Orthokeratology, often called Ortho-K, is a non-surgical treatment that involves wearing specially designed contact lenses overnight to temporarily reshape the cornea. This corrects myopia (short-sightedness), allowing clear vision throughout the day without the need for glasses or daytime contact lenses. It can also help slow the progression of myopia in children and teenagers.
Orthokeratology may sound dramatic, but it is quite simple. ‘Ortho’ means to ‘correct’. It corrects the refractive error by reshaping the cornea. Ortho-k treatment can be effective on nearsighted (myopic), farsighted, and astigmatic patients. As this technology continues to evolve, it can also successfully correct corneas with high astigmatism, presbyopia and post-LASIK (refractive surgery) with residual myopia or irregular treatment areas.
How Does Ortho-K Work?
Each ortho-k lens is individually designed using detailed corneal topography maps of your eyes. These lenses are worn overnight while you sleep. They gently reshape the top layers of the cornea using the forces of the eyelid and tear fluid beneath the lens. For the treatment of myopia, the lens produces a flatter central cornea, correcting near-sightedness by decreasing the power of the eye. For hyperopia and presbyopia, the design of the lens steepens the central cornea, correcting longsightedness by increasing the power of the eye.
In the morning, you remove the lenses and enjoy clear vision all day. To maintain the effect, lenses must be worn regularly (usually every night).
Who is Ortho-K Suitable For?
Ortho-K can be a great choice for:
- Children or teens whose myopia is gradually increasing.
- Adults who prefer to be free from glasses or contact lenses during the day.
- People who play sports, work outdoors, or experience dryness with regular contact lenses.
Ortho-k is most frequently used to correct myopia (nearsightedness). However, it can also address hyperopia (farsightedness) and astigmatism. Ideally, your prescription should be in the range of +2.00 to -6.00 with no more than -1.75 dioptres of surface astigmatism. In some cases, your eye care provider might attempt higher prescriptions.
Since successful vision correction relies on several unique factors, this prescription range should be used only as a general reference. We strongly recommend consulting an optometrist for personalised guidance on whether you or your child is suitable for orthokeratology.
What to Expect From Ortho-K Treatment
During the first few nights, your vision may fluctuate slightly as your eyes adjust to the lenses. Most wearers achieve clear daytime vision after 7 to 10 nights of consistent wear. A mild foreign-body sensation (like having an eyelash in your eye) can occur at first, but usually settles as your eyes adapt.
The treatment time to achieve clear and stable vision can range from one to four weeks, depending on the individual. Although the lenses may feel slightly uncomfortable at first, this sensation decreases with time. Most patients cannot feel the lenses when their eyes are closed.
While your vision is in the process of being corrected, you may need to wear temporary spectacles or disposable contact lenses.
You will have regular follow-up visits with your optometrist to monitor your treatment. It is crucial to attend these appointments and follow the instructions provided by your optometrist to maintain your eye health and minimise any complications. Potential complications include:
- Lens binding on awakening (this can easily and safely be dislodged following the provided instructions)
- Corneal Staining due to abrasion of the surface of the eye.
- Solution sensitivity.
- Fluctuating vision (if lenses have not centred properly or bubbles have been trapped under the lens)
- Microbial Keratitis, an infection of the cornea that requires intensive treatment with topical antibiotics
Some patients, especially those with large pupils, notice halos and flare during the evening when using ortho-k lenses. The halos are caused by the pupil enlarging in low light and allowing light rays from outside the ortho-k treatment zone to enter the eye. This improves over the first one to two months as the orthokeratology effect stabilises. When designing lenses to control myopia, this phenomenon is normal and part of the treatment process.
When your treatment is complete, you need to wear the final pair of ortho-k lenses every night to maintain your vision. Some patients with low prescriptions are even able to skip nights, and their clear vision will be retained for 40 hours. Regular aftercare visits are necessary to ensure the ongoing health of your eyes.
How do I get started?
A full eye exam is required to establish if your eyes are suitable for ortho-k lenses. An optometrist will assess the overall health of the eye, as well as vision and corneal shape. If you’re interested in orthokeratology for you or your child, contact your local Options Optometrist. We offer ortho-k treatment in Perth at our Joondalup and Canning Vale locations. Our team will assess your eyes and prescription to determine if ortho-k is right for you.