INTRODUCTION
This article aims to simulate the actual process of how Orthokeratology works to correct vision and what is to be expected during the treatment and follow-up visits. The vision outcome may differ from case to case, depending on the complexity of each case.
WHY ORTHOK
The end goal for ALL our OrthoK patients will be to improve the quality of their lives, to enjoy the many activities in life without the need for day-time spectacles and contact lenses.
For children who are under the age of 18, we aim to minimize the progression of myopia with the use of OrthoK.
For adults, we aim to provide the freedom of spectacles as well as improve the health of your eyes comparing to day-time contact lens wear.
THE JOURNEY OF ORTHOK
POWER
This patient’s power of the eye is:
Right Eye: 325 degrees myopia. 25 degrees astigmatism.
Left Eye: 300 degrees myopia. 75 degrees astigmatism.
VISION
CORNEAL MAP
This is a topographical map of her cornea. This shows the shape of the eye. Every cornea is like a fingerprint, unique to each individual. The corneal topography machine is a highly accurate equipment used to extrapolate important values of the cornea. The values and other measurements collected in the comprehensive eye examination are used to fully customize the design of the OrthoK lens. Corneal topography is done at every follow-up visit to properly document the progress of the treatment.
Right eye topographical map Left eye topographical map
CORNEAL HEALTH
This is the picture of the actual cornea. A picture is taken during the first visit to ensure that the cornea is healthy before commencing OrthoK treatment. Pre-existing cornea condition WILL be treated prior to starting OrthoK.
corneal health right left
1st visit cornea health for the right eye 1st visit cornea health for the left eye
ORTHOK LENS FITTING
Before wearing braces, a dentist will need to take a mould of your teeth. Similarly, before starting OrthoK, we will need to take a mould of your cornea. After the mould is taken, we use the software to design a retainer lens for the eye.
This is how a perfectly fitted OrthoK lens looks on the eye. We call this the Bull’s Eye look. It has a centre area of black zone to gently correct the vision, a green ring to accommodate the movement of the eye cells that will migrate while the vision is corrected, another area of black zone to align the lens onto the eye so that it stays in the appropriate location in the eye and a thin green ring at the edge to facilitate tears and oxygen exchange.
OrthoK treatment is similar to a lock and key. There can only be one key to the lock. Similarly, there can only be one lens for each individual eye. This is the reason why all our OrthoK lenses are fully customized for the right fit.
OrthoK lens fitting left right
OrthoK lens fitting on the right eye OrthoK lens fitting on the left eye
1st NIGHT
OrthoK lenses are worn before going to sleep. The patient will wear the OrthoK lens and return first thing in the morning to assess the results and ensure the eye is healthy.
DAY 1 CORNEAL MAP
A map of the eye is taken. This shows us how the OrthoK lens is performing while the eyes are closed during sleep.
In each picture, you will see 3 maps. Take note of the map on the right. The map on the right is the difference between the 1st visit and the current visit. Blue area is the OrthoK treatment zone. It is important to note the position (centre of the eye), smoothness of colour (representing the quality of vision corrected) and size of the blue treatment area.
treatment of right left eye
Treatment map of right eye Treatment map of left eye
In this case, the treatment is in the centre of the eye, the smoothness of the blue treatment area is not very smooth meaning the quality of vision is still not good. Treatment size is about 4.32mm in the right eye and 4.29mm in the left eye.
DAY 1 POWER
Right: 125 degrees myopia. 25 degrees astigmatism.
Left: 150 degrees myopia. 50 degrees astigmatism.
DAY 1 VISION
DAY 1 CORNEAL HEALTH
Pictures of the cornea health are taken. This shows the cornea 2 hours after the OrthoK lens is removed. Both eyes are healthy. There can be small amounts of cornea irritation during the first few days of treatment due to lens adaptation. Irritation should not be presented after a few days. There should be no pain and symptoms of discomfort after removal.
