Ortho-K: The Nightly Approach to Myopia Reduction and its Challenges

Is there such a thing as Ortho-K during the daytime? I feel deceived by my doctor. Understanding the nuances of Orthokeratology and its clinical applications can clarify any misconceptions about this promising eye care technology.

The Basics of Ortho-K

Orthokeratology, often abbreviated as Ortho-K, is a contact lens fitting system designed to reduce corneal curvature in myopic eyes. Using rigid gas permeable (RGP) lenses, this overnight treatment involves wearing these specially designed lenses while sleeping. Upon waking, the lenses are removed, and their effect can temporarily reduce myopia for several days.

The process works by applying gentle pressure on the corneal surface during the night. This pressure gradually reshapes the cornea, which remains flatter during the daytime, thereby reducing myopia. The effect can last anywhere from one day to several days, depending on the degree of nearsightedness.

What Happens During the Day?

There is no formal procedure for using Ortho-K during the waking hours. Essentially, if you were to wear RGP or even soft lenses during the day, it would not involve intentionally fitting the lenses flatter than the cornea nor would a specialized Ortho-K lens design be necessary. This means that without the benefit of overnight wear, the lenses would not achieve the same reduction in myopia as Ortho-K lenses would.

My Doctor's Recommendation

Based on your description, it sounds like you are being fitted with standard RGP lenses rather than Ortho-K lenses. While RGP lenses worn daily and properly cared for can last for a year or more, they are not designed for the same purposes as Ortho-K lenses. These lenses may still provide some benefits, but they are not intended to reduce myopia permanently or on a regular basis.

If you are requiring a correction that falls outside the normal parameters for Ortho-K, your doctor has likely chosen standard RGP lenses. These lenses may slow the progression of myopia somewhat but won't eliminate it. When you stop wearing the lenses, your eyes will return to their original myopic state as dictated by nature.

Common Concerns and Misunderstandings

Misunderstandings about Ortho-K can arise as the technology continues to evolve. Some of the common concerns include:

Temporary Versus Long-term Results: The effect of Ortho-K is temporary and requires nightly wear to maintain. Without regular overnight wear, the results diminish. Longevity of Lenses: While RGP lenses can last a year with proper care, the rigid structure and the wear can eventually lead to loss of permeability, requiring replacement. The "shelf life" of the plastic itself can lead to degradation over time. Screening for Ortho-K: Not everyone is a candidate for Ortho-K. Factors such as the degree of myopia and the shape of the cornea must be considered before fitting Ortho-K lenses.

Conclusion

Ortho-K is a promising option for individuals with myopia, offering a non-surgical and reversible approach to vision correction. However, it's crucial to clarify the expectations and limitations of the treatment. If you feel misled, it's important to discuss your concerns with your eye care provider to ensure you have the appropriate information and are making an informed decision about your eye care needs.