Orthokeratology (OrthoK) in Myopia Management

This Week’s Video: OrthoK!
One of my most favourite topics to talk about! OrthoK has become a hot topic when looking at the few strategies in myopia management. The principle reason to why I recommend Orthokeratology for my patients is because of it's proven effectiveness in slowing down myopia - it has a lot of literature to back it up. The BONUS is that the child is free from glasses and contact lens wear during the day so that they can enjoy their day-to-day activities without the hassle of glasses flopping around on their face or losing a contact lens out on the field.
Today, I go into the details of the design of the lens as a lot of parents ask how it works along with the safety and efficacy of Orthokeratology. I will go into another video focussed more on Orthokeratology and ADULTS! (Stay Tuned)
It is definitely a longer video, but there is a lot of good information especially if you're considering Orthokeratology for your child, or if your eye doctor has recommended it as an option. Most times, we aren't able to dive into all the information during our one on one time in the office, so here is the content in the comfort of your own home!
Watch on to learn more!
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If you're in the Edmonton region and looking for solutions in dry eye disease, myopia management or specialty contact lenses, feel free to schedule an appointment with me at our website:
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MEDICAL DISCLAIMER:
The information contained in this video posted represents the views and opinions of the original creator. The content has been made available for informational and educational purposes only.
The Video is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read or seen on the Site.

[@FFLapin]

I started ortho K as a 48 year old, and it has worked miracles ❤️

[@itsmeche3257]

May i ask u if it can help to reduce the grade of vission?my son struggle

[@LevyVarghese-s7s]

can you post more of these. You're making my life so much easier, I don't have to do extra work researching lol.

[@tomcruzeee]

you teaching me how to put it in like 3 hours ago

[@drnataliechai5551]

Hi William! Your dad told me you found me :) Yes, this is an introduction to what we are helping you with. I look forward to seeing you again for your follow up visit :)

[@viet5929]

Love the extra technical details makes information useful. Thanks.

[@drnataliechai5551]

Hi there, thank you for your kind words! I'm glad it was informative for you

[@deborahilo6792]

This is very informative and explicit. Please keep up the good work, Optometrist from Nigeria

[@drnataliechai5551]

Hi Deborah, thank you for your kind words. Difficult to balance work, life, and social media nowadays but trying! Hope you are doing well

[@deborahilo6792]

@@drnataliechai5551 I'm great

[@AkashKumar-gn6sh]

So good and informative for me 👍

[@JM-ii5yl]

1. I feel like I've found a gem with your channel. Everything is so well put together and explained and helpful and I feel like I'm a quarter of the views rn. 2. (PREFACE) I'm interested in orthoK because all soft lenses make my eyes feel 'heavy': I believe it's less a matter of imperfect fit or my slightly dry-eyes and moreso just my physical hypersensitivity. OrthoK sounds great for this during the daytime, but given my sensitivity I'm wondering if I could stand the physical sensation of wearing them overnight. I can barely fall asleep with soft lenses in, I feel them so acutely against my eyelids. (QUESTION) If I were interested in orthoK but concerned if I'd be able to comfortably wear them overnight, could an optometrist give me a 'fake' (0 prescription strength) pair of orthoK lenses for me to try on for a week before actually going through the topography process? If not, is there some "closest thing" to test running it like that? (like idk wearing rigids overnight or something)

[@drnataliechai5551]

Hi there - thank you for your kind words! I really appreciate the feedback knowing that you're getting value from the content. I consider that a success when I'm able to connect with just one person :) I'll work hard to continue to provide good educational content and awareness. Orthok is certainly a very good alternative for the right candidate. A few things to consider and to help with understanding - OrthoK lenses are smaller in diameter than soft lenses, so that it and of itself will already help with some of the sensitivity. However! the concentration of the weight is entirely on the cornea now - so yes, you will experience discomfort especially at the beginning of your experience. The lens awareness does improve either when your eyes are closed, or when your eyes are open but not blinking. As you probably know, it is the lens-lid mechanical interaction that causes a lot of the irritation. From the experiences of a handful of my patients, it is not bad and they've grown to get used to the sensation with no issues eventually. Unfortunately, to my knowledge, there is no trial OrthoK lens as these are considered custom lenses. However you do bring up a creative idea of possibly trying to experience the sensation with an RGP lens. Now, there are trial fit sets of RGP lenses out there and there is a possibility to be able to have you experience the sensation. You would have to chat with the eye doctor to see what would be possible around taking it home etc. I would imagine there may be some restrictions especially with COVID but hey, it doesn't hurt to ask right?! I hope that answers your question? Please let me know if I can further help your journey :) Thanks for your support! I really appreciate it

