision?

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Myopia, or nearsightedness, is a prevalent vision problem. If you have myopia, you see nearby objects clearly, but distant things appear blurry.

This happens because your eye is slightly longer than normal or your cornea (the clear front part of your eye) is too curved. As a result, light entering the eye doesn’t properly focus on the retina, the light-sensitive tissue at the back of the eye⁠.

What is Orthokeratology?

Orthokeratology, often called Ortho-K, is a safe, FDA-approved treatment that temporarily reshapes your cornea while you sleep. Here’s the key idea:

It uses unique, rigid gas-permeable contact lenses that you wear only at night. These lenses apply gentle pressure to your cornea, subtly flattening its central area. Think of it as a very comfortable, customized retainer for your eyes.

Because your cornea is somewhat flexible, this reshaping changes the way light focuses in your eye and improves your distance vision. When you take your lenses out in the morning, you can see clearly throughout the day without glasses or daytime contacts.

How Can Ortho-K Manage Myopia?

Ortho-K is about more than just correcting your vision in the short-term. Exciting research suggests it can also slow down the progression of myopia, which is especially important for children and teenagers.

In some nearsighted children, light may not focus properly on the retina, which could trigger the eye to continue growing longer.

Ortho-K lenses gently reshape the eye overnight and alter how light enters it. This might interrupt those signals that encourage growth, potentially slowing the progression of nearsightedness in your child.

Is Ortho-K Right for Me (or My Child)?

The best way to determine whether you’re a good candidate for Ortho-K is to talk to an eye doctor who specializes in this treatment.

They’ll carefully examine your eyes and discuss your individual situation, potential benefits, and risks to help you decide if it’s the right choice for your vision needs.

Remember, Ortho-K needs to be continued regularly to maintain both vision correction and the myopia-slowing effect.

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What’s the Orthokeratology Process Like?

The Ortho-K process is an appealing choice for many people seeking clear vision without daytime glasses or contacts. Here’s a step-by-step look at how it all works:

1. Eye Exam and Mapping

It starts with a thorough eye exam. In addition to checking your general eye health and vision, your eye doctor will map the unique shape of your cornea using a special device called a corneal topographer. This corneal map helps them create a truly personalized treatment plan.

2. Custom Lens Design

Using the information from your corneal map, your doctor designs Ortho-K lenses just for you. Think of them as tailor-made, gentle “retainers” for your eyes.

3. Overnight Wear

You’ll wear these special lenses while you sleep. The lenses are made of a highly breathable material to keep your eyes healthy and comfortable.

4. Corneal Reshaping

As you sleep, the lenses subtly reshape the front part of your eye (the cornea) to temporarily correct your vision. Once you remove the lenses in the morning, your vision will be clearer for the rest of the day.

What are the Benefits of Ortho-K?

Ortho-K offers a wide range of benefits, making it a great choice for both children and adults:

Freedom from daytime vision correction. No more glasses or daytime contact lenses. You enjoy clear vision throughout the day.
Non-invasive and reversible. If you decide Ortho-K isn’t for you or your needs change, simply stop wearing the lenses⁠—your cornea will gradually return to its original shape.
Great for active lifestyles. Perfect for people with busy routines, athletes, or anyone who struggles with traditional vision correction in dusty or wet environments.
Potential for myopia control in children. Studies suggest it can slow the progression of nearsightedness in kids and teens, potentially helping to protect their eyesight in the long run.
Comfortable and easy to use. The lenses are designed for safe, comfy overnight wear, and the routine becomes second nature after a short while.

To maintain clear vision and eye health, consistent use of Ortho-K lenses is necessary. It’s a commitment, but for many people, the benefits of the treatment far outweigh any adjustments to their routine.

Is Orthokeratology Safe and Effective?

Ortho-K is a safe option for vision correction and myopia control for many people. Most people enjoy clear vision throughout the day without glasses or contacts after wearing the lenses overnight.

Research also suggests Ortho-K can significantly reduce the severity of a child’s nearsightedness over time, which could help protect their long-term vision.

While the benefits are great, it’s essential to be aware of these potential risks to make an informed decision:

Infection. The most significant risk with Ortho-K is microbial keratitis, a serious cornea infection. This risk is significantly reduced with proper lens care and cleaning. However, it’s crucial to follow your eye doctor’s instructions and report any unusual symptoms immediately.
Corneal issues. The temporary reshaping of the cornea can sometimes cause mild swelling or temporary changes in the very outermost layer of your cornea. These issues are usually minor and often resolved with a little rest from the lenses.
Lens-related discomfort. Some people may feel slight irritation or dryness when first acclimating to wearing Ortho-K lenses. This usually improves as the eyes adjust.

How Can You Minimize Risks in Ortho-K?

Find an eye doctor specializing in Ortho-K with experience treating adults and children (if you’re considering it for your child). Once you begin the procedure, follow your eye doctor’s cleaning, care, and replacement instructions for your Ortho-K lenses.

