What Is Orthokeratology?

Medically Reviewed by Jabeen Begum, MD on August 24, 2022
4 min read

Orthokeratology, also referred to as ortho-k, is a noninvasive and nonsurgical process, during which specially designed contacts are fitted to a patient. This process temporarily reshapes the cornea to improve vision. It is often compared to dental braces, which are used to reshape teeth much as ortho-k is used to reshape the cornea. 

While these improvements to your vision are reversible, they can be maintained as long as you wear the contacts as directed. 

Ortho-k is primarily used to improve myopia: i.e., near-sightedness. Other methods of correcting myopia include wearing eyeglasses, regular contact lenses, laser eye surgery (also known as LASIK), or photorefractive keratectomy (also known as PRK). 

Since both LASIK and PRK are surgical methods, some patients prefer to forgo those procedures and instead undergo nonsurgical corrections such as ortho-k. This process allows patients freedom from wearing their glasses and contact lenses all the time without having to have surgery.

Since there is no orthokeratology age limit, sometimes, ortho-k is suggested to improve a child’s vision. Since vision continues to change into early adulthood for some children, surgical procedures such as LASIK and PRK are not recommended for children. Additionally, while there’s no firm evidence confirming ortho-k is able to stop the progression of myopia in children, the possibility is still being researched. 

If you’re considering undergoing the ortho-k procedure to help correct your vision, there are a few key details you should know prior to your fitting.

First, when choosing ortho-k, you’ll be expected to undergo a few important tests. The first test is used to determine the health of your eyes. The Orthokeratologist will examine your eyes, primarily the retina and the outside of the eye, to determine if your eye is healthy. 

The other test is to map your cornea by using a tool called a topographer. A topography of your eye will show your doctor the exact shape of your cornea. This information, along with the size of your cornea and your required prescription, is all used to design the special ortho-k lenses. 

When the lenses are created, you’ll be asked to come in and pick up your ortho-k retainer lenses. At this appointment, you will be told how to insert, remove, and care for your vision retainers. Your retainers will be fitted and evaluated. 

You will then be scheduled for a follow-up appointment after your first night of wearing the retainers. At the follow-up appointment, your doctor will re-evaluate the fit of your retainers, as well as your newly corrected vision. Following this, another mapping of your cornea will occur. 

Your orthokeratologist will monitor the health of your cornea during your initial fitting process. They will also evaluate the effectiveness of the ortho-k treatment. Sometimes, your retainer lenses may need to be modified. 

The time it takes for treatment to work will vary between patients. Sometimes, orthokeratology can work rather quickly. 

There are a few factors that can speed up or slow down the treatment: 

  • The rigidity of your cornea 
  • The quality of your first prescription 
  • Tear quality and quantity 

Some patients may need to wear their retainers every night in order to keep their newly corrected vision. Other patients, however, may only have to wear their retainers every few nights. 

To understand how orthokeratology works, first, you need to understand how the cornea functions. The cornea, which is a flexible tissue, is located at the front of your eye and works to focus light onto the retina. Its main responsibility is to help the eye to focus.

Ortho-k overnight lenses, which are the most common form, are rigid, gas-permeable lenses providing sturdy enough support to reshape the cornea. While worn, they allow oxygen into your eye so that your eye remains healthy. As you wear them, they also flatten the cornea’s middle. This changes how light is bent upon entering the eye. These lenses are mainly worn at night and then removed the following morning. 

Once removed, the cornea remains flattened for some time, correcting your vision so that you don’t have to rely on glasses or regular contact lenses. However, this is a short-term correction, and if you stop wearing the ortho-k lenses at night, then your cornea will eventually return to its original shape, and the refractive error of your eye will return. Due to this, you’ll need to continue to wear the lenses every night or every few nights to keep your vision corrected. 

There are some orthokeratology risks. Like normal contact lenses, ortho-k lenses carry an increased risk of infection. This risk is more concerning for children who may not practice good hand and contact lens hygiene. 

Eye infections are common with contact lenses, and ortho-k lenses are no different. In fact, roughly a million Americans visit their doctor every year due to eye infections. Infections of the eye can cause serious consequences, such as lifelong vision impairment. As such, it’s important to consult with your ophthalmologist if you’re thinking about getting ortho-k. It’s equally important that you also maintain good hand hygiene and take appropriate care of your lenses to prevent infection from occurring.