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Orthokeratology – Is Ortho K the Future of Myopia Control?

Optometry

My Health Career is pleased to present a guest blog post from Paul Graham, who is a director of Harmony Vision Optometry and Vision Therapy Clinic on the Gold Coast www.harmonyvisioncare.com.au. The practice is focussed on alternatives to sight correction with glasses, which include vision therapy, behavioural optometry, contact lenses and Ortho-K.  We have a dedicated site for Ortho-K, www.nospecs.com.au

“My interest in optometry started with my first pair of glasses at 14 when my family discovered that I couldn’t read a funny bumper sticker on the back of a car we were following.  We discovered I had early myopia or short sightedness and at the time, the main option was glasses. Contact lenses were offered to someone sportier than I was at the time. As the years progressed, so did my myopia.  In no time, I was wearing glasses full-time.

Optometry seemed to answer both my preference for science subjects and my desire to do something different.  Optometrists generally develop an interest in eye diseases and/or contact lenses outside the day to day eye examinations and refractions (testing for spectacles).  I developed an interest in children’s vision, vision therapy, behavioural optometry and contact lenses. To me, this has to be some of the most professionally and personally rewarding work that I do as an optometrist.

I was introduced to wearing contact lenses at university and loved the freedom they offered, but I was never truly comfortable in them. Then, a visiting lecturer introduced Orthokeratology (OrthoK) to us.  I loved the idea, but the technology costs meant that I could not convince employers to take the plunge.  Getting fitted was also a challenge as not many optometrists were offering Ortho K in Australia at time (maybe a dozen at best!).

Regular contacts were dry and uncomfortable and spectacles spoiled beach and sport opportunities. As costs came down, I was fitted by a colleague and when I started my own practice, I introduced Ortho-K to the Gold Coast. I now have a much more active lifestyle and enjoy the beach with good vision free from glasses or contact lenses.

Even now, 10 years after I started fitting patients for Ortho K lenses on the Gold Coast, it is a special interest in optometry and relatively unknown to the public.  It is a shame, because it has a broad range of applications for patients, and is in my opinion, much more professionally rewarding compared to regular eye care.

We can now correct up to -4.00 of myopia in cases, and have even had success with patients up to-8.00.  Longsightedness and astigmatism can also be treated with Ortho-K lenses.

While Ortho-K started as, and is a good alternative to glasses, contacts and Laser Eye Surgery (Lasik) for adults, it is gaining recognition for benefitting children and teenagers too. Unlike Lasik, Ortho-K can be used by children and teenagers to correct their sight. There is also a growing body of research that shows that the degree of myopia can be slowed and often halted by using Ortho-K. Long term studies are starting to be published, but the early evidence certainly makes Ortho-K something to consider for both direct life-style and long-term benefits.

The science behind how it works is complex but the process itself is simple:

  1. An individually designed and prescribed Ortho K lens is place on the eye at bedtime
  2. The unique curves on the back of the lens create a gentle pressure on the protective tear film, which in turn reshapes the elastic tissue of the cornea.
  3. The lens is removed upon waking, and the effect of the reshaping lasts all day.

This is why some of our patients refer to Ortho-K as “reverse contact lenses”.

The back of the Ortho-K lens has special curves that put gentle pressure on the tear-film, which then moulds the cells into a shape that corrects your sight. Because this happens under your eye-lid, the effect is quite rapid, but slow to wear off once you remove the lens.

Most people would have noticed how your clothes and jewellery leave temporary indents on your skin. Like our skin, the cells on the front of your eye (cornea) are “elastic” or mouldable in their shape. Ortho-K uses this to change eye-shape, but does it much more gently than clothes or jewellery because it does it through a cushion of tears. The elastic tissue is not harmed.

It takes a few days for the cells to reverse to their original shape completely, giving you one to two days of clear sight per each night of wear. Because the process is completely reversible, regular overnight wear of the Ortho K lenses are required.”

 

One reply to “Orthokeratology – Is Ortho K the Future of Myopia Control?”

  1. Nice post.

    I am 61, an optometrist for 32 years and find the onset of Ortho K extremely important. I spent a total of 5 years at medical school, specialising in optometry after one year and find this as the best thing to have happened to the industry – since then – ha!. This is in the UK. It can be a repetitive job but if you don’t mind that kind of thing the rewards can be great. I personally love it as you get to work with people – people who wish to have a life free of glasses and the reactions you get from patients for this is incredible.

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