Orthokeratology (Ortho-K)

Orthokeratology is the use of specially designed and fitted contact lenses to temporarily reshape the cornea to improve vision. Orthokeratology is nicknamed “ortho-k” and sometimes called corneal reshaping (CR), corneal refractive therapy or vision shaping. You can also think of Ortho-k as like orthodontics for your eyes and the treatment is often compared to dental braces. Most ortho-k lenses are worn at night to reshape the front surface of the eye while you sleep. Vision improvements are reversible but can be maintained if you keep wearing the lenses as directed.

Patients may wonder if ortho-k is for them. Good candidates for orthokeratology include kids age 8 to 12 with progressive myopia, as well as most adolescents and adults, although the best success is with people under age 40. Ortho-k is recommended for low to mild nearsightedness (-4 diopters or less). People who are not good candidates include those with dry eyes syndrome, a large pupil size, or high myopia. There are some new ortho-k lens designs that are now available for farsightedness and presbyopia.

Patients may also want to know what to expect from ortho-k. It can take two weeks or longer to attain the maximum vision correction from orthokeratology, although some patients experience significant vision improvement in days. In clinical studies of Food and Drug Administration-approved ortho-k lenses, most patients achieved 20/40 vision or better.

Patients may need a series of temporary ortho-k lenses to see properly until they reach the desired prescription. Typically, up to three pairs of orthokeratology lenses are used, one after the other, to achieve the best vision correction. Until they get used to them, they will probably feel the lenses on their eyes until they fall asleep. With time, patients usually become more comfortable. Once their corneas have gotten the final desired curve, they will use a retainer lens as often as their ophthalmologist or optometrist recommends to maintain their vision. Another question that may be asked is how safe is orthokeratology. Ortho-k is safe but it is associated with an increase of infection. This is normally a risk concerning children and adolescents, who may be less able than adults to maintain good hand and contact lens hygiene. But if your eyes stay healthy and comfortable, ortho-k could be used for many years.

In the end the biggest question is how much do ortho-k lenses cost. The cost of ortho-k including follow up care associated with the fitting the lenses can vary depending of the type and degree of refractive error. The prices generally range from $1,000 to $4,000. The replacement lenses, lens care solutions and follow up exams can range between $300 and $500 a year. Ortho-k is not covered by insurance.