Frequently Asked Questions | Ortho-k

General Ortho-K Questions:

What is orthokeratology?

Orthokeratology (ortho-k) with contact lenses correct nearsightedness and are worn at night. The lenses are put in before bed and worn while you sleep. The lenses are removed when you wake up and the wearer enjoys clear vision all day, without needing other vision correction like glasses or daytime wear contact lenses.

What are the benefits of ortho-k?

Ortho-k offers clear vision during the day without wearing lenses. Lens-free vision is less restrictive so children may be more active at school and in sports

Removes the worry and complications of your child wearing glasses or other forms of vision correction during the day. There is no risk of your child losing them at school.

More convenient than glasses or daytime correction.

What are the benefits of ortho-k vs. traditional contact lens?

You will experience clear vision without wearing contact lenses or glasses during the day when you are being treated with ortho-k! Traditional contacts or glasses, once removed, don’t provide any vision correction.

The lens-free vision is less restrictive so children may be more active at school or in sports.

Ortho-k removes the worry and complications of your child wearing glasses or contact lenses during the day. There is no risk to your child losing them or breaking them while at school.

In a study comparing the quality of life of ortho-k to soft contact lenses, 68% chose ortho-k lenses worn at night, whereas 32% preferred soft lenses worn during the day. The primary differences favoring ortho-k lenses were fewer activity limitations, less trouble with symptoms, and less dependence on refractive correction.1

1Lipson MJ, Sugar A, Musch DC. Overnight corneal reshaping versus soft disposable contact lenses: vision-related quality-of-life differences from a randomized clinical trial. Optom Vis Sci. 2005 Oct;82:886-891

How long does ortho-k treatments take to work?

The amount of time it takes for the daytime vision to achieve optimal results varies. In general, the higher the initial nearsightedness, the longer it takes to achieve optimal treatment. Many patients see a significant vision change after the first night of wear! However, it may take up to 7-10 nights to see the complete effect with consistent vision during waking hours. With a consistent wear schedule, your child should be able to wear the lenses at night and see clearly during the day.

Why have I not heard of this before?

As more research has been undertaken and eye care professionals have learned of the significant benefits of Ortho-K, more practitioners are making Ortho-K a frequent choice for their nearsighted patients. Its use has grown dramatically as a result of consumers sharing their own success stories and the positive impact it has had on their vision or the vision of their children.

How do ortho-k contacts correct my child’s vision?

When worn overnight, ortho-k contact lenses gently correct the curvature of the cornea, resulting in a corneal shape that focuses light correctly on the retina. When removed in the morning, distant objects will come back into focus and patients can see clearly without the use of glasses or daytime contacts. The process is reversible and during the day, the corneal curvature begins to return back to its original shape.

Do ortho-k lenses hurt?

When you first begin to wear ortho-k lenses, there may be an initial awareness under the eyelid that is experienced. After a few nights of wearing the lenses, most patients become more accustomed to that sensation and less aware of the feeling. If you experience pain with this lens or any type of contact lens, discontinue use and contact your eye care professional.

Is ortho-k permanent?

Unlike Lasik, the treatment with ortho-k contact lenses is temporary and completely reversible. When lens wear is discontinued, the corneal shape and myopia will return.

Handling and Care Questions:

How long will my child have to wear ortho-k lenses?

Once diagnosed with nearsightedness, or myopia, you will have to choose some form of correction that may include eyeglasses, traditional contact lenses or ortho-k. Every year you will choose the method of correction that best suits your needs. Many children that begin with ortho-k lenses prefer to be free from the hassle of daytime eyewear and continue ortho-k into adulthood.

What if my child cannot put the contacts on or take them off?

Your eye doctor will provide advanced training for your child and for you as a parent. You will not take the contact lenses home with you until you are confident in their ability to apply and remove the contacts. You can be trained in assisting the process if necessary. You will be very proud to see your child handling the lenses and caring for them as trained by our professional team.

What happens if my child skips a night?

Ortho-k is a flexible mode of myopia treatment. If your child forgets or skips a night of contact lens use, they will maintain most (sometimes all) of the vision correction they have. The more nights without wearing the lenses, the more unclear the vision will be until they return to their fully uncorrected state. Many children can skip a night without experiencing much decline in clarity. Keep in mind, the lenses are prescribed to be worn every night to maintain optimal clarity.

How often do I replace the ortho-k lenses?

The recommended replacement schedule is one year; however, your eye care professional may suggest a different replacement schedule.

Cost:

What is the cost of ortho-k lenses?

