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Child with Contact Lens

Ortho-K Lenses for Myopia Control (Night Lenses)

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Author: Jason Higginbotham
BSc (Hons) MCOptom Prof Cert Glau Prof Cert Med Ret Prof Cert LV FBDO MBCLA

An Introduction to Myopia Control - Orthokeratology hard contact lenses

You've likely now discovered specialist myopia control glasses and soft contact lenses, and now you might have heard the terms 'Ortho-K', 'orthokeratology' or 'Night lenses'. These are all names for the same thing, specialist rigid contact lenses used for Myopia control. Orthokeratology lenses  is pretty amazing.  was initially designed to reshape the cornea during sleep to non-permanently correct low to moderate levels of myopia during the waking hours. Simply put, 'ortho' means 'straightening' and 'keratology' refers to the cornea, so 'ortho-k' is a way to straighten the cornea to temporarily correct myopia and reduce the risk of progression. Essentially, whilst asleep, a specially shaped contact lens is used to mould the central cornea into a less steep/flatter shape, thus moving the eye's focal point back towards the retina, making vision clearer and sharper on waking after removing the lens. Every evening, the lens is put back in the eye after being cleaned during the day. Ortho-K can give many children freedom from glasses or contact lenses during the day. 

 

Now, with some newer lens designs, not only is Ortho-K more effective at correcting myopia, including higher prescriptions than previously thought possible but it has also been shown to be a highly effective way of slowing eyeball growth in progressive myopia.  

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Ultimately, vision must be corrected to the highest level possible whilst at the same time, controlling the mechanisms that seem to cause the axial length of the eye to grow. 

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In modern Ortho-K lenses for myopia management, central light is brought into focus on the retina. Peripheral light is, however, brought into focus in front of the retina. This is also known as peripheral myopic defocus, or sometimes as a peripheral myopic image shell. This phenomenon is illustrated in the diagrams below.

TL;DR Key Points
  • Ortho-K is a non-permanent way to correct myopia during waking hours.

  • Special contact lenses reshape the cornea while sleeping.

  • This improves vision upon waking by moving the focal point back to the retina.

  • Newer lens designs make Ortho-K more effective for higher prescriptions.

  • Ortho-K also slows eyeball growth in progressive myopia.

  • Peripheral myopic defocus is achieved with modern Ortho-K lenses.

  • Children can enjoy freedom from glasses or contacts during the day.

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FOCUSPOINT

Simply put, 'ortho' means 'straightening' and 'keratology' refers to the cornea, so 'ortho-k' is a way to straighten the cornea to temporarily correct myopia

Ortho-K 

Advantages 

  • Parents can monitor and control the handling of lenses, reducing the risk of eye infections.

  • Lenses offer convenience and freedom from wearing corrective eyewear throughout the day.

  • Children may be more likely to spend time outdoors and engage more in outdoor pursuits and sports.

Disadvantages

  • Some individuals may require an adaptation period to get used to wearing Ortho-K lenses during sleep.

  • Can initially cause discomfort or dryness

  • Strict wearing schedule required

  • More expensive than traditional contact lenses or glasses

  • Additional equipment and training required

  • Only effective over a narrow prescription range

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A real-life example of how Ortho-K can slow down myopia progression

On the right side of this page, you can find an interview-style video where Jason Higginbotham, Myopia Focus's Managing Editor and advisory committee member Sandip Doshi chat with Claire and her daughter Amelia. 

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Amelia was prescribed Ortho-K night lenses more than 7 years ago by Sandip, an optometrist and practice owner with over 30 years of industry experience. In the short video, she describes her experience with the night lenses and how they have positively improved her life and ultimately slowed down the progression of her myopia.

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