[@Allan-et5ig]

JM they are uncomfortable but you get used to it in my experience. They will feel as the doctor replied 'bad' no two ways but unless they drive you insane, you should be able to fall asleep so you won't feel them obviously. They will feel worse than soft lenses but like I say, you absolutely will get used to them. If you have Lasik (though let's hope in 20 years there are huge advancements) you may feel nothing but in as little as a year may experience much more serious side effects Depends on how near-sighted you are and other factors. If you're a candidate you'll get all the benefits of Lasik without the risk. It certainly works for me.

[@CasyMint]

Ortho k didn’t come up in any conversations with multiple eye doctors, I wonder why they don’t advertise this method at all. Suspicious!!!

[@prettysavage2203]

Very informative video 👍👍

[@drnataliechai5551]

Thank you again - I hope you are doing well!

[@anilbhosale1433]

Very nice technology is improved 👍

[@ilonaaltchuler9547]

I’m in my early 30s and my vision is around -8 in both eyes. I heard about this for the first time today! Is it worth moving forward considering my age? Thank you!

[@slamdunk73]

Great video, very informative and excellent non-biased advices. We are in the process of choosing between orthoK vs MiSight for our son (12) and daughter (10). Their vision is -2.75 and -2.00 respectively. Would you recommend one over the other ? What factor would consider if you choose orthoK vs MiSight ? Thank you very much.

[@Cliche8701]

Optometrist here. They have similar efficacy. If your children have problems with dry eyes, Ortho-K will be smarter. Also, if the enjoy swimming, like going to the pool/going on summer holidays, then Ortho-K is also wiser, since swimming while wearing soft lenses is not advised. Best regards.

[@invent1977]

Dr drnataliechai - I’m 47, and I had LASIK done when I was in my 20s. Unfortunately I still have -1.5 with asthmatism still today. I know you cannot answer straight yes or no to my question below, but interested in your thought if my previous LASIK surgery would not make me a good candidate for the ortho-k lens?

[@ngeriii8318]

Doctor why u still using glasses not using ortho K ??

[@drnataliechai5551]

Great question - unfortunately my prescription is outside the allowable parameters. Orthok as well as all other options for myopia management was not available during my childhood and so my prescription is quite high. If I could, I would've been my own 'first' patient :)

[@ngeriii8318]

@@drnataliechai5551 thank you Doc.... how about misight soft lense. Which one is FDA approved..

[@drnataliechai5551]

@@ngeriii8318 MiSight Soft lenses are a good option but again, my personal prescription is outside the treatable range. It is FDA approved for myopia management, so it is a great contact lens option for many

[@ngeriii8318]

@@drnataliechai5551 thx

[@dhalinyaro34]

Thanks a lot.

[@victoriah1088]

I am doing ortho k and I have a prescription of -6.00. I wore this lens every night and EVERY MORNING when i took them off, I had a slight glare and halo effect. Any reason for this Dr. Chai?

[@drnataliechai5551]

Hi Victoria, thanks for your question. Yes, I always make my adult patients aware, and in particular those with a higher prescription that glare and haloing is expected. So what you are experiencing is quite normal. The reason around that is simply there is more movement/tissue redistribution required for the orthok lens to achieve the result of good vision. With those changes, there is a chance of an increase of what we call "aberrations" - you can think of these as small imperfections in the structure and tissue of the eye that can cause light to not focus perfectly on a single point. In fact, glare and halo are common side effects even after laser correction. (The technology nowadays are getting better and better at decreasing these aberrations for patients) Typically, the glare and halo will gradually improve overtime as you continue to wear your lenses. Can't guarantee 100% but it can certainly improve. I hope that answers your question? Please let me know if I can further help.

