What is the concept behind the OrthoK process?
Think of the retainer you might wear to correct the alignment of your teeth. OrthoK utilizes a patented corrective lens that improves your vision by gently reshaping the cornea and shortening the length of the eye WHILE YOU SLEEP. You just put the specially fitted lens in at bedtime and when you awake, you will have clear, sharp, natural vision for your waking hours.
How do the mold lenses reshape the cornea?
The cornea is the clear outer covering of the eye, the window through which you see. This state-of-the-art therapeutic reshaping mold lens has several specialized curves that reshape your cornea. Thin layer shear forces, created by the tear film beneath this therapeutic lens, flow across the corneal surface. This continuous action moves the cells from the center of the cornea to the periphery thereby changing the overall shape of the eye. This resculpted shape can easily focus light directly on the retina.
Who is a good candidate?
This therapy can be effective on low farsighted, nearsighted (myopic) and or astigmatic patients. Your prescription must be in the range of +3.00 to –9.00 with no more than –1.75 diopters of surface astigmatism. In some cases we will attempt higher prescriptions.
If you have been unable to wear contact lenses for any reason (discomfort, allergies, inconvenience, dryness, etc.), you are also a great candidate because this lens is so easy to use and it’s worn while you sleep. This greatly reduces any discomfort you may have experienced while using conventional contact lenses.
You are also a great candidate if you need excellent vision without the use of contacts or glasses. OrthoK benefits pilots, police officers, military personnel and those with safety concerns such as, professional athletes, parents of small children, lifeguards and many others.
Finally, if you just don’t want to be bothered with wearing glasses or contact lenses during a variety of activities such as hiking, playing sports, swimming, skiing, camping, off-road driving, biking, snorkeling, scuba and more, OrthoK is for you
Why are children good candidates?
OrthoK can keep your children’s nearsightedness from getting worse. Increasing nearsightedness is a risk factor for detached retina and glaucoma. This therapy can protect their future sight. Also, your child is an especially good candidate if they have a tendency to lose or abuse their contact lenses/glasses, or if wearing them interferes with their active life. The lenses are worn at night, while they sleep, so the risk of a lost lens is much less.
If I wear bifocals, reading glasses or progressive lenses, am I a candidate?
You have Presbyopia and this can be corrected with monovision therapy. This involves correcting one eye for great distance vision and the other eye for near vision. Your brain automatically chooses the appropriate eye for the task. Another alternative is to have both eyes corrected for distance vision and wear reading glasses whenever you want to do near work.
What if I am a current contact lens wearer?
You will need to discontinue lens wear temporarily. The length of time will depend on the type of lens you are currently wearing, the condition of your cornea and the number of years you have been wearing lenses.
I suffer from dry eyes, am I a candidate?
Dry eye suffers are often excellent candidates for orthoK. While you sleep there is little tear evaporation in a closed eye, and the mold lenses are only worn while you sleep. If your dry eyes are a problem while you sleep, supplementing your natural tears is a simple option. OrthoK provides a dry-eyed person with freedom from scratchy contact lenses previously worn all day long..
If you have dry eye disease due to severe arthritis or a collagen-vascular disease, you may not be a candidate. However, a comprehensive exam will give us a better idea of your chances for success.
Is age a factor?
No. We can fit children as young as five, provided they can care for their lenses responsibly. There is no upper limit on age either.
I used to wear contact lenses, but stopped due to discomfort. Am I a candidate?
The corneal reshaping mold lenses are worn at night while you sleep. This greatly reduces any discomfort you may have experienced while wearing contact lenses during the day.
Is the vision improvement created by the corneal reshaping mold lenses permanent?
Patients who wear their lenses as prescribed find that they have great vision well into the evening. Some patients are even able to wear their lenses every other night and still maintain their enhanced vision. However, if you stop wearing your lenses while sleeping, your vision will return to its original state in as little as 72 hours.
How long will it take to achieve great vision?
It usually takes 7-10 days to achieve excellent vision. However, with some people, we have seen this occur in as little as 1 day. The speed depends on your initial prescription.
Can I see while wearing the mold lenses?
Yes. This allows you to read in bed or watch TV before falling asleep. It also provides safety should you need to get out of bed during the night.
What do I do about my vision while my eyes are in the process of re-shaping?
During the first few days of the OrthoK therapy process, you may find that your vision is quite good for a few hours, and then begins to diminish. We will fit you with a soft lens to wear that will improve your vision when it begins to fade. Often these are only worn in the afternoon and evening. We will reduce the strength of those lenses as your vision improves until they are no longer needed.
How successful are the corneal reshaping mold lenses?
The rate of success is very high, but it depends on your original prescription. During your evaluation you will receive full information about your potential outcome.
Do some people discontinue wearing their mold lenses?
