People looking for alternatives to traditional corrective lenses often consider Ortho-K lenses. But though you may see reviews online, do you wonder why eye doctors rarely recommend them? Despite the buzz, these contacts may not be as beneficial as they seem. At least not for everyone.
Learn what is Ortho-K, how orthokeratology works, how much Ortho-K lenses cost, and whether they're worth the investment. We'll also share the pros and cons so you know what you're getting yourself into.
What is Ortho-K & How Does Orthokeratology Work?
Orthokeratology, or Ortho-K, are special gas-permeable contact lenses worn overnight. They reshape the cornea while you sleep. Your vision will temporarily improve when you wake up and take the Ortho-K lenses out. So you can go without glasses or contacts during the day.
The corneal reshaping from sleeping with Ortho-K is only a short-term solution. The effect is not permanent and will likely wear out in the afternoon. If you commit, you need to wear the lenses each night to maintain the result. You also have to go for regular eye exams to keep up with the prescription.
In general, orthokeratology corrects nearsightedness (myopia). But in some cases, Ortho-K lenses can also help with astigmatism. If you want to try, consult an eye care specialist to determine if you are the right candidate for the treatment.
Ortho-K contacts are relatively safe as long as an eye doctor properly fits them and users maintain good hygiene and follow the wearing schedule. However, as with any contact lenses, there is a risk of eye infections.
Ortho-K Prescription Range
The prescription range for Ortho-K lenses depends on the type of refractive error:
Myopia (nearsightedness) up to -6.0 diopters
Mild to moderate astigmatism up to -1.75 diopters
These ranges vary with corneal shape. Higher prescriptions may require additional vision correction with glasses or "top-up" daytime lenses.
Some newer Ortho-K lenses may treat mild hyperopia, but this is less common.
RELATED: What It's Like to Live with Astigmatism?
Ortho-K Lenses Cost
Ortho-K lenses cost between $1,000 and $2,000 for both eyes*. The contacts may reach up to $4,000 depending on the complexity of your prescription and where you live.
The price covers initial fitting, lenses, and follow-up appointments for the first year. After that, replacement lenses and check-ups may add around $300 to $500 per year.
Wearers also need a special storage case, designed for Ortho-K lenses. The case needs to be replaced every 1-3 months to avoid contamination. The cleaning and disinfection solutions for orthokeratology are also different than the ones for regular lenses.
Since Ortho-K is an elective treatment, it's usually not covered by insurance. Feel free to check with your health insurance provider for more information.
*Ortho-K prices may vary in different countries and across different brands.
Advantages of Ortho-K Lenses
The Ortho-K lens benefits attract people looking for flexible, non-permanent vision correction:
Daytime Freedom from Glasses/Contacts
Non-Surgical Reversable Correction
Slows Down Myopia Progression in Children
Daytime Freedom from Glasses/Contacts
After wearing the Ortho-K lenses overnight, you can enjoy clear vision for most of the day. This is convenient for active lifestyles where traditional corrective lenses may be limiting. If you play sports or work in environments with steamy or dusty conditions, Ortho-K grants clearer vision without the hassle.
Non-Surgical Reversable Correction
Ortho-K contacts provide a reversible option for vision correction without surgery. These lenses are appealing to those who aren't ready or eligible for LASIK. Unlike laser procedures, the effects of orthokeratology are temporary. If you stop using the lenses, your cornea will gradually return to its original shape.
Slows Down Myopia Progression in Children
Ortho-K lenses can benefit children and adolescents. Orthokeratology may slow the progression of nearsightedness in children by controlling the axial length growth of the eye. By flattening the cornea, orthokeratology reduces the elongation of the eyeball, which affects how myopia progresses over time. Medical research suggests Ortho-K can decrease the axial length growth by nearly 45%​ (View Research).
The effectiveness of Ortho-K in children depends on consistent parental support. Parents must ensure their child follows the wearing schedule, practices good lens hygiene, and attends routine check-ups with their eye care provider.
Disadvantages of Ortho-K Lenses
While Ortho-K contacts do offer several advantages, there are also notable disadvantages:
Temporary Effect
Decline in Vision in the Late Hours of the Day
High Costs
Risk of Eye Infections
Frequent Follow-ups
Limited Candidates
Unpredictable Results
Lens Discomfort & Adaptation Period
Lack of Long-term Studies
Temporary Effect
Ortho-K lens correction is not permanent. If the lenses are not worn every night, the cornea will return to its original shape. This means the vision will revert to its pre-treatment state. Only regular use of Ortho-K lenses can maintain the effect.
