Lenses Reshape Cornea to Improve Vision

Orthokeratology helps girl, but it may not be for everyone.

Alyssa Brascia, 9, of Shorewood, shed her glasses last week.

At her annual eye exam, Alyssa’s mother, Lori Brascia, learned that Alyssa’s vision was worse than last year. Joliet optometrist Dr. James K. Cutler recommended Alyssa wear specialty contact lens at night to reverse the nearsightedness.

Alyssa did and Lori praised the results.

“Within three days she was seeing better,”

Lori said.

“Her vision is back to 20/20. She can see the blackboard. She can read the clock from the other room. It’s been amazing for her to wake up in the morning being able to see.”

Orthokeratology — Ortho-K — is the process of reshaping the cornea with a hard, gas-permeable contact lens rather than surgery.

The concept is not new. The ancient Egyptians placed sandbags on their eyes to attain the same result, said Cutler, who has offered the lens for the last 12 years.

“It’s gaining momentum. More people are asking about them now,”

Cutler said.

“The new software that’s been designed in the last four to five years makes it easier to create more precise lenses. The results are a lot better.”

An Ortho-K contact lens is larger than other gas-permeable contact lenses — about 12 mm across as opposed to 9 mm — to ensure the lens covers and seals the entire cornea while the wearer sleeps. “You don’t get a lot of movement with them,” Cutler said.

In the morning, the person removes the lens and experiences perfect vision for the remainder of the day. This usually, but not always, means he or she has no need to wear glasses or contacts.

Sometimes, the effects of the Ortho-K lenses last up to 72 hours, Cutler said. However, unlike Lasik surgery, the good results from Ortho-K contacts are temporary. If the patient stops wearing the lenses, the poor vision returns.

Nevertheless, Cutler said some studies suggest that for some patients wearing the Ortho-K lenses may slow down the rate that nearsightedness increases. Yet for all its benefits, Cutler does not recommend Ortho-K to every patient he sees.

For example, people with severe astigmatism may not experience sufficient vision correction or may need to supplement with glasses. Individuals with corneal disorders should not be fitted with them.

As with any contact lens, poor hygiene may lead to infection and permanent scarring. Cutler will not propose Ortho-K to any patient unwilling or unable to meticulously clean the lenses or to patients planning Lasik surgery.

In addition, Ortho-K, as well as Lasik surgery, can have some unpleasant side effects.

Dr. David Morimoto of Associated Ophthalmologists in Joliet said those can include floaters, double vision, ghosting and star bursts.

These may occur because the patient, in order to re-shape the cornea, is wearing a lens that does not properly fit the eye. Morimoto added that most of the time the side effects are temporary and end when the patient stops using the Ortho-K lenses.

“On the other hand, you are wearing a contact lens overnight,”

Morimoto said.

“The problem is two-fold. You are decreasing the amount of oxygen to the eye and you have a foreign body in the eye. Both can increase the risk of infection.”

Meghan Lapeta, 18, of Downers Grove, who has worn Ortho-K lenses for four years, did experience an infection early in her use of them from lack of proper cleaning.

“I had to take antibiotic drops,” she said. “But the infection is preventable. You just keep them clean and you’ll be fine.”

Lapeta, a triathlete who exercises three to five hours each day, loves the lenses because they eliminate the need to fiddle with glasses or to re-wet her contact lenses. She also has no fear of losing a lens.

“I noticed I had better vision in two days and my prescription has not changed,” Lapeta said. “I’m glad I took the time to get used to them.”

Teens, Cutler said, find these lenses especially appealing, partly because they fit their busy lifestyle and appearance concerns and partly because Lasik surgery is not FDA approved for individuals younger than 18 because they’re eyes are still changing.

But age is no barrier to Ortho-K. Cutler has fitted these contacts on patients as young as 2 years old; older adults, overall, tend to shun them.