This is rare because the results are so exciting. However, some patients drop out because they find they enjoy the convenience of completely “device-free” vision. They are no longer happy to even bother with lenses while they sleep. They then turn to laser vision correction. OrthoK can be a test drive for LASIK for some patients.
How safe are the lenses?
They are very safe. However, there is a small risk of infection or abnormal blood vessel growth involved when any contact lens is worn. This risk is minimized by adhering to scrupulous disinfection and care procedures, by wearing your lenses only as instructed and by coming in for regular progress checks. At the progress check your lenses will be cleaned with a special solution which removes surface buildup and cleans the pores of the lens increasing the breathability of your lenses. In addition, we will check to be sure the lens is free of chips or warpage.
Is this a lens that has been proven safe for overnight wear?
The FDA approved Paragon CRT® lens for overnight use on 6/13/2002. This issuance of approval is the culmination of the most extensive clinical study to date to establish the safety and efficacy of contact lens corneal reshaping in overnight use. Lenses made by other manufacturers (Wave and Gov) are FDA approved. However, some of the custom designs cannot be approved due to their custom nature. However, they are completely safe for overnight use when worn and cared for according to our instructions.
Corneal reshaping mold lenses are made from a material that allows twice as much oxygen to enter the cornea as a standard extended wear oxygen permeable lens. This significantly minimizes complications due to a lack of oxygen. Again, meticulous are and careful wear make a huge difference to safety.
Do the mold lenses hurt?
No. Initially, when you place the lens on your eye, you may feel as if you have something in your eye. That sensation diminishes as you continue to wear this therapeutic lens. But remember, you insert the lens just before you go to sleep. When your eyes are closed, the lens produces very little sensation. You will not feel your eyes being reshaped.
How quickly will my vision improve?
This depends on your prescription and age. In adults, the higher prescriptions can take two to four weeks to achieve good vision. Children’s corneas are much more easily molded. Some achieve excellent vision after the first night.
What sort of vision can I expect?
Studies show that 90% of OrthoK wearers enjoy 20/40 vision or better. This is the minimum requirement for the DMV. 60% achieve 20/20. The final outcome depends on your initial prescription. Dr. Cauchi or Dr. Peters will be able to give you a prediction about your final vision, after the exam is completed.
Are they difficult to insert and remove?
They are actually easier to insert and remove than most oxygen permeable lenses and much easier than a soft lens.
How often do the lenses need replacing?
We recommend replacing the lenses every two to three years depending on the conditions of the lenses. Lenses that have become warped will not produce consistent treatment. Lenses that have deposits or build up will not allow proper oxygen to the cornea and may even lead to infection. At your yearly exam, we will inspect your lenses and tell you if they need to be replaced.
What if I lose a lens?
OrthoK is different than wearing regular contact lenses. If you discontinue wear for one night, your vision may be impaired the next day. Immediate replacement of a lost lens is necessary. We recommend always having a spare pair of lenses as a back up… just in case.
What if I sleep less than most people?
Great results can be achieved in as little as five hours of sleep each night. Some people prefer to sleep for several short time periods of time rather than one consecutive period. This isn’t a problem, just put the lenses in when you sleep and remove them when you wake.
My driver’s license is marked that I need corrective lenses. What happens after I have OrthoK therapy?
You will be provided with a special card that you attach to your driver’s license. It states that you are participating in a visual therapy program that eliminates the need for corrective lenses while driving. The document will have an expiration date, which must be updated yearly. This certificate is accepted by state authorities.
Will my insurance cover these lenses?
This is an elective procedure and typically not covered by benefit programs. If your vision plan contributes towards regular contact lenses then, they may contribute toward OrthoK. Our OrthoK coordinator will assist you with insurance questions.
Is financing available?
If you chose to pay the entire balance by cash or check, we will extend to you a 5% discount . This cannot be combined with any insurance discount.
Many patients choose to finance this through their employment flexible spending (pre-tax) plan.
Finally, we offer a three, six or 12 month interest free-payment option through Care Credit® Please ask for details.
What does the fee include?
The fee includes:
One or more topographic maps, the evaluation of your Rx, corneal health and size to establish your candidacy for corneal reshaping
In-office sleeping simulation to evaluate the cornea’s response to overnight wear
Training on how to insert, remove, sterilize, and care for your lenses.
A maintenance kit containing solutions, a case and lens remover.
A pair of corneal mold lenses
Follow up fitting visits to refine the fit of the lens, assess the corneal shaping process and determine the final lens needed.
A six month follow up visit to insure the health of your eyes, polish your lenses and provide an intensive protein removal treatment with Progent®
Phone or on-line care with the OrthoK coordinator to handle questions or concerns.
Emergency access to Drs. Cauchi or Peters should you have a concern.
Do I pay the same fee each year?
No, after the initial fitting, you pay only for your yearly OrthoK comprehensive examination, replacement lenses (if needed) and the semi-annual follow up/deep cleaning. If your treatment needs adjustment, there will be a re-fitting fee.