Orthokeratology (Ortho-K)

Orthokeratology, commonly referred to as "ortho-k," involves the use of specially designed and fitted contact lenses to temporarily reshape the cornea to improve vision. Ortho-k is sometimes called corneal reshaping (CR), corneal refractive therapy, or vision shaping. You can think of ortho-k as similar to orthodontics for your eyes, and it 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 continue wearing the lenses as directed.

Is Ortho-K Right for You?

Patients may wonder if ortho-k is suitable for them. Good candidates for orthokeratology include children aged 8 to 12 with progressive myopia, as well as most adolescents and adults, although the best success is seen in people under the age of 40. Ortho-k is recommended for low to mild nearsightedness (up to -4 diopters). Those who may not be good candidates include individuals with dry eye syndrome, large pupil size, or high myopia. However, there are new ortho-k lens designs now available for farsightedness and presbyopia.

What to Expect from Ortho-K

It can take two weeks or longer to achieve maximum vision correction from orthokeratology, although some patients experience significant vision improvement in just a few 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. Initially, patients may feel the lenses on their eyes until they fall asleep. Over time, they usually become more comfortable. Once their corneas have attained the final desired curve, they will use a retainer lens as often as their ophthalmologist or optometrist recommends to maintain their vision.

Safety of Orthokeratology

Ortho-k is safe, but it is associated with an increased risk of infection. This risk is particularly concerning for children and adolescents, who may be less able than adults to maintain good hand and contact lens hygiene. However, if eyes remain healthy and comfortable, ortho-k can be used for many years.

Cost of Ortho-K Lenses

The cost of ortho-k, including follow-up care associated with fitting the lenses, can vary depending on the type and degree of refractive error. Prices generally range from $1,000 to $4,000. The cost of replacement lenses, lens care solutions, and follow-up exams typically ranges between $300 and $500 per year. It is important to note that ortho-k is not covered by insurance.