Orthokeratology (Night Lenses)

What is orthokeratology?

Orthokeratology, or Ortho-K, is a non-surgical process that uses customised rigid contact lenses (specifically made for each patient) which are worn overnight to remodel the curvature of the cornea (the clear front surface of the eye). They are removed in the morning, allowing clear vision without correction during the day.

The effects of the lenses are temporary, so if you stop wearing them your eye will go back to its original shape, and you will need to wear your glasses or contact lenses again.

Who is it for?

Children from 6-year-old, teenagers, and adults can use these lenses to correct their eyesight.

Ortho-K works best for people with up to about -6.00D of myopia and no more than -1.75D of astigmatism, with or without myopia. It’s an excellent solution to manage myopia in children. People who are longsighted or have a higher degree of myopia can try Ortho-K, but results are less certain to be good.

Ortho-K lenses are ideal for athletes and individuals with active lifestyles, as there are no lenses or glasses to worry about during sports or physical activities. They can be a more comfortable option for those who find daytime contact lens wear uncomfortable. Ortho-K can be considered as an alternative for those who are not suitable candidates for laser eye surgery. Individuals with dry eye issues may find Ortho-K lenses more comfortable than traditional daytime contact lenses.

To be suitable for Ortho-K you must have a healthy cornea. Ortho-K is not recommended for individuals with certain eye conditions or irregular corneal shapes. Your ophthalmologist will determine candidacy based on a comprehensive evaluation.

What are the Pros and Cons of Ortho-K lenses?

Pros

• Ortho-K allows you to enjoy clear vision during the day without the need for glasses or daytime contact lenses, providing freedom and convenience.
• It is a non-invasive and reversible procedure, meaning that if you decide to stop using Ortho-K lenses, your cornea will return to its original shape.
• Some studies suggest that Ortho-K may slow down the progression of myopia in children and young adults.
• Ortho-K lenses are gas-permeable, made of a material that allows oxygen to reach the eye and comfortable to wear during sleep, reducing dryness and irritation associated with traditional contact lenses.

Cons

• Successful Ortho-K requires strict adherence to wearing the lenses every night and follow-up visits with the eye care professional. Non-compliance may lead to less effective results.
• The lenses must be worn for at least 7-8 hours per night; with an ideal wear time of 8 hours to achieve the best results.
• The reshaping effect of Ortho-K is temporary. If lenses are not worn regularly, the cornea will return to its original shape, and the vision correction will be lost.
• It may take some time to get used to wearing the Ortho-K lenses during sleep. Initially, some people may experience discomfort or dryness.

What is the process to get my Ortho-K lenses?

Your ophthalmologist will first evaluate your eye health, measure your cornea, and determine if you are a suitable candidate for the treatment.If you’re a good candidate, your ophthalmologist will take detailed measurements of your cornea to design customised Ortho-K lenses specifically for you.

You will be provided with your Ortho-K lenses and instructions on how to wear and care for them. There will be a period of adjustment as your eyes adapt to the lenses.

Regular follow-up appointments will be scheduled to monitor your progress, make any necessary adjustments to the lens fit, and ensure your eyes are responding well to the treatment.

When will Ortho-K lenses start to work?

When you start wearing Ortho-K lenses, you’ll notice small changes in your vision gradually. The timeline of these changes will vary based on your unique vision problems and how much correction you need. Based on your prescription, you may see corrections in your vision as follows:

• Low-level myopia (less than -2.00D) in 3-4 days.
• Medium level myopia (-2.00 to -4.00D) in 1 week.
• Moderate level myopia (-4.00 to -6.00D) in 1-2 weeks.
• High-level myopia (over 6.00D) in 2-3 weeks.

• First day: after your first night of wearing Ortho-k lenses, you’ll likely notice an improvement in your vision. The correction is temporary, so wear the lenses every night to maintain clear vision. You will also see your eye doctor after the first night of wear to ensure the lenses fit correctly and perform as desired.

• First week: as you continue wearing the lenses, you may notice your vision improve even more. However, it’s common to experience some blurriness or halos around lights, especially in low-light conditions. These side effects usually resolve on their own within a few days to a week. Depending on your prescription, you will need to visit your eye doctor after the first week of wear to ensure the lenses continue performing as desired.

• First month: by the end of the first month, you should have achieved your full correction with Ortho-k lenses depending on your initial prescription. Your vision should be clear and stable, but you may still experience minor side effects like halos or glare around lights, so you will visit your doctor again after the first month of wear.

• Three months: at the three-month mark, you may need to return to your eye doctor for a follow-up appointment to ensure your vision is stable and the lenses fit properly. You may also need to adjust your prescription based on your vision needs.

• Six months and beyond: with regular use, Ortho-k lenses can provide long-term vision correction. You will need to continue wearing the lenses every night to maintain clear vision and should plan on a visit with your eye doctor every 3 months. Over time, you may notice changes in your prescription and need to have the lenses adjusted accordingly.

How long can I keep my Ortho-K lenses?

The lifespan of Ortho-K lenses can vary based on the individual wearer’s care and use. Proper cleaning and maintenance are essential to ensure that the lenses last as long as possible.

Ortho-k lenses should be cleaned with a specific cleaning solution and stored in a specialised lens case when not in use.

Please refer to the leaflet ‘Instructions for Using Ortho-K Contact Lenses’

What are the possible side-effects of Ortho-K?

Most Ortho-K side-effects are minor and can be avoided by following instructions from your ophthalmologist. Potential risks linked to orthokeratology include eye irritation, dryness, blurred vision and corneal infection or scarring.

In case of such symptoms do not wear your lenses or, if already worn, immediately remove them.

How to minimise the risk of side-effects?

By following your doctor’s instructions carefully, monitoring your vision regularly and seeking immediate medical attention if necessary, you can minimise the risk of Ortho-K side-effects.

Watch an educational video at here.