With Orthokeratology Refractive Therapy, vision can be improved to 20/20 without the need to rely on glasses during the daytime.

The treatment is generally applied at night using a pair of retainer contact lenses. This allows the eyes to be reshaped non-surgically when they sleep. IGARD provides a ONE month trial to both children and adults who are keen on this intervention modality. That gives ample time before they commit on their journey in maintaining clear vision without glasses and in myopia control.

Myopia Control with Orthokeratology is not new. Clinicians worldwide have long noticed that many adolescent children need not change their lenses during orthokeratology refractive therapy. But it is only until 2002 when researchers confirmed that this therapy reduces Peripheral Retinal Hyperopic Defocus and hence the retardation of the progression of Myopia. In general, the myopic prolate-shaped eye is reshaped until the cornea becomes more oblate in shape.

A two-year longitudinal pilot study (Longitudinal Orthokeratology Research in Children / LORIC) in 2005 concluded that Orthokeratology Refractive Therapy could both correct and control childhood myopia, and a further two-year study confirmed that the eye growth has slowed down at least after one and two years of treatment (Corneal Reshaping and Yearly Observation of Myopia / CRAYON).

What about ordinary contact lenses?

Ordinary contact lenses do not offer myopia control. However, multifocal contact lenses may be used. They are available in ‘soft’ material to children who suffers from progressive myopia. This strategy is most suited to a select group of children who have co-existing conditions that contribute to their eyestrain, such as increased levels of accommodative lag, high ocular accommodative convergence and near esophoria.

It is also understood that there is a possibility that multifocal contact lenses can reduce Peripheral Retinal Hyperopic Defocus. Research involving identical twins showed myopia progression reducing in the twin wearing multifocal contact lenses compared to the twin who is only wearing ordinary soft contact lenses.

Many patients with vision problems heartily embrace the idea of enjoying vision correction without having to wear eyeglasses or contact lenses. Not all of these patients, however, are good candidates for PRK or Lasik surgery, the two standard surgeries used to alter the way the cornea of the eye refracts light. If that describes you, don’t fret — because here at IGARD, we offer an advanced corneal reshaping technique known as orthokeratology, or Ortho-K. This non-surgical technique can produce changes to the way your cornea refracts light.

To understand the benefits of Ortho-K, let us first consider how the cornea works. The cornea is a transparent, spherical bulge that sits over the lens of your eye. In addition to protecting the inner parts of the eye, the cornea also performs some lens-like tasks of its own. The shape of cornea causes incoming light rays to be refracted, or bent, in such a way that the lens can focus them into a clear, sharp image before they pass on to the retina and optic nerve. Ultimately, the optic nerve transmits the image to your brain.

Deformations in the shape of the cornea cause refraction to go wrong in various ways, producing the fuzzy images characteristic of nearsightedness, farsightedness, and astigmatism. Glasses and contact lens are curved to “pre-refract” incoming light to compensate for your personal degree of corneal deformation. Laser surgery actually corrects the shape of cornea itself, eliminating most of all of the visual errors that might otherwise call for corrective lenses.

Corneal Reshaping While You Sleep

While you might leap at the thought of permanently correcting vision problems, laser surgery isn’t always the best eye care option. For instance, if you suffer from thin corneas, untreated cataracts, diabetes, certain autoimmune diseases, or a corneal disease called keratoconus, you should avoid laser eye surgery.

Some of our patients simply don’t like the idea of any kind of surgery, or they want a reversible procedure. Orthokeratology may be an ideal choice for these individuals. The team in Singapore will map the shape of your corneas precisely and then fabricate special contact lenses. Unlike standard contacts, you’ll wear these lenses at night. The lenses perform a subtle corneal reshaping as you sleep, meaning that you can take them out the next morning and enjoy perfect or near-perfect vision.

Ortho-K can help you see clearly for one or two days at a time, or possibly even longer. By wearing them regularly at night, you can maintain your clarity of vision for as long as you decide to continue using them. If you decide to use another form of vision correction, simply stop wearing the Ortho-K lenses and your corneas will assume their previous shape once again. Talk to our knowledgeable staff to see whether Ortho-K makes sense for you.

Efficacy of OrthoK Treatment

Since receiving FDA indication for temporarily correcting refractive error in 2002, OrthoK has been prescribed for children and adults as an alternative to glasses, daytime contact lenses, and refractive surgery. Over time, clinicians observed that myopic children using OrthoK were not progressing in myopia like those wearing other types of correction. Extensive study of this effect has shown myopic children undergoing OrthoK have 37-63% less axial elongation than those wearing spectacles or daytime contact lenses.

Some frequently asked questions: 

1. How long does orthokeratology treatment take?
At IGARD, you would usually see clearly as soon as you put orthok lenses on but full treatment effect typically takes about one week assuming that you apply the lenses every night and remove them in the morning everyday. Spectacles and/or contact lenses are usually not needed during the daytime once treatment is in effect. We have very good results in children myopia control because the lenses at IGARD are customised for each individual patient. Before you decide on the treatment, you will be able to get a 1-month trial at IGARD and optimal results can be achieved when you start the actual treatment plan. 
 
2. Would there be eye infection from wearing Orthok lenses? 
Orthok lenses are designed for you to sleep in them, so you will not simply wake up with an eye infection. If you get the orthok lenses from IGARD, you need not worry about getting enough oxygen into your eyes because the lenses are high in oxygen transmissibility. If you decide to wear contact lenses, you will need to be serious about hygiene and compliance to your doctor/optometrist’s instructions, and you must strictly avoid using water on contact lenses. Eye infections can occur if you do not take proper steps in cleaning and/or hygiene, and if it does happen the redness should clear up with a course of antibiotic eye drops under your doctor/optometrist’s instructions. Do not wear contact lenses and please get your eyes checked immediately if something doesn’t feel right.
 
 
3. Where can I find the best place to buy orthok lenses? What is the best brand?
Orthok lenses are not typical contact lenses that you can buy from a shop and whether it is good has nothing to do with the brand. Every pair of orthok lenses needs to expertly fitted in order for treatment to take effect. We recommend you to find an expert in Orthokeratology treatment because you will have to rely on his/her professionalism and expertise in order to achieve the most desirable treatment outcome. If you are looking at children myopia control, orthok lenses have to be specially customised as part of a comprehensive children myopia control treatment plan and there will be a need for the child to have regular follow-up evaluations in order to monitor treatment progress. If you are in Singapore, you can look for Dr Yap Tiong Peng, Rachel Kelly, Isobelle Wong and the IGARD team. 
 
4. How do I know if I am suitable for Orthokeratology treatment? 
You have to ask an Orthokeratology expert to check your eyes and find out if you are suitable for Orthokeratology treatment. The doctor/optometrist would usually check your eyes to find out if you have any medical or ocular contraindications. While it is uncommon, some adults and/or children may have undiagnosed eye/vision problems that makes them unsuitable for Orthokeratology treatment. Therefore it is essential to get a proper and complete eye check with an expert. 
 
5. Where can I find more information?
IGARD’s website is very informative and you will find information on nearly every topic. There’s also a very good article here written by Dr Paul Gifford from the University of New South Wales: 

https://theconversation.com/what-is-orthokeratology-and-will-it-help-slow-the-deterioration-of-my-childs-eyesight-171826?fbclid=IwAR0uoA8iX_0K8_8V-wsAAnaNpmnuXLvt9dPDX-i5G4hDueQim5eyqGXrmOk

 

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