Orthokeratology, commonly known as ortho-k, is a specialized type of corneal reshaping procedure used to temporarily reduce or eliminate myopia (nearsightedness) without the need for eyeglasses or contact lenses during waking hours. It involves wearing specially designed gas permeable contact lenses overnight that apply gentle pressure to the cornea to reshape its curvature.

Workings

The cornea, the clear front cover of the eye, is flexible enough that its shape can be gently changed through controlled pressure from a rigid gas permeable contact lens placed on the eye overnight. Ortho-k contact lenses are engineered to reverse the characteristic bulge seen in myopic eyes and flatten the cornea just enough to reduce or fully correct nearsightedness temporarily. The lenses are worn while sleeping and removed in the morning, allowing clear unaided or reduced vision for up to 16-20 hours.

Benefits of OrthokeratologyS
Some key benefits of ortho-k compared to traditional vision correction options include:
- Provides clear unaided daytime vision without the hassle of lenses. Daytime comfort is better than hard or rigid gas permeable contact lenses.
- Reversible non-surgical procedure that does not permanently alter the cornea. Vision returns to baseline once treatment is discontinued.
- Potential slows progression of myopia in children. Regular ortho-k treatment may slow axial elongation of the eyeball and slow worsening of nearsightedness over time.
- Enhances night vision compared to eyeglasses. The reshaped cornea provides a wider field of view in darkness without lenses.
- More active lifestyle. No need to fiddle with lenses during sports, swimming or other activities. Clear vision all day makes activities more convenient.
- Potential cost savings over time versus replacement of increasingly stronger eyeglasses or contact lenses. Initial fitting costs are similar but long term costs are lower with ortho-k.

Patient Selection and Continued Use
Ortho-k is generally recommended for patients with 1.00 to -6.00 diopters of myopia and up to 1 diopter of astigmatism. Younger patients under 18 are ideal candidates as myopia progression is slowed the most during childhood visual development. Success depends on proper fitting, careful use, compliance with wearing overnight lenses as prescribed, and occasional lens replacements as the cornea reshapes further over time. Regular follow ups are important to monitor vision stability and ensure safe and appropriate treatment.

Risks and Precautions
While safe for most patients, potential risks of Ortho-K include initial discomfort from the rigid lenses, infection from improper lens handling, and temporary visual disturbances if lenses are not removed properly in the mornings. Stopping treatment also results in a gradual return to baseline refractive error as the cornea reassumes its original shape over weeks. Precautions like good hygiene habits and scheduling lens replacement visits are important to minimize potential complications and ensure optimal care.

Growing Acceptance and Adoption
Ortho-K has gained popularity over the past decade as advances in lens design and fitting techniques have improved safety, efficacy and patient comfort levels. More eye care professionals are integrating ortho-k into their practices amid growing demand for non-surgical options. Newer multifocal ortho-k lenses also allow for simultaneous correction of both distance and near vision, further improving patient acceptance and compliance. Broad acceptance by optometrists worldwide points to Ortho-K becoming an increasingly viable refractive alternative.

Future Outlook
With ongoing research revealing long term stabilization of reduced myopia progression in children using Ortho-K, adoption is likely to grow steadily worldwide. Advocacy groups support wider screening and availability as a safe means to slow myopia worsening. More insurers may also provide coverage as the merits are recognized. Improved materials, fitting protocols and lens options will drive comfort levels higher while bolstering the long term potential of this promising nonsurgical refractive method. The application of ortho-k in correcting other refractive errors also holds promise to widen its capabilities and reach in years ahead.

In summary, orthokeratology presents a compelling alternative to eyeglasses and traditional soft contact lenses for correction of myopia. As techniques mature and long term benefits are increasingly established, it appears set to play a far greater role in refractive care overall. Broader availability will undoubtedly benefit many seeking a more convenient option for clear unaided day vision without glasses or the need to wear contact lenses.

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