An Inside View of Your Ortho-K Procedures

ON THE FIRST DAY OF YOUR ORTHO-K PROCEDURE you should arrive at the office as rested and relaxed as possible. Pre-Procedure expectations vary from office to office. Wear comfortable clothing. Don’t wear make-up on your initial fitting. It may interfere with the cleanliness of the procedure. Expect this visit to last approximately one hour.

Ortho-K contact lenses rest over the cornea, separated only by a layer of tears. They don’t stick to the cornea itself, they float. The lens is partially under the top upper lid, so you will feel it slightly when you blink. This generally lasts only a few days, while the lid and eyes adjust to the contact lens.

Illustration showing the curvature of regular contact lenses

Illustration showing the curvature of Ortho-K contact lenses

The doctor will then discuss your lens wearing schedule with you. To ensure the best possible ortho-k results, it is essential that the wearing schedule be followed closely. Your exact wearing schedule depends on the severity of your myopia and your lens-wearing success. Most patients with low to moderate myopia will begin wearing the accelerated ortho-k lenses at night. Patients with higher myopia will usually wear the ortho-k lenses during waking hours. During night wear, the eyelid covers the lens; this results in very little lens movement. You likely will have very little feeling of the lenses the first night. The lenses are highly oxygen permeable so the cornea will not be deprived of oxygen even when the lenses are worn while sleeping.

The First Night Of Wearing Your Ortho-K Lenses
It is best to insert your ortho-k lenses 15 to 20 minutes before you go to bed. It is recommended that you put a drop of lubricating (wetting) solution in your eyes just prior to retiring for the evening. This added moisture is necessary to minimize potential, dry eye problems.

When you awake in the morning, put one to two drops of wetting solution in the eye to increase moisture and assist in getting the lenses to move on the eye. You should not immediately remove the lenses, instead, wait 15 minutes; make sure the lenses are moving on the eye prior to removing them. This lens movement smoothes-out the corneal change that has occurred during the night.

Upon removal, you should notice a remarkable improvement in your (natural) unaided vision. This improved vision may last most of the day. If your vision regresses, you may wear your accelerated ortho-k lenses one to two hours in the mid to late afternoon.

Nightwear is not recommended for all patients. Your doctor will advise you if day wear is best for you. The doctor may have you wear the lenses during the day for at least eight, and up to sixteen, hours a day. In the beginning, time of wear is gradually built up during day wear. If the patient does night wear it may be for a time period of six to eight hours during sleep. If vision decreases later in the day, one to two hours of lens wear will "tune-up" your acuity.

Accelerated Ortho-K Follow-up Care
After the initial session of contact fitting, you will be scheduled for an appointment, one to two days later and at the end of the wearing schedule. This is a very important visit since the cornea and resulting vision are rapidly improving at this stage.

The accelerated ortho-k follow up exam includes the following:

1. An exam with the lens on. This includes evaluation of the lens fit and a discussion of the symptomology and wearing time.
2. The exam with the lens off. This includes measuring unaided visual acuity, corneal curvature measurements with keratometry, and corneal topography. The objective and subjective refraction determines your new vision correction, and biomicroscopy evaluates the health of the eye. A refitting of new accelerated ortho-k contact lenses as necessary or possible contact lens modifications may take place. The doctor will discuss the new wearing schedule.

Follow-up ortho-k appointments are usually scheduled for one week, two weeks, one month, and then each month after that until the end of the treatment phase. Your particular schedule will be determined based on your response to orthokeratology therapy and severity of vision correction.

When your doctor determines that your maximum desired results have been achieved, a retainer lens program will be arranged. Retainer lens exams will be performed every six months. Retainer lens wear will vary from a few hours day wear to wearing the lenses three to seven nights per week.

For the low to moderate myopic patient, the goal usually is to limit retainer wear to nightwear with no day wear. The patient with a higher degree of myopia may not be able to achieve normal unaided vision with nightwear alone and may need to use the retainer lenses during the day.