2024-10-05
Myopia, or nearsightedness, is one of the most common vision conditions worldwide, and its prevalence is increasing rapidly, particularly among children. While eyeglasses and standard contact lenses correct the symptoms of myopia, they do not address its progression. Orthokeratology, commonly known as ortho-k, takes a fundamentally different approach by temporarily reshaping the cornea to correct vision and, in children, slow the rate at which myopia worsens.
What Is Orthokeratology?
Orthokeratology uses specially designed rigid gas-permeable contact lenses that are worn overnight while sleeping. These lenses gently flatten the central curvature of the cornea through a controlled, reversible process. When the lenses are removed in the morning, the reshaped cornea allows light to focus correctly on the retina, providing clear vision throughout the day without glasses or daytime contact lenses.
The effect is temporary. If you stop wearing the lenses, the cornea gradually returns to its original shape over one to three days. This reversibility is actually considered a safety feature, as no permanent surgical alteration is made to the eye.
How the Reshaping Process Works
The ortho-k lens has a complex multi-curve design that applies gentle hydraulic pressure to the tear film beneath the lens. This pressure redistributes the epithelial cells of the cornea, flattening the center and steepening the periphery. The process unfolds over a fitting period:
- Initial fitting: Your optometrist uses corneal topography to map the exact shape of your cornea and designs a custom lens based on those measurements.
- First week: Vision improvement begins after the first night of wear. Most patients notice significant improvement within three to five days, though vision may fluctuate during this period.
- Stabilization: After one to two weeks of nightly wear, most patients achieve stable daytime vision. Fine-tuning of the lens fit may be required during follow-up appointments.
- Maintenance: Continued nightly wear maintains the correction. Regular check-ups, typically every six months, monitor corneal health and ensure the lenses continue to fit properly.
Myopia Control in Children
The most compelling application of orthokeratology is in slowing myopia progression in children. Childhood myopia tends to worsen year after year as the eyeball continues to grow in length. Higher levels of myopia later in life are associated with increased risk of serious conditions including retinal detachment, glaucoma, and myopic maculopathy.
Research published in peer-reviewed journals has consistently shown that ortho-k can slow the axial elongation of the eye, the physical change that drives myopia progression, by approximately 50 percent compared to standard spectacle correction. Some studies have reported even greater effects. This means a child wearing ortho-k lenses may end up with significantly less myopia as an adult than they would have otherwise.
For parents concerned about their child's rapidly worsening prescription, orthokeratology represents one of the most evidence-backed myopia control strategies available today, alongside atropine drops and specialized multifocal contact lenses.
Who Is a Good Candidate?
Ortho-k works best for certain prescriptions and patient profiles:
- Myopia up to approximately -6.00 diopters, with the best results typically seen in prescriptions of -4.00 or less.
- Mild to moderate astigmatism (up to about -1.75 diopters) can also be corrected with modern ortho-k designs.
- Children aged 8 and older who are responsible enough to handle lens care with parental supervision. Many ortho-k patients are in the 8 to 14 age range.
- Adults seeking freedom from daytime eyewear who are not candidates for or not interested in laser surgery.
- Athletes and active individuals who find glasses and daytime contacts inconvenient for their sports and activities.
Ortho-k is not suitable for everyone. Patients with very high prescriptions, certain corneal conditions, severe dry eye, or chronic eye infections may not be good candidates. A thorough eye examination is essential to determine suitability.
Benefits Beyond Myopia Control
Freedom During the Day
The most immediately noticeable benefit is not needing any corrective eyewear during waking hours. For children, this means no worrying about broken frames during recess, no fogged-up lenses during Alberta winters, and no self-consciousness about wearing glasses. For adults, it means clear vision for swimming, sports, and outdoor activities without any of the hassles of daytime contacts or glasses.
Reversible and Non-Surgical
Unlike LASIK or other refractive surgeries, ortho-k makes no permanent changes to the eye. If you decide it is not for you, or if your prescription changes, you simply stop wearing the lenses and your cornea returns to its original shape. This is particularly important for children, whose eyes are still developing.
Safe Track Record
Orthokeratology has been practiced for decades, and modern lens materials with high oxygen permeability have made overnight wear safe and comfortable. The risk of complications is comparable to that of standard daily-wear contact lenses, provided the lenses are cleaned and maintained according to instructions.
What to Expect in Terms of Cost
Ortho-k is typically more expensive than standard eyeglasses or soft contact lenses. The initial cost includes the comprehensive fitting process, custom lens fabrication, and multiple follow-up visits. Annual costs include lens replacement (typically once per year), cleaning solutions, and regular monitoring appointments. Many families find the investment worthwhile, particularly when weighed against the long-term costs and health risks of progressively worsening myopia.
Complementing Ortho-K with Eyewear
Even ortho-k patients benefit from having a backup pair of eyeglasses for situations when lenses cannot be worn, such as during eye infections or when travelling without proper lens care supplies. Our 3-for-1 deal is ideal for ortho-k patients who need an affordable backup pair along with prescription sunglasses for UV protection.
Speaking of sun protection, ortho-k patients should be diligent about wearing quality sunglasses outdoors. Brands like Maui Jim and Oakley offer excellent polarized options that protect the eyes from UV damage. Without corrective lenses during the day, non-prescription sunglasses become an essential accessory.
Getting Started with Ortho-K
If orthokeratology sounds like it could benefit you or your child, the first step is a comprehensive eye examination that includes corneal topography mapping. At Fantastic Glasses in Okotoks, we can assess your candidacy and discuss whether ortho-k is the right approach for your specific situation.
Book your appointment today or call us at (587) 997-3937 to learn more. With childhood myopia rates climbing across Canada, early intervention with proven strategies like orthokeratology can make a meaningful difference in your child's long-term eye health and quality of life.