Alternative to Laser Eye Surgery

I found out through a Christmas letter. My friend's 11 year old daughter is using Ortho-K to correct her nearsightedness.

What the heck is Ortho-K, and why haven't I heard of it until now?

Ortho-K, or orthokeratology, involves the wearing of a hard gas permeable lens overnight while sleeping. This reshapes the cornea so that during the day, you do not need to wear eyeglasses! It also prevents further worsening of nearsightedness. This is a very simple explanation of it. The suggested use is for children and adults, although you should not have a prescription higher than -5.00 or -6.00, depending on the lens.

The idea for Ortho-K, or orthokeratology, has been around since the 1940s, however only since 2002 has the FDA granted approval for overnight wear of lenses for corneal refractive therapy.

While rigid gas permeable lenses are not comfortable, similar to the feeling of having an eyelash in your eye, you only need to wear them at night (usually). As a wearer of "hard" gas permeables from 1980 to 1992, I am well familiar with the eyelash in the eye feeling. It is something you can become accustomed to, but since your eyes are closed, you will not notice it in your eye since the eyelash feeling is caused when your eyelids blink over the hard edge of the lens.

The technology is not without problems. An 11 year old boy lost his vision due to an eye infection, having "severe acanthamoeba keratitis". He was using the proper cleaning solution, however he rinsed and stored the lens in tap water instead of using the proper solution. If children are undergoing the therapy, they really should have an adult caregiver watch over their hygiene routine. Otherwise, they can develop corneal ulcers, corneal scarring, and PERMANENT vision loss. Six children from ages nine to 14 experienced just this, having developed bacterial eye infections after wearing lenses overnight. However, it was not clear whether those children were properly fitted or were wearing actual ortho-k lenses designed for overnight use.

In a look at the technology by CBC's Marketplace was the following quote:

But the procedure is not being praised by everyone in the field. Opthamologist Dr. Sheldon Herzig has his doubts.

"Just because you flatten out the cornea temporarily with a contact lens, you're not going to change how that eye develops internally," Herzig told Marketplace.
...
We asked Derek Gaume whether there was long term data to show that kids are saving a lot of vision problems by using Ortho-K.

"Accelerated Ortho-K has been around for about twelve years so we have data up until the twelve year mark," Gaume told us. "Currently … in the US they've been doing a long term longitudinal study called the Ohio Myopia Study. Some of the data is just starting to come available with that and I think beyond a shadow of a doubt, Ortho-K definitely reduces the progression of myopia."


"Just because you flatten out the cornea temporarily with a contact lens, you're not going to change how that eye develops," says opthamologist Dr. Sheldon Herzig

When we checked the study Gaume was referring to, there was no conclusive evidence that, overnight, Ortho-K lenses slow or stop the progression of myopia over the long-term.


Having worn hard gas permeable lenses for twelve years since I was 16, I had the lens in only one eye (I have a lazy eye), and the eye WITH the lens is now -4.00, and the eye WITHOUT is -8.00. It seemed to me that the worsening of my eye was stopped, but I am only a sample of one.

Another issue is cost. In my Obsessive Researching Mommy mode, I called local optometrists to determine the cost of the system.

Here is the procedure:

1. Computer mapping of your cornea.

2. Teaching you how to wear the lens

3. One pair of trial lens, $165

4. Creation of custom lens, $1850, which includes follow up appointments

5. Retainer lenses are worn after treatment which must be replaced every 2-2.5 years, at a cost of $350

6. Depending on the measured base curvature, a third set of lens may be required at a cost of $380

Low prescriptions require less steps, and thus are less expensive.

I am undecided for the moment on whether I will seek this technology. It is still in its infancy, in my opinion, having only been in use for 10 years.

Have you had any experience with these? What is your opinion on the risk?