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Awaken to Clarity with Ortho-K!
Shift lenses or Shift lenses Ortho-K (short for Orthokeratology) is the only non-surgical procedure that allows you to see 20/20 without the use of correcting lenses during the day. It is a revolutionary therapy offered at Visique Rose Optometrists, which involves the use of specially crafted molds/retainers that gently reshape your cornea while you sleep. Upon waking, your corneas are the correct shape to accurately focus light, enabling you to see clearly without the hassle of contact lenses or glasses during the day!
Who can use it?
Traditionally, Ortho-K has been used solely for short-sighted patients. However, recent advancements in technology now mean that this is a safe and effective option for patients of most spectacle prescriptions. Visique Rose Optometrists are the first in New Zealand to be able to offer Shift lenses for long-sighted patients, patients with astigmatism, and those struggling with reading vision (vision after 40). Recent research also shows that the use of Shift lenses Ortho-K may help to slow down or halt the progression of myopia (short-sightedness) in children.
What does the treatment involve?
The process begins with an initial consultation where our optometrists carry out a full eye examination and take precise measurements of the shape of your corneas using special computerised instrumentation (corneal topography). Assuming your eyes are suitable, you will undertake an overnight trial wearing Shift lenses / Ortho-K lenses and the following morning, the effect on your eyes will be assessed.
It may be necessary to have more than one trial to optimise the lens design. With most people, 70% of the reshaping is obtained during the first night and 100% within 10 days. To retain the correct shape, your Shift lenses / Ortho-K lenses need to be worn as a retainer at night. If wear is stopped, the cornea gradually returns to its original shape over a couple of weeks. Therefore, unlike surgical options, Ortho-K is completely reversible and no ocular tissue is removed.
- What if I have been unsuccessful with contact lenses before?
There is a good chance that you will still be able to succeed with Shift lenses Ortho-K. Many contact lens wearers discontinue wear because of dryness or discomfort. These are usually not an issue with Shift lenses Ortho-K because the lenses are only worn while you sleep. Also, because your eyes are not wearing lenses while awake, they receive more oxygen to help maintain optimum eye health.
- What are Shift lenses?
Shift lenses are a type of orthokeratology lens. These are designed specifically for you by your Optometrist and provide a clear range of vision for a wide variety of patients.
- How safe is Ortho-K?
The safety and effectiveness of modern Ortho-K has been demonstrated by independent studies at University Research Departments in Australia and around the World. As with all contact lenses, good hygiene and regular check-ups are important.
Between 1997 and 2007 there were 123 reported cases globally of microbial keratitis associated with orthokeratology use (1). In 2007 the Singapore National Eye Centre presented a five patient case series suggesting an association of pseudomonas aeruginosa infection with overnight orthokeratology lens use(2). In 2008 the American Academy of Ophthalmology reviewed seventy-five articles investigating the safety of orthokeratology and concluded that ‘‘future research should be directed at assessing the rate of infectious keratitis among overnight orthokeratology users and whether the rate varies by age”(3). In 2010 a Canadian study presented three cases of keratitis related to overnight orthokeratology lens use(4). Choo et al studied pseudomonas and infection rates on cat epithelia and compared alignment fit and orthokeratology lenses. In order to elicit a infectious response with overnight orthokeratology lens wear the lenses had to be soaked in pseudomonas and a corneal abrasion present, whereas lenses soaked and worn in the absence of corneal trauma, showed no significant increase in risk(5). Bullimore et al concluded that the overall estimated incidence of microbial keratitis is 7.7 per 10,000 years of wear (95% CI = 0.9 to 27.8) whilst the estimated incidence of microbial keratitis is nearly twice as high (13.9 per 10,000 patient-years 95% CI = 1.7 to 50.4) in children. This contrasts to adults, where the estimated incidence of microbial keratitis is 0 per 10,000 patient-years (95% CI = 0 to 31.7) The fact that the CIs for the rates estimated overlap should not be interpreted as evidence of no difference.(6). Key factors in complications include poor patient knowledge of cleaning systems and hygiene.
It has been suggested that corneal iron lines may be caused by hyperopic orthokeratology corrections over +3.50, with the current proposed mechanism being microepithelial trauma or irregular folding of the epithelium from irregular pooling of tear film beneath the contact lenses(7). Other case series of iron line formation have concluded that this is a benign finding with no long term effect on visual acuity and physiology(8,9). The research is yet to report on their resolution following cessation of orthokeratology lens wear.
- Koffler BH, Sears JJ. Myopia Control in Children through Refractive Therapy Gas Permeable Contact Lenses: Is it for Real? American Journal of Ophthalmology. 2013 Nov 30;156(6):1076–10e1
- Chee EWL, Li L, Tan D. Orthokeratology-related infectious keratitis: a case series. Eye & Contact Lens: Science & Clinical Practice. 2007 Sep;33(5):261–3.