Your certified eye care professional will discuss the cost with you. They will include fees for ortho-k treatment and the contact lens devices designed with your prescription needs in mind. Some doctors charge based on the number of office visits and the cost of lenses and others bundle the visits and lenses into one treatment plan. After the first year of treatment, the cost is usually closer to other modes of contact lens and eyeglass packages.

Is ortho-k covered by insurance?

Most vision plans are defined benefit plans and may allow you to apply a defined benefit towards an eye exam or the purchase of eyewear or contact lenses. This may cover a small portion of the costs. Ortho-k is considered a cosmetic program by most medical insurers and they do not provide payment for myopia treatment. Check with your insurance plan for more details about your benefits.

Is my child too young for contacts? When should I start ortho-k with my child?

There are no age limitations with ortho-k lenses and it depends on your child and the recommendation of your eye care professional.

Children may get the most benefit from choosing ortho-k when they begin treatment at a young age. Parents are able to assist in every aspect of contact lens wear. The insertion and removal of the contacts take place at bedtime and upon awakening. This allows your child to leave the house without taking any eyeglasses or supplies with them when they leave the house. It can be the most convenient option for busy families. No more misplaced eyeglasses or lost contact lenses!

The sooner ortho-k is started after the onset of nearsightedness, the more positive of an influence it may have.

Is there a drawback or “downside” to this option?

Ortho-k requires some follow up though out the year. Your doctor in invested in your success and the health of your eyes and you will spend extra time in his or her office. There are more visits required to monitor your success and get started with the program. Once you or your child are successfully wearing the lenses and enjoying the clear vision, most find the occasional follow up visit to be quick and not inconvenient.

Ortho-k questions for Adults:

Should I get Lasik instead of ortho-k?

You should be aware of all the choices available to you and what the benefits of each are. Ask your eye care professional what is right for you.

Though the eye continues to change until 20 to 24 years of age, LASIK is FDA-approved for those over 18. Many doctors suggest waiting until a person’s eyesight has stabilized for two years before undergoing refractive surgery. Ask your eye care professional what is right for you.

Ortho-k is a non-surgical option with no age limitation. Many patients also enjoy the flexibility of being able to adjust the prescription from year to year.

If your prescription changes (if it increases or decreases) your doctor can adjust the corrective power of the ortho-k treatment immediately. Once you have Lasik surgery, without undergoing another surgical procedure you cannot change the correction you received from the surgery.

How long do I need to sleep at night for this to work?

The recommended wearing time for ortho-k is 7-8 hours a night. This varies from person to person. If you sleep less than that, then the change in corneal shape will not be as great and the clear vision may fade during the day.

References

  1. Jan C, Li S-M, Kang M-T, Liu L, Li H, Jin L, et al. Association of visual acuity with educational outcomes: a prospective cohort study. Br J Ophthalmol.: Published Online First: 18 January 2019
  2. Lipson MJ, Sugar A, Musch DC. Overnight corneal reshaping versus soft disposable contact lenses: vision-related quality-of-life differences from a randomized clinical trial. Optom Vis Sci. 2005 Oct;82(10):886-91.
  3. Xu L, Wang Y, Wang S, Wang Y & Jonas JB, ‘High Myopia and Glaucoma Susceptibility: The Beijing Eye Study’ Ophthalmology, Volume 114, Issue 2, February 2007;
  4. Jones, et al, Parental History of Myopia, Sports and Outdoor Activities, and Future Myopia. Invest. Ophthalmol. Vis. Sci. 2007;48(8):3524-3532. doi: https://doi.org/10.1167/iovs.06-1118.
  5. Xiong, Shuyu & Sankaridurg, et al, (2017). Time spent in outdoor activities in relation to myopia prevention and control: A meta-analysis and systematic review. Acta Ophthalmologica. 95
  6. Hu Y, Ding X, Guo X, Chen Y, Zhang J, He M. Association of Age at Myopia Onset With Risk of High Myopia in Adulthood in a 12-Year Follow-up of a Chinese Cohort. JAMA Ophthalmol. 2020;138(11):1129–1134. doi:10.1001/jamaophthalmol.2020.3451
  7. Sankaridurg P. Contact lenses to slow progression of myopia. Clin Exp Optom. 2017 Sep;100(5):432-437
  8. Zhao F, Zhao G, Zhao Z. Investigation of the Effect of Orthokeratology Lenses on Quality of Life and Behaviors of Children. Eye Contact Lens. 2018 Sep;44(5):335-338.