Without a doubt, starting an Orthokeratology program is one of the most exciting things you can do. One day you’re wearing glasses and the next you’ve forgotten how you used to see prior to your treatment.
How does it work? How long does the effect last? What determines how well a particular patient does on their program? All these are good questions and they certainly relate to patient outcomes.
If you’ve ever worn a ring on your hand and pulled it down to your first knuckle, you may have noticed that the skin under the ring has been flattened. You didn’t lose skin or other tissue and the process of wearing the ring most likely didn’t hurt at all. You simply reshaped the loose skin of your finger by using a more rigid mold (the ring). The same thing happens to the clear (skin-like) tissue of your cornea under your OrthoK mold.
Using this same analogy, depending on how long you’ve worn this ring determines how long your finger retains this new shape. Typically, the longer a patient is on their program, the longer their retention of vision correction is. We tell patients to expect to wear their molds every night (and recent research has shown this to be the most effective way to maintain myopia control in children).
So what determines how well someone does on OrthoK? There are certain factors which the Orthokeratologist can assess to give a reasonable prediction of success. These are:
>Pre-treatment prescription. Lower values of myopia typically do better on OrthoK than extended range cases. This also goes for astigmatism which can factor in depending on its amount and location on or in the eye.
–>Pre-treatment eye shape. Corneas which are more moderately curved typically respond better than those which are extremely flat or steep.
–>Corneal and general eye health. In order to assure success, the cornea should itself be free of disease. Issues such as dry eye should be addressed prior to treatment as well.
– >Corneal rigidity. This measurement is not found in common use by Orthokeratologists, as untreatable corneas are not themselves very common; but a more rigid cornea may take longer to treat and may be found to not be fully correctable.
–>Previous rigid lens use. Although this is counter-intuitive, previous hard lens wearers are by far the most challenging cases faced by the Orthokeratologist and in some cases will preclude the commencement of treatment altogether.
>– Patient expectations.This is by far the largest factor as regards a successful outcome. Patients who want “to see through walls” will most certainly be disappointed by OrthoK. Those who wish to have clear, functional vision; be free of glasses and daytime contact lenses; and slow down their children’s progressive myopia will find that Accelerated Overnight Orthokeratology is a great treatment approach.
Orthokeratology has been referred to as a “miracle” and based on its life changing and vision enhancing outcomes, this is not an exaggeration. Via the American Academy of Orthokeratology and Myopia Control’s website (http://www.orthokacademy.com/find/) practitioners can be located in your area to help you determine if you and your children might be good candidates for OrthoK.
Robert Gerowitz, Optometrist-Orthokeratologist