Vision Without Glasses: A Safer Alternative to Laser Eye Surgery?
You'd love to throw away your glasses, but Lasik (laser eye surgery) scares you. There is an alternative—orthokeratology. Ortho-K involves the wearing of special lenses at night that gently correct the shape of your eyes while you sleep so you can see perfectly without glasses when you’re awake. In this article, I'll share my experience of this technique.
Ortho-K is marketed as being ideal for people who can't wear ordinary contact lenses but don’t want to take the risk of Lasik surgery.
People who can’t tolerate daytime contacts can usually wear Ortho-K lenses without any problems. Because you only wear the Ortho-K contacts at night with your eyes closed, there's no problem with dryness and no risk of dust and pollution getting in your eye. And unlike soft lenses, the Ortho-K lenses don't absorb the soaking solution, which is a boon if your eyes are sensitive to the disinfecting chemicals.
I sounded like a perfect candidate: I have sensitive eyes and although I can tolerate contact lenses during the day, my eyes do get irritated and red-looking, to the point where people comment about it. Since my main reason for wanting to wear contacts is to look good, having bloodshot eyes defeats the purpose.
I can vouch for the fact that it works. Even on the very first day, I was able to do without my glasses for several hours.
By the end of the week, I was completely free of glasses. It felt strange to walk around and see the world, clear as a bell, without any spectacles on my nose!
Why Not Just Have Lasik?
When I decided to try Ortho-K, I knew several people who've had Lasik and loved it, but I also knew someone who had complications and had to have a special implant put in his tear duct, as well as a woman who was left with a droopy eyelid. That was enough to give me pause.
Of course, there are risks with Ortho-K too. As with anything you put in your eyes, there’s a risk of infection. However, it’s lower than the risk with daytime contact lenses, where you can pick up infections from contamination blowing into your eyes, from your fingers if you touch your eyes, or from make-up brushes or pencils. The only risky time with Ortho-K is when you insert and remove the lenses—and that is exactly the same risk that applies to any contact lens.
How Does it Work?
Short-sightedness occurs when the eyeball is too long or the cornea is too steep, causing light to focus short of the retina. The Ortho-K lenses flatten the front of the eye, so that the light hits the retina in the right place – and voila, you can see perfectly without spectacles or contact lenses! Because the reshaping is so gentle, it wears off gradually, so you have to wear the lenses several times a week to keep the eye in shape. How often you wear them depends on the individual - some people only need to wear them twice a week, others every night.
How Does it Feel?
I have to confess that when I started Ortho-K, I wondered if I'd made a big mistake. The small, hard lenses were tricky to put in my eye and horribly uncomfortable once they were in. When I tried them in the optometrist's office, I couldn't see a thing because my eyes were watering so much!
But then, the optometrist told me to close my eyes and as soon as I did, I realised I could hardly feel the lenses. He also explained that because I would be wearing the lenses for several hours each night, my eyes would get used to them very quickly.
And he was right. The first couple of nights, I took several attempts to get the contacts in my eyes. Then, I had to feel my way from the bathroom to the bedroom with my eyes closed because I couldn't bear the discomfort of opening them! And in the morning, my eyes were stuck together with gunk. But while I was lying in bed with my eyes closed, I couldn't feel them and so they didn't disturb my sleep—and within two or three days, I could tolerate them enough to pop them in and see my way to the bedroom without wanting to scratch my eyes out.
Soon, I was so used to the lenses, I have even watched a short late-night TV show while wearing them (when I got up for a midnight snack!).
A Fantastic Idea—But Not for Me
I never ceased to be delighted by my daytime experience. To be able to go anywhere and do anything without glasses or even contacts was simply fabulous—especially as I did a lot of swimming in those days. And once I closed my eyes at night, I didn't even know they were in my eyes.
However, I still found the lenses uncomfortable before bedtime and on getting up in the morning. I couldn't read in bed with my lenses in (or any other bedtime activities!), because my eyes felt too gritty. And in the morning, the moment I opened my eyes, I couldn't wait to get to the bathroom to get the lenses out
My optometrist was mystified, because the vast majority of users get so used to the lenses, they put them in long before bedtime, and even watch TV for extended periods. Some people happily wear them all day, if they happen to miss a night.
The benefits were so great, I persevered. I found that I could maintain perfect vision on a two nights on/one night off regime, which helped. But a year later, the discomfort was starting to get to me. So when I was told that one of the lenses needed replacing, I decided not to go to the expense.
I do miss those days when I could walk and run and swim without glasses, and I would still recommend the lenses to anyone; just not someone with eyes as sensitive as mine!
Where Can I Get Ortho-K Lenses?
There are still very few practitioners, though the number is growing all the time. Adding to the confusion is that some lens manufacturers have different names for Ortho-K, so the optometrists who sell them may use that terminology:
Paragon Vision Sciences: "CRT (Corneal Refractive Therapy)"
Bausch & Lomb: "VST Process (Vision Shaping Treatment)"
If Googling doesn't lead you to a practitioner in your area, it's worth trying the optometry department at your local university as they are often involved in trials, due to the great interest currently being shown in the orthokeratology technique.
At a recent conference, Ortho-K came in for criticism because of the alleged higher risk of infection from overnight lens wear. Personally, I'm suspicious that the critics may have had a vested interest in bagging it (being Lasik surgeons or conventional contact lens practitioners), but let's look at the facts.
A higher incidence of infection has been found in studies wearing continuous wear soft contact lenses at night, not orthokeratology lenses. Both continuous wear and Ortho-K lenses are worn at night, but there the similarity ends.
Continuous-wear contacts are soft lenses. The risk of infection has always been higher with soft lenses than with rigid ones, because the soft lenses absorb fluid. Get some contaminated water on a rigid lens and you can rinse it off - get some on a soft lens and it will soak it up!
If you're of the older generation, you probably knew people who wore the old hard contact lenses during the day. Did you ever have to get down on your hands and knees to find a lens that had been dropped? Nine times out of ten, the wearer found the lens, licked it to moisten it, and put it back in their eye! I would never recommend doing such a thing, but many thousands of people got away with it, because the hard lens didn't absorb the saliva. Try doing that with a soft lens and you're at very high risk of severe infection - as happened to a well-known Australian boxer recently. He lost most of the sight in that eye.
The other problem is that continuous wear lenses are worn for several days and nights without a break. Clearly, if the lenses are contaminated when you put them in your eye, bacteria have days to breed! By contrast, your Ortho-K lenses are removed and disinfected for at least a day between each wear.
With anything you put in your eye, it's crucial to be very careful with hygiene, but at this point there's no evidence Ortho-K lenses are any different from daytime lenses.
Questions & Answers
Will this work if you have astigmatism?
Yes, this will work with very few and rare exceptions. Correcting astigmatism is one of the primary reasons for this surgery. It is also used to correct other refractive errors in the eye including nearsightedness and hyperopia.
© 2007 Kate Swanson