Orthokeratology ("Ortho-K")

> What is Ortho-K?
Ortho-K involves the wearing of custom-made rigid contact lenses during sleep, which gently imprints a new shape onto the cornea to improve vision.  Ortho-K patients sleep with contact lenses on, in order to see clearly without them during the day.  Ortho-K provides freedom from spectacles and daytime freedom from contact lenses.
Ortho-K is non-invasive and completely reversible.
Ortho-K is a process - not just a product.

> Background History
The original hard plastic contact lenses were noted to imprint corneas even during day-to-day wear as early as the 1960s.  This was then seen as a design problem, so lenses were redesigned to eliminate this effect.
The introduction of new lens materials and instrumentation in the early 1990s enabled this imprinting effect to be precisely and safely controlled by overnight rigid lens wear.

> Who wants Ortho-K?
Ortho-K offers a lifestyle alternative for short-sighted people such as those who play sports, work in dusty environments, or suffer from mild dry eye with soft lens wear in air-conditioned offices.
Daily wear of rigid contact lenses has been shown to slow the progression of short-sightedness for many years.  Current research in Asia has shown that myopia can be slowed by up to 50% by Ortho-K.

> What happens to my eyes?
The outermost layer of cells of the cornea is normally 60 microns thick.  A very thin layer of fluid is trapped between the back of the contact lens and the cornea, and this layer creates hydrodynamic suction forces that encourage these slimy superficial corneal cells to slide around.
For the treatment of short-sightedness, the corneal cells are moved away from the centre, effectively flattening the front corneal surface. The cornea thereby becomes its own contact lens.
As soon as the contact lens "suction cup" is removed, the corneal cells slowly start to "slime and slide" back to their original position with every blink, so vision returns to the original prescription.  How quickly depends on the original prescription, but this usually takes longer than a day or so.

> When should these lenses by worn?
Once the correct lenses are determined, they are worn every night for a specified number of sleeps.  Once the imprint is "established", the wearing routine required to maintain the desired effect is tailored to each individual.
Many Ortho-K patients wear their lenses 3 nights a week, whereas some must wear them every night to maintain adequate vision throughout the day.
Ortho-K is not a part-time option, but a lifestyle commitment.

> The Process
The process of being fitted for Ortho-K begins with a comprehensive eye examination, including scanning of eye curvatures using the Medmont E300 Topographer.  This session takes around an hour.
The optometrist then calculates the lens design required and selects the appropriate diagnostic lens.
The optometrist delivers the diagnostic lenses, also teaching you about lens handling and care.  You are then sent away to sleep in the lenses.
You are later re-examined and your eyes are re-scanned the next morning to measure what imprint has been generated.  This step is repeated if necessary with the same or different lenses.
Following this measurement your lenses are individually designed and ordered from the laboratory.
Finally you collect your lenses and attend for reviews as directed by the optometrist.  Ongoing 6-monthly reviews are compulsory.

> Lens Trial
The lens trial is conducted so the optometrist can study the response of your corneas to the lenses, and for you to learn about comfort and handling issues before custom-made lenses are ordered.  Often there is some degree of vision change during this fitting process.
Once the desired topography results are achieved the trial ends and the final lenses are ordered.  This is the time to either commit or abort.

> Fees
A bulk fee of $1,710 is charged to cover all visits and lens costs involved in Ortho-K.  As a minimum this includes:
* Intitial one-hour examination specifically for Ortho-K

* Diagnostic fitting visit
* After-care examination after the first night's wear
* Routine after-care visits at 1 week, 1 month, 3 months & 6 months
* Other fitting visits as required
* One pair of rigid contact lenses for overnight wear
Replacements for lost or broken lenses are $240 per single lens.
Half the fee ($855) must be paid before you can take the initial diagnostic lenses home.  This payment is usually made at the second (delivery) visit.  The balance of the fee is due when you have confirmed that you are satisfied with the lenses and your vision.
Should you be unsuccessful with Ortho-K and/or decide to discontinue within 2 months of the original delivery visit, all fees paid less $195 will be refunded on the return of all lenses.

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