Keeping your scheduled follow-up appointments is also a great way to minimize risks, as it allows your doctor to monitor your eye health and ensure everything is on track.

Orthokeratology vs. Other Vision Correction Options

Here’s a table to help you quickly compare Orthokeratology to other vision correction options:

Ortho-K provides an effective way to improve your vision and potentially slow the progression of myopia. Like any form of vision correction, it carries some risks, but these risks are significantly reduced when you prioritize lens care, hygiene, and regular eye exams.

If you’re intrigued by the idea of Ortho-K, we encourage you to schedule a consultation with an experienced Ortho-K specialist. They can help you weigh the potential benefits and risks and determine if Ortho-K is the right choice for you or your child.

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Vincent et al. “CLEAR – Orthokeratology.” Cont Lens Anterior Eye, 2021.
Charm J. “Orthokeratology: clinical utility and patient perspectives.” Clin Optom (Auckl), 2017.
Li et al. “Orthokeratology in controlling myopia of children: a meta-analysis of randomized controlled trials.” BMC Ophthalmol, 2023.
Logan et al. “Contact Lens Correction and Myopia Progression.” Contact Lenses (Sixth Edition), 2018.
Nau AC. “Medical Application of Contact Lens Technology.” Advances in Ophthalmology and Optometry, 2019.
VanderVeen et al. “Use of Orthokeratology for the Prevention of Myopic Progression in Children.” American Academy of Ophthalmology, 2019.

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What Is Orthokeratology?

A hand holding an orthokeratology lens in a container.

Orthokeratology, or ortho-k, is the use of specially designed and fitted contact lenses to temporarily reshape the cornea to improve vision. It’s like orthodontics for your eyes and the treatment is often compared to dental braces. Most ortho-k lenses are worn at night to reshape the front surface of the eye while you sleep. Vision improvements are reversible but can be maintained if you keep wearing the lenses as directed.

Who is ortho-k for?

Ortho-k is mainly used to correct near-sightedness (myopia) . This vision problem can also usually be corrected by eye glasses , regular contact lenses, LASIK or PRK . Orthokeratology is a surgery-free way for some people to leave their glasses behind and not have to wear contact lenses all the time.

Ortho-k is sometimes recommended to correct children’s vision. Vision can continue to change for some children into adulthood and their 20’s. Vision correction surgeries like LASIK are not recommended until vision is stable. There is no firm evidence that ortho-k can slow down the progression of myopia in children, but this is also being studied as a possibility.

How does ortho-k work?

The cornea is a clear, dome-shaped window in the front of your eye that focuses light onto the retina and is responsible for most of the eye’s ability to focus. Its tissue is very flexible.

Your ophthalmologist will map and measure the surface of your cornea using an instrument called a corneal topographer and then design a lens especially for your eye. The cornea map is created by reflecting light off the surface of the eye. The machine doesn’t touch your eye, and there is no pain. The corneal topography map shows your ophthalmologist the shape and curves of your cornea.

The lenses work by flattening the center of the cornea, changing how light is bent as it enters the eye. Most orthokeratology lenses are worn overnight to flatten the cornea, then removed during the day. These overnight lenses are rigid, gas-permeable lenses that are sturdy enough to reshape the cornea, but also allow oxygen through so your eye stays healthy.

When ortho-k lenses are removed the cornea stays flattened for a while and vision is corrected without the need for glasses. If you stop wearing the lenses at night, your eyes will eventually go back to their original shape and the refractive error will return. You have to keep wearing the lenses regularly to keep the vision correction.

What can you expect from ortho-k?

It can take two weeks or longer to attain the maximum vision correction from orthokeratology, although some people experience significant vision improvement in days. In clinical studies of Food and Drug Administration-approved ortho-k lenses, most patients achieved 20/40 vision or better .

You may need a series of temporary ortho-k lenses to see properly until you reach the desired prescription. Typically, up to three pairs of orthokeratology lenses are used, one after the other, to achieve the best vision correction. Once you’ve reached the desired prescription, you’ll use the same shape of lens each night to maintain the correction.

Until you get used to them, you will probably feel the lenses on your eyes until you fall asleep. With time, they usually become more comfortable. Once your corneas have gotten the final desired curve, you will use a retainer lens—as often as your ophthalmologist recommends—to maintain your vision.

Is orthokeratology safe?

Ortho-k is associated with an increased risk of infection ( microbial/bacterial keratitis ). This risk is especially concerning for children and adolescents, who may be less able than adults to maintain good hand and contact lens hygiene .

Each year, nearly a million Americans go to the doctor because of eye infections. And the biggest risk factor for infections is contact lens wear. Eye infections can have serious consequences including lifelong vision impairment. For this reason, ortho-k may be more dangerous than glasses, which can be used to correct the same conditions. That’s one of the reasons it is important to consult with an ophthalmologist if you are considering ortho-k.