DAY 1 CORNEAL HEALTH
Corneal health for the right eye Corneal health for the left eye
DAY 2 CORNEAL MAP
Treatment map of right eye Treatment map of left eye
Day 2 maps show that the treatment is in the centre of the eye, the smoothness of the blue treatment area is improving and the quality of vision is getting better but it is still not perfect yet. Treatment size is about 4.21mm in the right eye and 4.15mm in the left eye.
DAY 2 POWER
Right eye: 75 degrees myopia
Left eye: 75 degrees myopia
DAY 2 VISION
DAY 2 CORNEAL HEALTH
Both corneas are healthy without scratches or irritation. . Cornea is clear without any signs of irritation. Cornea is healthy and appears to be in the same health as compared to before starting treatment. Shows that the lens is indeed not coming into contact with the eye and is sitting nicely on a bed of tears. No complains of pain and discomfort.
Corneal health for the right eye Corneal health for the left eye
DAY 3 CORNEAL MAP
Day 3 maps show that the treatment is in the centre of the eye, the smoothness of the blue treatment area is improving and the quality of vision is getting better. Treatment size is about 4.38mm in the right eye and 4.55mm in the left eye.
Treatment map of right eye Treatment map of left eye
DAY 3 POWER
Right eye: No myopia. 50 degrees astigmatism.
Left eye: No myopia. 50 degrees astigmatism
DAY 3 VISION
DAY 3 CORNEAL HEALTH
Cornea is still clear without any irritation or scatches. Reaffirms that lens is a good fit. No complains of pain and discomfort.
Corneal health for the right eye Corneal health for the left eye
WEEK 1 CORNEAL MAP
Treatment map of right eye Treatment map of left eye
Week 1 maps show that the treatment is in the centre of the eye, the smoothness of the blue treatment area has improved and is now smooth. Quality of vision is great. Treatment size is about 4.91mm in the right eye and 4.99mm in the left eye.
WEEK 1 POWER
Right eye: No myopia. No astigmatism.
Left eye: No myopia. No astigmatism
WEEK 1 VISION
WEEK 1 CORNEAL HEALTH
Healthy looking corneas! Eyes are as good as new!
Corneal health for the right eye Corneal health for the left eye
WEEK 3 CORNEAL MAP
Treatment map of right eye Treatment map of left eye
Week 3 maps show that the treatment is in the centre of the eye, the smoothness of the blue treatment area is smooth. Quality of vision is great. Treatment size has increased and is about 5mm in the right eye and 4.99mm in the left eye.
WEEK 3 POWER
Right eye: No myopia. No astigmatism.
Left eye: No myopia. No astigmatism
WEEK 3 VISION
WEEK 3 CORNEAL HEALTH
Healthy looking corneas!
Corneal health for the right eye Corneal health for the left eye
WEEK 7 CORNEAL MAP
Treatment map of right eye Treatment map of left eye
Week 3 maps show that the treatment is in the centre of the eye, the smoothness of the blue treatment area is smooth. Quality of vision is great. Treatment size has increased and is about 5.35mm in the right eye and 5.26mm in the left eye.
WEEK 7 POWER
Right eye: No myopia. No astigmatism.
Left eye: No myopia. No astigmatism
WEEK 7 VISION
WEEK 7 CORNEAL HEALTH
Healthy looking corneas!
Corneal health for the right eye Corneal health for the left eye
CONCLUSION
OrthoK treatment takes time to stabilize. Power can be reduced significantly in the first 1-7 days but generally takes about 1-2 weeks to stabilize and can vary for different amounts of myopia and astigmatism. As we always tell ALL our patients, our priorities are:
- ENSURE HEALTHY EYES – To eliminate the risk of infection. We need the cooperation and compliance of our patients to ensure a safe treatment.
- A PROPERLY CENTRED LENS – To ensure good vision outcome, as well as good myopia control for children.
- GOOD VISION – This is not to say vision is not important but rather, priorities 1 and 2 are more important and if we achieve 1 and 2, good vision will follow!
Enjoy your OrthoK treatment!
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