Orthokeratology, commonly known as Ortho-K, is a nonsurgical technique that uses specially designed rigid contact lenses, worn overnight, to temporarily reshape the cornea and correct refractive errors such as myopia (nearsightedness), hyperopia (farsightedness), and astigmatism. The lenses are generally made of gas-permeable silicone-containing materials that do not obstruct the movement of oxygen to the cornea.

Workings

During overnight wear, the contact lenses gently mold the shape of the cornea to temporarily improve vision without lenses. The lens flattens the central area of the cornea so light focuses correctly on the retina without glasses or contacts during waking hours. This corneal reshaping begins within hours of lens wear and vision improvement can last several days after removal of the lenses. The cornea gradually returns to its original shape before the next overnight lens wear.

Benefits of Orthokeratology
Ortho-K offers several benefits compared to glasses or daily disposable contact lenses:

Improved Cosmetic Appearance: Without glasses or contacts during the day, Ortho-K improves appearance and takes away the self-consciousness that some feel from wearing glasses. It allows for clearer peripheral vision and improved safety without lenses during activities like swimming or sports.

Less Dependence on Lenses: Ordinary contact lenses or glasses have to be worn all the time for clear vision, but Ortho-K provides temporary lens independence while awake for several days after just one overnight session of lens wear. This makes it more convenient than daily wear contact lenses.

Delayed Progression of Myopia: Some studies have shown Ortho-K may help slow the progression of nearsightedness in children compared to no vision correction or simply wearing single vision glasses. However, more research is still needed in this area.

Reduced Risk of Infection: Unlike daily or extended wear contacts, Ortho-K lenses are only worn overnight, reducing the risk of eye infections and inflammation compared to prolonged daytime lens wear. Proper lens hygiene must still be followed.

Potential Risks and Side Effects of Orthokeratology
As with any vision correction method, Ortho-K is not risk-free and has some potential downsides to consider:

Comfort Issues: New Ortho-K lens wearers may experience mild irritation, tearing, blurred vision or other discomfort during the first few nights as the cornea adjusts to the lenses. Discomfort usually lessens within a few weeks.

Dependence on Lenses: Vision remains dependent on the temporary refractive changes induced by the lenses. If lenses are not worn overnight as prescribed, unaided vision may be blurred until reshaping occurs again.

Corneal Warping: In rare cases, long-term Ortho-K lens use has been associated with ectasia, a warping of the cornea. However, this risk is very low when lenses are properly fitted and care guidelines are closely followed by the doctor and patient.

Incomplete Correction: Ortho-K lens prescriptions may not fully correct refractive errors in some patients, necessitating occasional glasses for clearer vision or tasks requiring full correction like driving at night.

Risk of Infection: As with any contact lens wear, Ortho-K does carry a slight increased risk of eye infection compared to non-lens wearers due to handling the lenses and contact with eyes. Proper hygiene is important.

Patient Selection and Lens Fitting
Ortho-K is generally only recommended for non-presbyopic adults and children over the age of 7-10 years who have a stable refractive error. Good general eye health and ability to comply with care guidelines are also necessary. A comprehensive eye exam and corneal topography are required for proper lens fitting and customization to each patient's vision needs and corneal shape. Follow-up appointments are important to ensure appropriate reshaping and monitor ocular health with lens wear. Orthokeratology is not suitable for all patients and alternatives like glasses or daily contacts may be a better option depending on an individual's eye condition and lifestyle. Close supervision by an experienced ophthalmologist is important for successful Ortho-K treatment.

Conclusion
In summary, Ortho-K provides an alternative to glasses or daily contact lenses for temporary improved unaided vision during waking hours. When the proper Ortho-K lenses are carefully fitted and follow-up care guidelines are diligently followed by both doctor and patient, Ortho-K can safely and effectively reshape the cornea on a temporary basis. While not risk-free, it offers potential benefits in appearance, comfort, convenience and delayed myopia progression for appropriately selected patients. As with any vision correction method, Ortho-K success relies on the professional guidance of a comprehensive eye exam and experienced corneal refraction specialist.

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