When meeting someone for the first time, you may be asked “What do you do?” Responses are usually something like: “I’m an accountant,” “I’m a teacher,” or “I’m an IT person.” In our field, the answer might be, “I’m an eyecare practitioner” or “I’m an optometrist.” But that does not really answer the question. That answer just describes what “you are” rather than what “you do.”

When describing orthokeratology (ortho-k) as specially designed contact lenses that are worn overnight so that vision is clear all day without the need for glasses or contact lenses, you are likely to see a look of amazement and disbelief. A majority of people have never heard about ortho-k and can’t believe such a process is even possible. This is the time to explain what ortho-k actually does for patients.

It changes the shape of the cornea with reverse geometry lenses worn while sleeping. When the lenses are removed in the morning, the topographic change of the cornea provides improved unaided vision, creates spherical aberration, and alters relative peripheral refraction.

Intangible Effects

Certainly, practitioners know the effects of ortho-k on patients’ eyes. But, the effects of ortho-k on the patients themselves are even more impactful:

• Ortho-k gives patients freedom from the need for daytime vision correction. This lifts a huge burden and can change a person’s attitude toward life and trying new things.
• A number of studies show that ortho-k patients appreciate improvement in many of the attributes that contribute to Vision-Related Quality of Life (VR-QOL). Attributes that are improved include clarity of vision, activity limitations, symptoms (dryness, itching, etc.), dependence on correction, worry, appearance, confidence, self-image, and overall satisfaction with vision/vision correction (Lipson et al, 2005; Hiraoka et al, 2009; Queiros et al, 2012; Santodomingo-Rubido et al, 2013).
• Ortho-k patients have less symptoms of dryness, itching, and lens awareness than soft lens wearers do (Lipson et al, 2005; Hiraoka et al, 2009; Queiros et al, 2012; Santodomingo-Rubido et al, 2013).
• Ortho-k provides unaided vision equal to that of glasses or soft contact lenses (Lipson et al, 2005).
• Ortho-k patients report more self-confidence and better self-image than when they were corrected with glasses (Berntsen et al, 2006; Santolaria et al, 2013).
• Ortho-k patients report less worry about losing or breaking their glasses, progressive vision changes, and feeling handicapped without their correction (Rose et al, 2000).
• Ortho-k patients also report feeling less restricted in the activities in which they participate (particularly water sports) or social situations.
• In VR-QOL studies, ortho-k users report higher overall satisfaction with their vision and vision correction compared to spectacle or soft lens wearers (McAlinden et al, 2018).

So, What Does It Really Do?

Ortho-k changes how patients see the world and how the world sees them. The key is to realize what ortho-k does for patients, not what it does to the eye. It truly changes patients’ lives.

Remember, when you practice ortho-k, you can truly say, “I change the way people see the world.” CLS

For references, please visit www.clspectrum.com/references and click on document #282.