- Van Meter WS, Musch DC, Jacobs DS, Kaufman SC, Reinhart WJ, Udell IJ. Safety of Overnight Orthokeratology for Myopia. Ophthalmology. 2008 Dec;115(12):2301–1.
- Yepes N. Infectious Keratitis After Overnight Orthokeratology in Canada. 2010 Oct 19;:1–4.
- Choo JD, Holden BA, Papas EB, Willcox MDP. Adhesion of Pseudomonas aeruginosa to orthokeratology and alignment lenses. Optom Vis Sci. 2009 Feb;86(2):93–7.
- Bullimore MA, Sinnott LT, Jones-Jordan LA. The risk of microbial keratitis with overnight corneal reshaping lenses. Optom Vis Sci. 2013 Sep;90(9):937–44.
- Kirkwood BJ, Rees IH. Central corneal iron line arising from hyperopic orthokeratology. Clin Exp Optom. 2011 Jul;94(4):376–9.
- Rah MJ, Barr JT, Bailey MD. Corneal pigmentation in overnight orthokeratology: a case series. Optometry. 2002 Jul;73(7):425–34.
- Liang JY-B, Chou P-I, Wu R, Lee Y-M. Corneal iron ring associated with orthokeratology. Journal of Cataract & Refractive Surgery. 2003 Mar;29(3):624–6.
- Myopia Control
Until relatively recently there has been no scientifically proven way of reducing the progression (worsening) of myopia (short-sightedness). It has been long understood that genetics and environment play a role, but the mechanism of myopia progression has now had some clarification in research conducted internationally. It has been shown that where the light focuses in the periphery (side) of the retina has a strong influence on the progression of myopia. Studies show that Ortho-k is the best option for myopia control treatment with 50% or greater potential for reduction. For more on myopia control click here. If you are a parent of a short sighted child then make sure you take the self test today to assess your childs risk.
- How does Ortho-k control Myopia?
When wearing spectacles or traditional contact lenses, the image is clear on the central part of the retina and blurry in the outer parts (or periphery) of the retina. After Ortho-K or corneal moulding, the image is now clear in the periphery of the retina. Creating this situation for a short sighted patient has shown to be a “dimmer” switch for myopia progression. In other words Ortho-k creates a condition that can reduce the progression of myopia.
- How long has it been around for?
George Jessen first announced the concept of “Orthofocus” in 1964. Many manufacturers have coined terms for it such as CRT (Corneal Refractive Therapy), VST (Vision Shaping Therapy), Dreamlens, OK, Emerald, GOV and Orthokeratology. Since then technology has moved this procedure into the 21st century more so in the last 15 years, and this is mainly due to manufacture technique, research into safety and infection rates, and standards of practice in both Australia and New Zealand set about by the Orthokeratology Society for Oceania, this is an concept which is relatively new to New Zealand in many respects but old to the world.
- How does it work?
Ortho-K works by gently remolding the front surface / window of the eye called the cornea. It does this by using the tears underneath a specially designed mold or lens. The lens itself creates an shape like a dental retainer and it is the sucking forces of the tears which actually do all of the work. The lens itself does not physically press on the eye in any way.
Here’s what some of our patients have to say about OrthoK…
No longer having to juggling three pairs of glasses (safety, sunnys and normal) through out the day has been liberating! –Erin
I used to lose my contacts a lot while in the water, now with Ortho K I can swim, dive and surf with my eyes open without having to worry about losing my lenses. Ortho K has also been fantastic for eliminating the dryness and irritations I used to experience wearing contacts while working on the computer all day, my eyes are now free to breath! –Naomi
I was last able to read a telephone book unaided at the age of about 40. I agreed to a short trial and was amazed after the first night to be able to read relatively fine print without glasses. –Ruth
The trial was very successful, the night time wearing of the lenses was without a single issue and our son now has great vision and the freedom to do what he likes during the day without the issues one has with spectacles or daytime wear contacts. Carole and I are extremely happy with Ortho K and I am so impressed with it that I have been taking every opportunity that I can to tell people of this as a great option for correcting their eyesight, particularly their children. –Langley & Carole
Our family is made up of second and third generation clients of your practice and I would like you to know that it is always a pleasure to deal with any member of your staff. They exude friendliness and professionalism and go out of their way to be helpful. Ortho K has given me the glorious ability to read again without having glasses stashed at numerous points in my everyday life. Thank you I am delighted. –Kind regards, Diane Green.
For more information feel free to go to shiftlenses.com. and remember to book in for a quarter hour free assessment.