The following article will outline everything you need or want to know about orthokeratology – what it is, how it works, who is a good candidate, and the risks and benefits involved. If you are a contact lens or glasses wearer who is looking for a non-surgical option that frees you from your glasses or contact lenses, orthokeratology lenses may be right for you!
What is Orthokeratology?
Orthokeratology, also known as ortho-k or corneal reshaping technology involves the use of specialty contact lenses to temporarily reshape the front surface of the eye, the cornea. By reshaping the cornea, these lenses are able to improve vision and allow patients to see clearly without the use of glasses or daily wear contact lenses. These ortho-k lenses are worn overnight and therefore free a patient from relying on glasses or contact lenses during the day.
How Does Orthokeratology Work?
Orthokeratology lenses work by temporarily flattening the center of the cornea, which changes the way light bends in your eye and allows for these rays of light to properly land on the back of the eye, the retina, therefore creating a clear image. These lenses work overnight by flattening the cornea which allows for clear vision to be utilized during the day. When the lenses are removed, the cornea temporarily stays flattened; however, these lenses need to be utilized every night in order for the cornea to maintain this temporary shape.
In order to fit these lenses correctly, your eye care provider who is fitting you will likely use a device called a corneal topography to map out the shape of your cornea. They will also use this data to order a lens that will flatten your cornea to a specific amount that is specialized to your eye and for your prescription.
You can expect to have a few visits with your eye doctor at first in order to obtain the data for the lenses and to make sure that the fit and vision from the lenses are adequate. However, once these elements are finalized, follow-up for orthokeratology lenses is usually yearly just like any normal eye examination that involves glasses or contact lenses.
How Long Do the Effects of Orthokeratology Last?
It is recommended that ortho-k lenses are worn every night as the cornea can only hold the shape created by the lenses for a couple of days. If you forget to wear the lenses for one night, typically you will still have functional vision the following day but it might not be as clear as it normally would be.
For patients who do not wish to wear the ortho-k lenses anymore, it can take up to 3 weeks for a “wash out” period of time in which the cornea will fully return to its normal shape.
Can Orthokeratology Be Permanent?
Because of the way that orthokeratology lenses temporarily change the shape of the cornea, their effects are not permanent. However, if worn consistently every night, these lenses can provide long-term relief from glasses and contact lenses. Many patients wear ortho-k lenses for years without any complications.
If at any point a patient wishes to stop wearing ortho-K lenses, they can go through a “wash out” period in which they will stop wearing the lenses overnight and their cornea will return to its normal shape. Their glasses or contact lens prescription will return to normal and therefore the patient will need to wear glasses or contact lenses again during the day for clear vision.
Are There Risks Associated With Orthokeratology?
The risks involved in orthokeratology are few, but still worth considering when deciding if ortho-K is right for you. As with the use of any type of contact lens, there is an increased risk of infection. This should be considered in patients who are more susceptible to infection or in children who may not be able to properly practice good contact lens hygiene including cleaning and care of the lenses.
Overall, however, ortho-k lenses are a very safe option for clear daytime vision and arguably have much fewer risks than refractive surgery options such as LASIK, LASEK, and PRK (photorefractive keratectomy).
Where Can You Get Orthokeratology?
Many skilled and trained optometrists provide orthokeratology lenses in private practice settings. These lenses are also available in some ophthalmology settings as well as in some hospital eyecare systems. However this technology is relatively new, so not all optometrists or eye care providers may provide these services.
To find a doctor who is fitting these lenses close to you, you can keyword search “orthokeratology in my area” or simply ask your normal eye care provider if they fit these lenses. Even if your normal eye doctor does not fit these lenses, they may be able to refer you to a provider who does specialize in orthokeratology.
How Much Does Orthokeratology Cost?
The cost of orthokeratology lenses varies depending on the practitioner who is fitting you and their cost/fitting policy. These lenses are not covered by insurance and will be a full out-of-pocket expense.
The university that I work for charges roughly $2000 for the full fitting fee and cost of lenses. This covers all the “back-and-forth” appointment costs.
Prices generally range from $1000-$4000 depending on your location, the demand, and the eye care professional who is fitting the lenses.
Once an adequate ortho-K fit is established, yearly ortho-K lens evaluations and costs are much less, roughly $100-$500 a year depending on the fit and care of the lenses. If ortho-K lenses are properly taken care of and the fit is stable, some lenses can be worn for a few years.
When compared to the costs of yearly glasses, contact lenses, and solution, ortho-K lenses may even be cheaper in the long run depending on the patient.
Final Thoughts on Orthokeratology
Orthokeratology lenses are a wonderful technological advancement that can provide patients with clear functional vision without the need for glasses, daily contact lenses, or refractive surgery. The use of ortho-k lenses also are widely used for myopia management in children and has been proven to slow the rate of myopia, or nearsightedness.
However, not everyone may be an ideal candidate for these types of lenses. Ortho-K is primarily utilized for patients who are myopic or near-sighted. Patients who are hyperopic or far-sighted, or those who have high amounts of astigmatism may not be good ortho-k candidates.
If you are interested in seeing if ortho-k lenses may be right for you, schedule an appointment with an optometrist or eye care professional who specializes in fitting these lenses.
Dr. Olivia Burger, O.D. is an optometrist who graduated from the Pennsylvania College of Optometry. She is pursuing a 1-year residency at the UC Berkeley School of Optometry in Vision Science in Primary Care / Contact Lens. Her optometric areas of interest include private practice, contact lenses, and optometric service organizations such as VOSH. In her free time, she enjoys live music and is a freelance concert photographer.