There is no limit to how long you can use orthokeratology lenses. You must see your ophthalmologist for regular check-ups. But if your eyes stay healthy and comfortable, ortho-k could be used for years.

How much do orthokeratology lenses cost?

In most cases, orthokeratology would be an elective treatment. There are often other, cheaper and better-known methods for correcting refractive errors, like eye glasses. But there may be some cases where insurance would recommend and pay for ortho-k lenses. The cost of ortho-k, including follow-up care associated with fitting the lenses, can vary significantly depending on the type and degree of refractive error. Ortho-k prices generally range from $1,000 to $4,000. Ongoing costs for replacement of lenses, lens care solutions and follow-up exams can range between $300 and $500 a year.

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5 lens care tips for traveling patients

Keep your patients in safe and comfortable lens wear while on the road

Many of our patients travel for both business and pleasure. They are traveling across the country and abroad, often spending more time outdoors, in the pool, by the lake or ocean, and in the dry air of an aircraft. Are you talking with your patients about best practices for contact lens wear and care while they travel?

Related: Why accountable contact lens fitting matters

The annual exam is the perfect opportunity to discuss additional contact lens care and hygiene that may not normally apply while at home. For example, if your patient is traveling to a developing country, it might be best for her to leave her contact lenses at home and just wear glasses. The water quality and other risks of infections could potentially be dangerous for our contact lens-wearing patients. However, we know that most patients want to continue wearing their contact lenses during travel. We need to help them do that safely.

Here are five tips to help keep your patients safe and comfortable when wearing contact lenses. Share them with all of your patients so they’re ready for whenever or wherever they travel.

Related: How to keep athletes’ eyes healthy in contact lenses

1. Pack contact lens gear in a carry-on bag, not checked baggage

This includes glasses, back-up pairs of contact lenses, lens care solutions, and rewetting drops. If all of these items were in checked bags and the patient’s luggage was lost, your patient would be facing the challenge of contacting your office for additional trial contact lenses or to have a copy of the prescription sent to her location.

This huge hassle can be prevented by recommending patients to carry their eyecare necessities on the plane with them. Be sure to offer trial-size bottles of lens care solutions and rewetting drops.

2. Recommend patients travel with daily disposables

Even if your patients wear only monthly or two-week lenses, recommend a 30-day supply of daily disposables in conjunction with their current lenses when purchasing. Having a supply handy just in case a lens is lost down the drain or rips can save an annoying situation.

In addition, wearing daily disposables for activities such as swimming, hiking, biking, and more makes lens wear and care much easier. Patients won’t need to carry solutions or worry about infection or contamination while trying to clean lenses outdoors.

Related: Fitting ortho-k contact lenses

3. Give patients a copy of their Rx to carry with them

Recommend your patients carry a copy of their prescription for both glasses and contact lenses in case of emergency. Patients won’t be able to get new glasses made or additional contact lenses without a written Rx. This makes life easier with time zone changes or if the emergency happens over a weekend and the assisting doctor can’t reach your office.

Related: A new contact lens app with potential to harm the public

4. Provide trial-sized products for ease of travel

Offer for sale or provide trials of lens care solution and rewetting drops for patients who travel. Full-sized products will need to be stored in checked baggage, and offering the smaller sizes will discourage patients from transferring solutions from a big bottle into a smaller container.

Patients may not understand that pouring solutions from one bottle to another may lead to significant clinical concerns or infections.

In addition, discuss with your patients the benefits of purchasing and packing larger bottles in checked bags if they will be gone for an extended period of time. P

utting off the purchase of lens care products until they reach their final destination may result in purchasing a different product or brand. Switching products could lead to noncompliance or adverse results.

Related: Monthly contact lens wearers can thrive, not just survive

Orthodontic Travel Kit

The Orthodontic Travel Kit is your ultimate companion for maintaining excellent oral health while on the go. This comprehensive kit contains all the essential tools you need to keep your orthodontic appliances clean and your smile shining bright.

Ortho Toothbrush: Designed specifically for effective cleaning around braces and brackets.
Ortho Travel Toothbrush: Perfect for travel and onthe-go oral care.
10m Nylon Dental Floss: Glide through tight spaces and remove plaque.
Interdental Brush: Reach between teeth and braces with ease.
10pcs Dental Floss Threader: Simplify flossing around braces.
Ortho Wax in Plastic Case: Protect your soft tissues from irritation.
Dental Mirror: Get a clear view of those hardto-reach areas and ensure thorough cleaning.
Two Minute Timer: Maintain proper brushing time with this handy timer, promoting optimal oral hygiene.
Zipper PVC Bag: Stay organized and portable with this durable and convenient bag.

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Stella Municipal Drama Theater
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Fifth House Gallery
Likino Dulevo Museum of Local Lore
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