Advanced Orthokeratology (AOK) at Vision Arts Eyecare Centres

Orthokeratology (often shorted to "ortho-K") is a technique using specialized contact lenses to mould the shape of the cornea to correct refractive error. It has been around since the mid 1950's and until recently, involved a gradual process using frequent lens changes to achieve the desired effect. The degree of nearsightedness (myopia) and astigmatism that could be corrected was limited, and the effect lasted only 10 to 12 hours. The patient would typically wear the contacts between supper and bedtime, and enjoy clear vision the next day without the need for glasses or contacts until the following evening. This system worked, but was not consistent and required a great deal of dedication from the doctor and the patient.

Over the past ten years research in vision science has been improving on these older techniques. With today's ADVANCED ortho-K, a quick, accurate and lasting effect can be achieved. It all starts with an instrument called a topographer which measures 15,000 points on the cornea to give a detailed contour map. Then, using sophisticated mathematics and engineering, a customized rigid gas permeable contact lens is designed for each eye. After a period of trial wear to gauge the success of the lenses, a final pair of lenses are ordered, and an additional pair as backup spares. The patient then inserts the contacts right at bed time, and removes them in the morning upon awakening. They enjoy 20/20 vision throughout the day without the need for glasses or contact lenses. They then re-insert the lenses at bedtime the following night. Depending upon the degree of nearsightedness, the lenses may only need to be worn every second or third night.

Advantages

All over central Vancouver Island, people are experiencing the advantages of ortho-K for vision correction.

Safety. AOK is extremely safe! In the unlikely event of an adverse reaction, you simply take out the lenses and the eyes completely revert to the way they were. The risk of AOK is no greater than for daily wear contact lenses. Laser surgery, LASIK and PRK, is advancing all the time, but reports of corneal scarring, night glare, severe dry eye and loss of vision make many people unwilling to undergo the procedure. AOK is a completely safe, and reversible alternative to surgery.
Reversible. The effect of AOK wears off quite quickly once the lenses are not worn. This not only provides excellent safety, but also flexibility. If you are in your late 30's or early 40's and considering laser surgery, it is important for you to understand the effects of presbyopia. Someone who is nearsighted at age 38 might be thrilled with the results of laser surgery, but five years later may regret the decision as they constantly reach for reading glasses. AOK gives us the flexibility to change to monovision when or if needed, adapt the prescription if your eyes change (which is much more difficult following laser surgery), or revert back to where you were.
Cost. Quality laser surgery is costing about $3400. In our office, AOK treatment including two pairs of lenses is $1,800. Safer and $1600 less, what could be better?
Vision. The quality of vision is often superior with AOK over LASIK. Acuity is often sharper, with better contrast perception and no glare problems.

Disadvantages

Reversible. AOK is not a 'cure'. The contacts must be worn to enjoy the effect. For those not willing to wear the lenses, laser would be a better choice.
Myopia. AOK only works for nearsightedness, up to a prescription of about -5.00. If you are farsighted or have astigmatism greater than 1.25, then AOK won't be able to help you, at least not yet.
Fitting. A fitting procedure is required to gain all of the precise measurements required to design the lenses. This involves sending the patient home over night with a trial lens in order to measure the induced effect. Sometimes only one trial pair is needed, other times three or four These extra lenses certainly don't cost you anything extra, but they do require patience from you as we go through the process. You will be expected to invest some time into this process. The fitting process will reveal if you are not a good candidate for AOK, well before you've paid for the lenses. In other words, we'll know fairly soon if you're going to enjoy good success from AOK.
Imitations. Fitting of AOK lenses requires a serious commitment from the doctor in equipment, trial lenses, and training. We are starting to see some outfits offering ortho-K lenses for less money. They are offering traditional older designs which compare to AOK lenses the way a 1960's era computer would compare to today's 2 GHz speed demons. Be careful of who is offering ortho-K lenses. Check into their equipment, training, and the type of lenses that are offered.

We are extremely excited about this latest advance in vision care and are pleased to be the first on Vancouver Island to have all of our doctors certified to fit AOK lenses. Drop by one of our offices in Nanaimo, Ladysmith or Qualicum Beach, or call our office or arrange an in-office consult to learn more about this fascinating new option.

Sam Ireland is the three time Canadian windsurfing champion. After suffering with disposable contacts for years, and leery of laser surgery, Sam turned to our office for help. Sam reports, "Ortho-K lenses are awesome! After windsurfing all over the world in high winds and blowing saltwater, my contacts would always trouble me. Sand from the beach was another source of irritation. The lenses would flip and fall out all the time. It was very inconvenient in a World Cup final!! Now with Ortho-K lenses, my eyes are totally free during the day. I can open my eyes under water for the first time ever and my vision is 100% clear! I also surf and play beach V-ball a lot and it is unbelievable how much better it is with Ortho-K. I would highly recommend Ortho-K to anyone who lives an active lifestyle and doesn’t want the complications of eye surgery.”

For more on the details of what is involved with AOK click here to read the "fine print".