Ortho-k (Orthokeratology): Procedure & Costs

What is Orthokeratology?

Orthokeratology (ortho-k or corneal refractive therapy) uses special contact lenses that temporarily reshape the cornea to improve vision. Regular corrective lenses focus light on the retina, but only while you are wearing them.

Orthokeratology illustration of the process edited

Ortho-k or corneal refractive therapy lenses are painless alternatives to laser eye surgery. They’re also a good option for contact lens wearers who don’t want to wear them daily.

Orthokeratology doesn’t offer permanent vision correction. However, if you wear them as directed, they can improve your eyesight.

Who is Ortho-K for?

Orthokeratology lenses are primarily used to treat myopia (nearsightedness).

However, these contact lenses can also correct mild astigmatism (blurred vision) and hyperopia (farsightedness).¹

Doctors usually treat these refractive errors with glasses, contact lenses, and/or refractive surgery such as LASIK and PRK.

Ortho-k lenses can be prescribed as an alternative if:

You prefer a non-surgical approach
You want to avoid wearing glasses or lenses all the time
Wearing contact lenses is not possible (e.g., you play contact sports)
LASIK surgery is not an option

Ortho-K Lenses for Astigmatism and Myopia

Most orthokeratology lenses are spherical.

Spherical ortho-k lenses can treat near-sightedness caused by myopia. But they are not as effective for high astigmatism.⁴

According to studies, toric ortho-k lenses provide better vision correction than spherical lenses.⁷ They can:

Improve visual acuity in people with combined myopia and astigmatism.⁵
Correct myopia and astigmatism in children aged 6 to 12 with moderate to high astigmatism.⁶

Toric orthokeratology uses specially-designed ortho-k lenses that better stay in place. Research shows they can treat low to moderate myopia with moderate to high astigmatism.⁷

Special ortho-k lenses have been developed for people with hyperopia. These include Ocular Surface and External Integrated Remodeling Therapy (OSEIRT) and Alexa H lenses.

Both show promising results. But research is still limited.^8,9

How Does Ortho-K Work?

Ortho-k lenses correct them by flattening the center of the cornea.¹

When the cornea is not the right shape, it causes refractive errors such as myopia, hyperopia, and astigmatism. The cornea is a transparent eye structure. It helps you see by focusing light on the retina.

Corneal reshaping changes the way that light enters your eye. It temporarily improves your eye's ability to focus on objects.

Is Ortho-K Safe & Effective?

Yes, ortho-k lenses are safe and effective for people of all ages.

A systematic review of 170 ortho-k studies shows it can safely treat and delay the progression of myopia.³

People who start overnight orthokeratology between the ages of 7 and 16 can slow their myopia's progression.⁴

Researchers followed their progress over 12 years. They found ortho-k lenses to be clinically safe.⁴

Risks of Ortho-K

According to the American Academy of Ophthalmology (AAO), ortho-k lenses put you at risk for bacterial keratitis.¹ Poor hand hygiene and contact lens maintenance further increase your risk.

However, studies show that the risks associated with ortho-k are no higher than other contact lenses.³

You can lower your risk by cleaning lenses with a contact lens solution. Wash your hands before handling lenses to avoid contaminating them.

What Can You Expect from Ortho-K?

Here is what you can expect from wearing ortho-k contact lenses:

Lens Fittings

The treatment involves wearing a series of specially designed contact lenses, which are made to fit the surface of your eye.

A doctor will use a corneal topographer to ensure a good-fitting contact lens. The imaging device measures and maps out your cornea and helps determine the shape of your lenses.

Optometrists and ophthalmologists perform most ortho-k fittings. However, a contact lens technician may also do lens fittings with their supervision.

Comfort and Wearability

You might feel ortho-k lenses when wearing them. This is because orthokeratology uses rigid gas permeable (RGP) lenses. They’re not as flexible as regular contact lenses.

There are two types:

Overnight ortho-k contact lens. Worn for 8 hours at night and removed during the day.
Daytime ortho-k contact lens. Worn during the day and for longer hours.

Doctors usually recommend wearing overnight lenses to help with the discomfort. Either way, most people feel more comfortable as they get used to wearing them.

Note: Consult your eye doctor if these contact lenses cause difficulty sleeping, prolonged discomfort, and/or irritation.

They may replace your pair with better-fitting lenses or suggest alternative treatment options.

Treatment Time

Ortho-k lenses gently reshape the cornea. Your doctor may prescribe up to three pairs worn one after another.

Treatment can take two weeks or longer until you get the desired vision correction. However, you may see improvements within days of wearing ortho-k lenses.

Your eye doctor will prescribe retainer lenses once you attain the ideal corneal shape.

Remember to wear contact lenses as prescribed to maintain the effects. You can wear ortho-k lenses for as long as you like. As long as they feel comfortable and your eyes stay healthy, there is no limit on how long you can wear them.¹

How Long Does Ortho-K Last?

Ortho-k lenses should last you a few years. However, you may need to replace your contact lenses if your:

Vision changes
Lenses get damaged

Regular eye exams ensure that your lenses are still right for you.

How Much Do Orthokeratology Lenses Cost?

Ortho-k lenses cost an average of $1,000 to $4,000. Ongoing treatment will cost you $300 to $500 per year.¹

These additional treatment costs will cover the following:

Lens replacement
Contact lens solution
Follow-up visits with your eye doctor

Is Ortho-K Covered By Insurance?

It depends. Most insurance companies don’t cover these contact lenses since it is an elective procedure.

However, there are some cases where an insurance company pays for a portion of the total ortho-k cost.¹

Alternative Treatment Options

Orthokeratology uses temporary lenses. Like glasses and regular contact lenses, they can temporarily improve:

Nearsightedness (myopia)
Farsightedness (hyperopia)
Astigmatism

If you prefer a more permanent solution, you can opt for the following treatments:

LASIK Eye Surgery

LASIK surgery can treat hyperopia and other refractive errors. It uses a laser to reshape your cornea and correct how your eye refracts light.¹⁰

Studies show this surgery has a 90 percent success rate.

Photorefractive Keratectomy (PRK)

Another option is photorefractive keratectomy (PRK). It’s a refractive eye surgery that uses a laser to reshape the cornea and correct your eyesight permanently.¹¹

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.⁷LASIK and PRK surgeries are quick and easy.

Eyeglasses

You can use eyeglasses if you want to improve your vision with the least risks possible.

Many people with myopia use single-vision lenses. These glasses can correct various focusing issues.¹²

Regular Soft Contact Lenses

Alternatively, you can wear regular contact lenses that focus light on your retina.

There are two types of contact lenses:

Disposable lenses. Worn and thrown away after daily, weekly, or monthly use.
Extended wear lenses. Can be worn for up to 30 days.

Before you decide which treatment is best for you, consult your eye doctor. Be aware of possible risks like corneal ectasia.

Can I have LASIK after ortho-k?

If you initially opted for orthokeratology, you can eventually get LASIK surgery for permanent vision correction.

The effects of ortho-k are reversible, so you can always switch eye treatments if you change your mind.

Summary

Ortho-k lenses are a great way to improve your vision temporarily. It’s a safe, non-invasive way to correct refractive errors.

It’s affordable and may even be covered by insurance in some cases. However, you must wear these contact lenses as prescribed since they only provide temporary effects.

Consult your doctor to know whether you're a good candidate for this type of contact lens.

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