Myopia Management & Ortho-k
If your child's prescription is rapidly deteriorating, we can help. We offer evidence-based treatment to prevent the onset or reduce the progression of myopia in pediatric patients.
Although a cure for nearsightedness has not been discovered, we can now offer a number of treatments that may be able to slow the progression of myopia.
Currently, four types of treatment are showing promise for controlling myopia:
- Atropine eye drops
- Multifocal contact lenses
- Orthokeratology (“ortho-k”)
- Multifocal eyeglasses
Topical atropine is a medicine used to dilate the pupil and temporarily paralyze accommodation and completely relax the eyes’ focusing mechanism.
Because research has suggested nearsightedness in children may be linked to focusing fatigue, clinicians have investigated using atropine to disable the eye’s focusing mechanism to control myopia.
And results of studies of atropine eye drops to control myopia progression have been impressive. Four studies found atropine produced an average reduction of myopia progression of 81 percent among nearsighted children.
One interesting note was that control was achieved in very low dosage of 0.01 % Atropine compared to the standard Atropine .1% and there were much less side effects.
Multifocal contact use:
Multifocal contacts are special lenses that have different powers in different zones of the lens to correct presbyopia as well as nearsightedness or farsightedness. The more effective contacts (Biofinity and Proclear Multifocals) had a special dual-focus multifocal design with full corrective power in the center of the lens and less power in the periphery.
A two-year study that revealed nearsighted children who wore multifocal soft contact lenses daily had 50 percent less progression of their myopia, compared with similarly nearsighted children who wore regular soft contact lenses for two years.
Orthokeratology is the use of specially designed gas permeable contact lenses that are worn during sleep at night to temporarily correct nearsightedness and other vision problems so glasses and contact lenses aren’t needed during waking hours.
Many eye care practitioners refer to these lenses as “corneal reshaping lenses” or “corneal refractive therapy (CRT)” lenses rather than ortho-k lenses, though the lens designs may be similar
But some eye doctors use “ortho-k” lenses to also control myopia progression in children. Evidence suggests nearsighted kids who undergo several years of orthokeratology may end up with less myopia as adults, compared with children who wear eyeglasses or regular contact lenses during the peak years for myopia progression. In 4 studies, myopic progression was reduced by approximately 45%.
What is the process like?
We will begin by measuring the curvatures of your corneas using an instrument called a corneal topographer which produces a topographical map of your eye’s front surface.
We order your custom ortho-k lenses for fitting. You need a series of temporary lenses to see properly until you reach the desired prescription. In most cases, up to two pairs of lenses are required to achieve the maximum vision correction effect.
When you begin to wear ortho-k lenses, you will likely have some awareness of the lenses on your eyes until you fall asleep. With time, the lenses typically become more comfortable immediately upon insertion.
Some people can have excellent vision after a day or two of overnight ortho-k. But for higher prescriptions it can take two weeks or longer for maximum correction.
Until your eyes are fully corrected, you might notice blurred vision and glare and halos around lights. In some cases, you may need to wear glasses (with a lesser prescription than you originally had) during the ortho-k process.
How much does Ortho-K cost?
Fitting ortho-k lenses is a more time-consuming process and requires more expertise than fitting regular contact lenses. It requires a series of office visits and multiple sets of lenses.
The cost of ortho-k, including follow-up care associated with fitting the lenses, can vary significantly depending on the type and degree of your refractive error and whether you are choosing ortho-k lenses for long-term myopia control in addition to the temporary correction of existing myopia.
Ortho-k prices in our practices range from $650 to $1000 (for both eyes), making the procedure roughly a quarter the cost of LASIK. There are future additional costs for replacement ortho-k lenses, lens care solutions, which can total about $100 to $200 per year.
Normally, orthokeratology is not covered by vision care insurance plans.
Ortho-k therapy is ideal for sports and active lifestyles:
- Clear unaided vision during activities.
- Unobstructed field of view and total peripheral vision without interference from glasses.
- No more spectacles that steam up from perspiration or become foggy when the temperature changes rapidly.
- No irritation caused by contact lenses.
- No need to bring spare contacts and contact lens solutions to practice and game days.
- No worrying about potential complications of refractive surgery, which could adversely affect athletic performance for a lifetime.
- They don’t fog up or get splattered with rain, mud or perspiration.
- They also provide more stable vision during quick head and body movements
Ortho-k overnight lenses are ideal for most athletic activities, especially for sports where the ability to see without glasses or contact lenses is especially important. These sports include: archery, baseball, basketball, boxing, climbing, cycling, diving, football, golf, gymnastics, hockey, hunting, martial arts, motorcycle racing, rugby, racket ball, shooting sports, softball, skiing, snowboarding, soccer, surfing, swimming, tennis and wrestling.
Why Ortho-k Can Be Better Than Contact Lenses:
- Contact lenses can dry out, especially during periods of intense concentration when an athlete may not blink frequently enough to keep them moistened. If they become too dry, vision can fluctuate.
- Contact lenses can sometimes become dislodged from the eye, especially during contact sports or if they become dry.
- Contact lenses for astigmatism can rotate on the eye during movements causing unstable vision.
- Eye allergies can be a problem for contact lens wear. Athletes who normally can wear contact lenses successfully may find their contacts become intolerable during allergy season, when pollen and other airborne irritants can stick to the lenses.
Ortho-k therapy helps eliminate these contact lens related vision problems and provides the freedom to experience sports and active lifestyles that traditional contact lenses can’t.
Our doctor partner: Dr. Szalajko has been using Ortho-K for years!