Orthokeratology (Ortho-k)

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What is Orthokeratology (Ortho-k)?

Orthokeratology, also known as ortho-k, refers to a specific type of fitted contact lenses that temporarily reshape the cornea.6 Orthokeratology lenses are generally worn at night to improve your vision while you sleep. They are sometimes compared to dental braces (but for the eyes).

Ortho-k is an ideal option for people who do not want to undergo laser eye surgery or wear their glasses or regular contact lenses everyday. Plus, orthokeratology is completely painless.8

Orthokeratology is not a permanent solution for vision correction. But if you continue to wear ortho-k lenses as directed, you can maintain improved vision with this corneal refractive therapy.6

What Does Ortho-k Correct? 

Ortho-k treats various refractive errors. However, the treatment is primarily used to correct myopia, which is also known as near-sightedness.

Myopia is a common condition that affects about a quarter of Americans.4 People with myopia may see nearby objects clearly but have difficulty seeing objects that are far away, such as road signs and blackboards.

Some common symptoms of myopia include:

  • Eyestrain
  • Squinting
  • Headaches

Myopia may develop gradually or aggressively and can change throughout your lifetime. Symptoms may come and go. Myopia may also feel worse at night in low-light settings.

How Does Ortho-k Work?

Typically, when light meets the eye, the cornea and lens bend it so it focuses on the retina, which receives images and sends them to the brain via the optic nerve.4 


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However, with myopia, the eye is either longer than normal or the cornea is steeper than usual. This means that light rays focus in front of the retina instead of on the retina. The result is blurry vision.

Ortho-k corrects refractive errors like myopia. Your ophthalmologist will use an instrument called a corneal topographer to map and measure your cornea and design an ortho-k lens for your eye.6 Temporary Ortho-k lenses are rigid gas permeable lenses that flatten the center of your cornea to change the way that it bends light.

Most people wear ortho-k lenses at night. After wearing ortho-k lenses for just one night, you should start to see immediate results. You need to keep wearing them every night or else your eyes will eventually revert back to their original shape.

It may take some time to get used to wearing ortho-k lenses at night. For some people, it can take a few weeks to get comfortable putting them in and wearing them. But if your ortho-k contact lenses are giving you major discomfort, or if you are having trouble sleeping, talk to your eye doctor.

Is Orthokeratology Safe & Effective?

Orthokeratology is considered safe and effective for people of all ages. It is an ideal temporary treatment option because it does not cause any pain. 

Wearing the contact lenses while you sleep also means you don’t have to deal with contact lenses during the day. If you have sensitive eyes that are easily irritated by daytime contact lenses, nighttime ortho-k lenses may be a better alternative.

However, wearing ortho-k lenses may increase your risk of infection, including microbial and bacterial keratitis.6 This refers to an infection of the cornea. If you have red or itchy eyes, you may have an eye infection.

It is important to use contact lens solution to keep your contacts clean when not wearing them. It may take a while to get used to wearing your ortho-k lenses, which can cause some discomfort at first. 

If you have prolonged discomfort and/or irritation after using ortho-k lenses, consult your eye doctor. You may need to replace your pair or opt for an alternative form of treatment.

Who is a Candidate for Orthokeratology?

You are likely a good candidate for orthokeratology if you do not want to have surgery or wear glasses or daytime contact lenses.

Because orthokeratology is considered safe for all ages, children are also good candidates for it. It may also slow myopic progression in children.5 

Plus, children’s eyes continue to change shape as they grow up, which means that their vision is also subject to change. Nearsightedness can change and/or worsen throughout childhood and adolescence.3 So temporary vision correction is ideal for them. 

How Long Does Ortho-k Last?

Your ortho-k lenses should last you a few years, and then you will need to replace them. With anything, the better you take care of them, the longer they will last you. 

If your vision needs change, you will also have to replace them. Regular eye exams with an eye doctor will ensure that your ortho-k lenses are still right for you.

There is no limit for how long you can safely use these lenses.6 The effects can last for up to two days, but you should wear them every night to keep up the results. Regularly wearing ortho-k contact lenses will maintain clear vision, but this is still a temporary treatment option.

If you are looking for a permanent vision solution, ortho-k contact lenses are not for you. Refractive eye surgery is the only way to achieve permanent vision correction.

How Much Does Orthokeratology Cost? 

Orthokeratology is a much more cost-effective option than refractive surgery for vision correction. With ortho-k lenses, you can improve your vision for about $1,000 to $4,000.6 That being said, you will also have to pay for replacing your lenses, lens care solutions, and eye exams that can range between $300 and $500 every year.

If you have vision insurance, orthokeratology may be covered. Consult your insurance provider to see if orthokeratology is part of your plan. If it is, your insurance company can help to cover some of the costs.

Alternative Treatment Options

There are other treatments you can have to treat myopia. One popular option is LASIK eye surgery. LASIK surgery uses a laser to reshape your cornea and correct the way your eye refracts light.1 LASIK can fix myopia, hyperopia (far-sightedness), and astigmatism.

LASIK surgery is a permanent solution that is considered to be very successful. It is minimally invasive, quick, and safe, and the results are immediate. In fact, the success rate is around 90 percent.

Photorefractive Keratectomy (PRK) is another refractive surgery option. Like LASIK, PRK also uses a laser to change the shape of your cornea and correct your vision.7 It is also a permanent solution.

You may opt for PRK over LASIK if you have particularly dry eyes or thin corneas, as these may disqualify you as a good LASIK candidate.Both LASIK and PRK surgeries are quick and easy. Consult your doctor about which option is best for you if you choose to go with refractive surgery.

You can also wear eyeglasses to improve vision. Many people with myopia use single-vision lenses, which help to correct various focusing issues.2 You should consult your eye doctor for prescription glasses. 

Your vision can change throughout your life, so you will have to keep getting regular eye exams to make sure your glasses are still the right prescription.

Like glasses, contact lenses also provide vision correction. Instead of being worn overnight (like ortho-k lenses) you wear them during the day. You can choose between daily contact lenses that you throw away after one-time use or longer-term contacts. For example, some may last a week or a few weeks to a few months.

Various factors may affect your choice of corrective therapy, including your eye condition, general health status, and budget. Talk to your eye doctor about what option is right for you.

Remember that orthokeratology is a safe option for anyone of any age. You may choose to use ortho-k lenses and still have surgery down the line or wear glasses from time to time. Since orthokeratology is temporary, you can try it out for as little or as long as you want.

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Resources
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Boyd, Kierstan. “LASIK - Laser Eye Surgery.” American Academy of Ophthalmology, 3 Mar. 2021.

How to Choose Eyeglasses for Vision Correction.” American Academy of Ophthalmology, 27 June 2020.

Nearsightedness.” Mayo Clinic, Mayo Foundation for Medical Education and Research, 2 Apr. 2020.

Nearsightedness: What Is Myopia?American Academy of Ophthalmology, 9 Apr. 2021.

Use of Orthokeratology for the Prevention of Myopic Progression in Children: A Report by the American Academy of Ophthalmology.” Harvard Medical School Department of Ophthalmology.

What Is Orthokeratology?American Academy of Ophthalmology, 24 Oct. 2018.

What Is Photorefractive Keratectomy (PRK)?American Academy of Ophthalmology, 16 July 2018.

All You Need To Know About Orthokeratology.”Harvard.

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