THERE ARE MANY WAYS TO PRESENT EXPECTED results after accelerated orthokeratology treatment. Some doctors may talk about the percentage of patients who achieve 20/20 vision after the treatment, while others present data on the number of patients who achieve 20/40 vision or better. It is important for you to understand that the expected outcome is not a guarantee of a particular result for you. Even with the most precise measurements of your eyes with the proper contact lenses, it is not always possible to predict your EXACT response to this therapy.

Expected Visual Acuity Results

The figures here provide a guideline for what a typical person can expect from the orthokeratology procedure. Keep in mind that the goal for every orthokeratology patient may not be to be completely independent of lenses during their waking hours. Many people are very pleased to be able to navigate around the house without the need for glasses or contact lenses.

Here is a review of myopia and expected visual acuity:

There are three general degrees or stages of the condition: mild, moderate, and severe.

Mild myopia ranges from 20/25 to 20/100 unaided visual acuity. Patients at this stage do very well with the accelerated ortho-k procedure and most likely gain 20/20 unaided visual acuity.

Moderate myopia ranges from 20/100 to 20/300 un-aided vision acuity. The expectation for this group is to achieve 20/20 to 20/40 unaided acuity.

Severe myopia may be defined as unaided acuity worse than 20/300. The results with ortho-k for severe myopia can range from 20/50 to 20/200 unaided vision acuity. This is significant improvement and can allow the patient to be free of contact lenses or glasses for many activities. More retainer lens wear is necessary in this case.

Risks and Complications
In order to make a decision as to whether ortho-k vision correction is a good alternative, it’s important to understand the potential risks involved. When the ortho-k procedure is performed by an experienced doctor, the risks are low. Over the past 35 years, studies of ortho-k have determined it is the safest method of vision improvement.

The following are several factors that influence whether or not accelerated orthokeratology may be right for you.

It is wise for those who elect to have ortho-k to be fully informed and to carefully assess their expectations. As a patient, your job is to understand exactly what the procedure can and cannot do and to convey, as best you can, your goals for improved vision. Communication with your doctor is essential. He or she should understand all of your vision desires and expectations and then explain which are realistic and which are not. Although this procedure is highly successful, even the most skilled and experienced doctor cannot promise that you will gain 20/20 vision without correction by contact lenses or glasses.

In the hands of a skilled doctor of orthokeratology it is possible to significantly reduce your dependence on glasses and contact lenses during your waking hours, It is best to think of this procedure as reducing your dependence upon glasses and contact lenses with the end result of im-proving your unaided vision.

Eyesight changes slightly over time. This is true even if you do nothing to enhance your vision. With ortho-k, as with other vision procedures, your eyes may change. This does not mean the procedure is unstable. Many outside factors affect vision progression. These include age, eye growth in children, and close work as well as other factors. Your cornea may simply change in vision acuity. However, with most patients, vision does not change significantly with proper retainer lens wear.

The advantage to the ortho-k procedure is that it is reversible. This allows for the patient’s vision to be altered at a later date. Results may need to be reversed due to loss of focus at near from age related lens changes, or from ortho-k results that need modifying. If the retainer lenses are discontinued for days, the cornea will regress. If this happens then reshaping is possible. Refractive eye surgery on the other hand is not reversible. As mentioned before, the tissue is pemanently removed.

Eye Infections
Eye infections are extremely rare with the ortho-k program of reshaping the cornea. As with all contact lens wear, infections are avoided through proper hygiene and proper lens wear along with careful monitoring by your doctor. If infection does occur, it is important to contact your doctor so treatment can begin in a timely fashion. Most infections respond to antibiotics, but it may be necessary to discontinue or limit your orthokeratology lens wear while the infection is active.

Dry Eye
It is important that your doctor be aware of any dry eye problems you have prior to beginning the ortho-k procedure. Tell your doctor if you experience dry, scratchy symptoms or if you frequently use "drops" to lubricate your eyes to receive relief from dry eye problems. If dryness exists prior to the procedure, or if dry eye symptoms persist after the procedure despite the frequent use of artificial tears, your doctor may recommend blocking your tear drainage canals with punctal plugs. This painless procedure prevents your natural tears from draining away so quickly and results in improved lubrication of the surface of the eye.

Unfortunately, some patients who suffer from dry eyes may not be good candidates for any contact lens wear, particularly accelerated orthokeratology. However, with aggressive treatment many people with slight to moderate dry eye problems can be successful, safe wearers of contact lenses.

Ortho-K Limitations

From the information presented here, you can see that while accelerated ortho-k is an exciting procedure, it is not for everyone. It is important to understand the natural limitations of the eye (such as presbyopia) and certain specific conditions that may limit your prognosis as an ortho-k candidate. Orthokeratology should not be thought of as a guarantee to eliminate your need for glasses or contact lenses, but rather as a way to improve vision and reduce your dependency on glasses and/or contact lenses.