If you or your child is nearsighted (struggling to see things beyond), you may have heard of orthokeratology.
Also called OK or ortho-k, orthokeratology has been around since the 1960s. However, there has been recent interest in its ability to slow the progression of myopia (nearsightedness).
Orthokeratology involves wearing a specially designed rigid contact lens overnight. Like a mold, the lens temporarily reshapes the eye while you sleep by gently changing the profile of the cornea (the transparent, protective outer layer of the eye that acts as a powerful lens).
This creates a temporary change; when you wake up, you remove the objective and voila! You can see.
It takes about a week of cycling for the full effect to be achieved, but after that – assuming you wear them every night and take them off every morning – you should be able to go your days without glasses or contact lenses.
Most importantly, there is good evidence that it can help slow the progression of myopia.
Like all treatments, however, orthokeratology has its pros and cons – and its risks should be fully understood before use.
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Orthokeratology can be an interesting option:
for people who want an alternative to glasses but find contact lenses uncomfortable or unsuitable (because, for example, they suffer from dry eyes, work in dusty environments or practice water sports)
as an alternative to refractive surgery, also known as laser eye surgery or LASIK. Refractive surgery is permanent but orthokeratology is temporary; if you stop using the lenses, things will return to normal within a week
for parents of a child who might otherwise wear contact lenses in school; ortho-k allows a child to go to school without glasses or contact lenses, which can get lost or come off during the day.
The potential drawbacks include:
up-front costs are higher than daily contact lens wear where the similar overall cost is spread over time
the effect wears off if you do not use them every night
any use of contact lenses carries a higher risk of eye infection than if you had no contact lenses at all.
Some people might think that orthokeratology has a higher risk of infection than standard soft contact lenses. However, this is not supported by the research evidence.
A study in Japan compared the results after 10 years of wearing in children with orthokeratology or soft contact lenses. He found that there were no serious adverse events and that the frequency of mild and adverse events was roughly equal between the groups.
If you get an infection from a standard contact lens or orthokeratology lenses, it usually goes away with a course of antibiotics. However, it is possible to get a rare infection called microbial keratitis, which can damage your eyesight.
It’s not common. According to one study, if you had to wear an orthokeratology lens every night for 1,000 years, you would only be at risk of one serious infection.
If you use sterile contact lens solutions and avoid tap water, wearers of orthokeratology lenses will greatly reduce their risk of eye infection. Exposure to tap water from lenses or lens accessories greatly increases the risk of infection.
Reduce the risk of devastating eye disease later in life
Half of the world’s population is now predicted to be nearsighted by 2050, and the World Health Organization has sounded the alarm, saying in a bulletin:
High myopia greatly increases the risk of macular atrophy, glaucoma, and other causes of severe vision loss, the incidence of which is not reduced by wearing standard glasses.
Slowing the progression of myopia reduces the risk of eye disease threatening sight. It also means less frequent vision changes, which can save money in the long run by avoiding having to change fewer glasses.
Myopia progresses more rapidly in younger years, therefore myopia control prevention should be prescribed as soon as possible. We don’t know exactly how orthokeratology slows the progression of myopia, but compelling research shows it does.
If you are considering orthokeratology for your child, you and your eye doctor need to find a balance. The child must be old enough to handle it – but waiting too long and the myopia control benefits it offers diminish.
Every child is different. Some are more able than others to cope with orthokeratology, or ready to wear it overnight. It can be uncomfortable at first, and some might find the idea of a contact lens too confronting. He cannot be forced.
Review all the options
Orthokeratology is not the only solution; there are also special lenses you can get for eyeglasses and daily wear soft contact lenses that help slow the progression of myopia. Seek advice from eye care professionals to review all options.
I also recommend that children do no more than two hours per day of “outreach” leisure time (ie non-school work: close-up screen time or reading books) outside of school hours. . Parents can also teach children the “20-20 rule” (for every 20 minutes of close work, take a 20 second break to look into the distance). Time spent outdoors (two or more hours per day) is also crucial for healthy eye development in children.
What is clear, however, is that all myopic children should do something to control their myopia. It is not enough to give a child standard single vision glasses to help them see, without doing more to slow the progression of myopia.
If it’s right for your child, orthokeratology has one of the strongest research pedigrees for slowing the progression of myopia.
Read more: How to Keep Your Contact Lenses Clean (& What Can Go Wrong If You Don’t)