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How effective is Ortho-K for correcting vision?

Eye Health

Hi Doctors, I was wondering if Ortho-K would be able to help correct my vision. How effective is Ortho-K for correcting vision?

DOCTOR’S ANSWER (4)

Ortho-K involves the use of a rigid contact lens while you sleep and works by reshaping your cornea to reduce your need for glasses in the day. It is more suitable for low to moderate myopia and would not be suitable for degrees that are too high. 

The effect of Ortho-K lenses last for 1 to 2 days at most, which means you will have to wear it continuously every night if you do not want to wear glasses in the day.

The down side to Ortho-K is because its a contact lens that is worn at night, there is risk of severe corneal infections that may come about. Even if your personal hygiene is optimal, it may be that the deprivation of oxygen to your cornea due to the contact lens will tip the balance and lead to an unwanted infection (a lack of oxygen makes your cornea more prone to infections). Contact lenses that are worn at night starve our cornea of more oxygen than contact lenses worn in the day, in part because of our closed eyelids at night. 

Unfortunately, I have seen many cases of young children who have suffered severe corneal infections requiring corneal transplants due to Ortho-K lenses. As such, I personally wouldn't recommend my own children or patients to use Ortho-K, as the potential risks of infection may outweigh the short-term benefits of not having to use glasses in the daytime. Ortho-K is not a permanent fix for myopia. 

In addition, as the Ortho-K lens reshapens the cornea, it may cause corneal thinning in the process, which puts you at a disadvantage should you want to seek a refractive procedure such as LASIK in future. As you know, LASIK is not suitable in people with too thin corneas.  

Moreover, Ortho-K lenses can be rather costly. My advice would be to control myopia through other means such as daytime contact lenses, atropine eyedrops and good near work habits, before considering LASIK in future. 

Hope that helps!

Dr Claudine Pang

843 views 21 Aug 2018

Ortho-K is generally very good at reducing levels of myopia (and to a lesser extent the degree of astigmatism) for patients of low to moderate degrees of myopia. It involves the use of a reverse-geometry rigid gas permeable lens that is worn overnight that differentially flattens the corneal curvature to reduce the degree of myopia of the wearer.

It is effective for less than 5 dioptres of myopia, and even less of astigmatism. It is generally less effective at higher degrees of myopia and astigmatism. With understanding that it is worn overnight, the user can expect that the myopia will progressively return to baseline levels during the course of the day, and hence cause some vision fluctuation during the daytime. 

Ortho-K, together with the use of atropine eye-drops, are the 2 evidence-based and validated treatment options to retard the rate of myopia progression.

The downside of Ortho-K however is that with any contact-lens, scrupulous hand hygiene and maintenance is essential, and there is the ever-present risk of infectious keratitis, especially since the lens is worn overnight whilst sleeping.

Do consider your options, and discuss in detail with your ophthalmologist how any or either of these, or other options would be most suitable for you.

Best of luck! 

ESG

831 views 21 Aug 2018
Hi there

For the right kind of cases, Ortho-K is just as effective at correcting vision/spectacle power as spectacles or regular daily wear contact lenses.

Ortho-K (or orthokeratology in full) refers to the use of a rigid (hard) contact lens that is worn at night while sleeping to flatten certain parts of the cornea (the clear window at the front of the eye). This flattening occurs as the lens presses lightly on the cornea the whole night, so that the cornea is molded into a shape that is more similar to the shape of the lens. As can be expected, once the lens is removed during the day, the cornea slowly returns to its original shape. And the original spectacle power also correspondingly returns. Therefore the Ortho-K lens needs to be worn every night to sleep to maintain its effect during the day.

For low spectacle powers eg below about 500-600 degrees of shortsightedness, the results can be quite good with good vision maintained during the day while awake. With higher spectacle powers, some problems may occur such as significant short-sightedness and blurring returning during the day time, and sometimes glare and halos around lights at night.

As with any option for correcting vision, there are pros and cons. The pro of Ortho-K is generally good day time vision without glasses - so it is good for eg water sports where glasses would get in the way and regular contact lenses may confer an increased risk of infection if worn. On the flip side the cons of Ortho-K include the higher risk of corneal infection (due to wearing the lens while asleep), and the problem of fluctuating spectacle power if for whatever reason the lens cannot be worn (eg eye redness or irritation). 

Of course, glasses also have pros and cons-the latter of which include a restricted field of clear vision, misting up, and getting in the way of certain activities. 

At the end of the day, you should discuss the various options with your eye care practitioner, consider each option's pros and cons and how it applies to you and your lifestyle, and then go with the one that suits you best.

821 views 21 Aug 2018

Hi,

Ortho-K is as effective as glasses and soft contact lenses to correct your vision. It is meant to correct only low to moderate myopia, and not effective for correcting astigmatism.

The effect would only last for 24 hours - 48 hours, and you would need to wear it every night If you do not want to wear glasses.

600 views 22 Oct 2018
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