Decline in Vision in the Late Hours of the Day
A decline in vision quality may occur in the afternoon or evening. That's because the corneal reshaping effect begins to wear off. It makes tasks like reading or driving challenging due to blurry vision or decreased sharpness. The issue is more evident in low-light conditions at night, where glare and halos can become bothersome. Such gradual vision decline could impact daily activities and raise potential safety concerns.
High Ortho-K Costs
Ortho-K lenses are more expensive than regular contact lenses or glasses. The price includes the initial fitting, the cost of the lenses, and ongoing follow-ups to track progress and make adjustments. After a while, you need to replace your contacts with new ones. So that's further straining the budget in the long run.
Risk of Eye Infections
Since you have to wear Ortho-K lenses overnight, there is a high risk of eye infections. Corneal straining makes the eyes vulnerable to bacterial growth or painful corneal ulcers. Poor lens hygiene and improper storage are contributing factors. The most common infection risks with orthokeratology are microbial keratitis and pink eye.
Unpredictable Results
Ortho-K lenses can correct mild to moderate myopia, but the results may be inconsistent. Some individuals may not achieve the desired level of correction at all. That's very common in the case of higher prescriptions or irregular corneas.
Frequent Follow-up Visits
Regular follow-ups with an eye doctor are a part of the Ortho-K experience. They assess the fit of the lenses and ensure the treatment is on track. Such frequent eye exams may be inconvenient for some patients. In particular, those with busy schedules and those who have to commute.
Lens Discomfort & Adaptation Period
A notable disadvantage of Ortho-K lenses is discomfort. Some people may find the initial adaptation period challenging. Since the lenses are worn overnight, users may need time to adjust to sleeping with rigid lenses in their eyes. The sensation tends to improve after a few nights of consistent wear. There is also a learning curve for proper lens care and insertion.
Lack of Long-term Studies
Although Ortho-K has been around for several years, there is still limited long-term data on its effects. With a lack of medical studies on the potential for corneal health issues or regression after stopping the treatment, deeming Ortho-K lenses as safe and effective is an overstatement.
Limited Candidates for Ortho-K Lenses
Not everyone is a good candidate for orthokeratology. People with certain corneal shapes or chronic eye problems may not achieve optimal results. Ortho-K lenses are also less effective for people with high levels of astigmatism or severe myopia. Only an eye doctor can estimate if you are eligible for the treatment.
How to Put in Ortho-K Lenses?
The process is similar to putting on regular contact lenses:
Wash your hands with soap and water
Dry your hands with a lint-free towel to avoid contaminating the lenses
Remove the lens from its case
Inspect the lens for any debris or damage
Place the lens on the tip of your finger and fill it with a few drops of the prescribed lens solution
Use one hand to hold your upper eyelid open and the other to pull down the lower eyelid
Insert the Ortho-K lens into the center of your cornea
Slowly close your eye
Blink a few times
How to Remove Ortho-K Lenses?
Wash your hands before taking out the Ortho-K lens.
Then proceed with a suction cup or manual removal by hand:
Use a suction plunger:
Open your eyelids wide with your fingers
Align the suction plunger with the center of the lens and apply gentle pressure
Tilt the plunger upward and lift the lens out
Manual Removal
Open your eyelids wide with your fingers
Push your eyelids together under the lens, using slight pressure to "pop" the lens out
After removal, clean the Ortho-K lenses and store them in the case filled with fresh solution.
Who Are the Best Candidates for Ortho-K Treatment?
The best candidates for Ortho-K are patients with mild to moderate myopia (nearsightedness). Also, children and adolescents who want to slow the progression of myopia. Other ideal candidates include those with low levels of astigmatism and those not eligible for LASIK.
Is Ortho-K Worth It?
Ortho-K lenses can be worth it for some people but may be a waste of effort and money for others. Since results can vary, some people might not find the short-term vision improvement worth the hassle.
On one hand, orthokeratology offers freedom from glasses and daytime contact lenses. This can be appealing if you play sports, work in dusty environments, or simply don't like wearing glasses. It’s also a non-surgical option for vision correction, unlike LASIK.
Even so, the Ortho-K lens downsides may outweigh the initial benefits. The effect is temporary, so you need to wear the lenses every night. Ortho-K contacts can also be expensive, require careful maintenance, and there’s a risk of eye infections if not used properly.
Before committing, talk to your eye doctor about whether orthokeratology is the best option for your vision needs.
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Checked by Atanas Bogoev, MD.