Fortescue Optometrists

What is Ortho-K?

Orthokeratology is the use of rigid contact lenses to mould the shape of the cornea (front surface of the eye) to reduce or correct myopia (short sightedness) as well as small amounts of astigmatism (the irregular shape of the cornea). This will enable you to see clearly without the assistance of spectacles.

In some ways it is similar to the use of dental braces by an orthodontist to straighten crooked teeth. The main difference is that if tooth position is corrected for some months it will usually stay in the new position. The cornea is highly elastic however, and always returns to its original shape. Thus, lenses are required to be worn on an ongoing basis (typically every night) once the ideal corneal shape has been achieved. In some cases patients may only need to wear their lenses every second or third night to maintain satisfactory vision.

Why Have Ortho-K Done?

The main purpose of Ortho-K is to be free of both contact lenses and spectacles for all waking hours, which is ideal for swimming, for sportsmen and those who work in dusty or dirty environments.

Ortho-K also helps slow the progression of myopia!

Can anyone have Ortho-K?

No. Whilst new lens designs and improved accuracy of corneal measurement have resulted in a dramatic improvement in the effectiveness of this procedure, only prescriptions up to four dioptres of myopia (short-sightedness) and one dioptre of astigmatism can be treated. Hence low to moderate myopes are best suited.

The speed of moulding of the cornea will vary from person to person depending on corneal shape and rigidity. Allergies, dry eyes and other health problems may restrict wearing times and thus the success of ortho-K.

Does Ortho-K Have Any Advantages Over Excimer Laser Surgery?

Yes. Ortho-K costs less and is a reversible procedure. As well it is more appropriate for people whose eyes are still changing (ie. children and young adults), since it slows the progression of myopia.

What does Ortho-K involve?

The first stage is an initial examination to assess the general condition and health of the eyes. This also provides the opportunity to discuss the likely effectiveness of the procedure with more precise background information.

The next step is the fitting. Using a computerised corneal mapping system the shape of the cornea is measured and a lens is ordered, which takes approximately 5 working days.

When the lenses arrive the Optometrist will instruct you upon insertion, removal and lens care. The lenses are taken home and inserted before going to sleep and removed in the morning.

Overnight the cornea is gently reshaped to reduce its power, thereby reducing short sightedness and astigmatism and improving vision. Most of the changes occur rapidly during the first few days to weeks. Stabilisation occurs over the next few months at a lesser pace. Thus the Ortho-K program runs for one to three months depending on the initial degree of myopia or astigmatism and the rates of change of corneal shape. As therapy progresses and the cornea is moulded, the lenses give good unaided vision for longer periods of time.

The success of Ortho-K is intimately related to the fitting of the lenses. If the lenses do not fit well then the vision will be compromised and the lenses may feel uncomfortable on the eyes. Over the first week your Optometrist will ask you to return for review to assess the vision and the fit of the contact lenses. If it is felt that the lenses are not fitting ideally then the Optometrist will re-order the lenses taking into account any adjustments that may need to be made. Orthokeratology is a precise science and changes as small as one hundredth of a millimetre can affect the final result. Often the first pair of lenses ordered may require a number of subtle adjustments before optimum performance is achieved.

Once you have become adapted to the lenses and the myopia has been eliminated you will continue to wear the lenses nightly to maintain the corneal shape. Depending upon your degree of myopia this may involve wearing the lenses every night, every second night or in some cases even every third night. The lens wearing time may be increased or decreased to a level which gives the desired reduction in myopia. If the lenses are not worn your eyes will return to their original prescription. The reversibility of these changes is also an advantage as there are no long term effects of the procedure.

Your lenses will have a prescription to allow you to see clearly whilst the lenses are worn. This is important because it allows you to leave the lenses in if your sleeping schedule has been disrupted and you are forced to wake earlier than expected. The lenses may then be removed after the normal wear time.

Fees & Charges

The total fee for professional time and all lenses used for reshaping is $1300 for two eyes. A proportion of these fees may be claimable with your private health fund. A $400 non-refundable deposit is required prior to the ordering of the lenses at the first appointment. The remaining $900 is paid in two $450 instalments. The first is paid at the delivery visit with the second payment made upon finalisation of the fitting procedure (once the lenses are fitting and performing to satisfaction). On average this second instalment is paid approximately 4 to 8 weeks from the initial delivery. If you decide not to proceed with ongoing ortho-K lens wear, the final $450 need not be paid; however your lenses must be returned to our practice to ensure that your account is properly adjusted. The initial $400 paid is non-refundable.

The total $1300 fee includes all lenses (except lost or broken) and consultations for a 12 month period. After that time new lenses will be charged at the current retail price (approximately $500), with aftercare and extra fitting fees (if required) charged at industry recommended rates.

Lost Lenses

Lenses lost during the fitting period are charged at a reduced cost.

Lenses used in the corneal reshaping therapy period must be returned when the change to the new fitting lenses is made.

In the event of a lost lens the cornea will return to its original shape. In this situation we may be able to loan soft contact lenses, whilst ordering a new lens.

Once successful long term wear is reached it is strongly advised that a spare pair of lenses is obtained.

After Care

Over the first year numerous visits may be scheduled to ensure the ongoing health and integrity of your eyes. After the initial period of therapy an examination twice a year is considered essential, and will generally be covered by Medicare.