[@victoriah1088]

@@drnataliechai5551 thank you so much!

[@RomanticPopPunk]

Hi Victoria, how’s your eyesight now?

[@prettysavage2203]

Does ortho k lens able to correct - 1.0 D myopia ?? Help me out , I want my original vision back , cuz now lights in the night are blurring and colours in lights also start blurring . Can you help me bring my vision back 😿🙇‍♂️

[@drnataliechai5551]

Hi there, yes, orthok is able to correct for -1.00D. Please remember orthok is a reversible, temporary strategy for vision correction and is not permanent. Nor will it reverse your prescription.

[@hannahpark6201]

Hello! I've recently been introduced to this treatment and am in the process of deciding between continuing with my glasses or getting orthoK lenses. I am currently 13 and am quite concerned about what regrets I might have if I choose to move forward with the lenses. I have a prescription of -3 diopter and -1.5 astigmatism. I've never had contacts so I'm not sure how I'll react to the lenses. I've found little about this treatment online which adds to my concern. My eyes are on the dry side so if I were to choose orthoK lenses, would the dryness of my eyes affect the treatment? Thanks!

[@drnataliechai5551]

Hi Hannah - thanks for your question and I apologize for the delay in response. Based on the strength of your prescription, you should be a good candidate for orthok (given that all other factors are normal) I always counsel my patients and never sugar-coat that at the beginning, you will definitely feel the lenses in your eyes upon application. However, remember, you are sleeping in them and as long as there is no dynamic movement such as blinking, you will feel them minimally. Also, the longer you wear them, the more you get used to them. Around dry eye, you are right, any contact lens (even the soft ones) can cause dry eye. The advantage of the orthok lens is that they are worn less than that of a soft daytime soft lens. So the dry eye profile is a little better. The material used nowadays have great moisture and oxygen permeability even on the closed eye so it is very agreeable for children and teenagers like yourself. I hope that helps answer your question?

[@shuklee3602]

Hi, my son is 13 years old. He has right eye -3.50, left eye -4.00 for myopia. He also has astigmatism. Right eye -3.00. Left eye -2.25. His eye shaped like a foot ball. Is he a good candidate for ortho-k lens?

[@kojyjokajambooka1560]

My daughter is 11 years old, her prescription is -5:50 and -5:25 , They told me it fits perfectly until -4:75 , so what is your opinion doctor?

[@drnataliechai5551]

It depends .. I have fit patients with maximum prescription of up to -6.00 sph. However it does depend on what the corneal topography scans look like. Without knowing what her scans look like I am unable to provide an accurate recommendation however what I can provide is what I’ve already done for my patients. I can understand that with the orthok lenses with higher prescription, we may not be able to provide perfect 20/20 vision however it will provide the myopia control we are looking for. As long as vision is functional, I sometimes will decide to fit my patient with orthok to provide the management. I hope that helps, please let me know if you have any further questions !

[@kojyjokajambooka1560]

@@drnataliechai5551 and what do you think about the Kubota glasses solution please? Thank you so much for your reply🙏🏼dr Natalie

[@drnataliechai5551]

@@kojyjokajambooka1560 Yes, glasses is definitely a viable option. I would suggest looking into lenses that are designed to control for myopia. There are many notable technologies. I have been using the MiyoSMART lenses. Recently there were new lenses that were released called Stellest … I haven’t personally used them yet. However these technologies provide better control than your normal tradition glasses. You will need to see if they are available in the area you live. I hope the access is not too much of a bother for you. I hope that helps!

[@jamesspencer9830]

I am 68, in good health, wear soft contacts,(although in the day started out with hard lenses), mild astigmatism. Would love to try Ortho K, Any reason not to? James S.

[@indianaajoness]

I got my ortho K lenses and I can barely keep them in because it just hurts so much :(

[@Dobemandan]

I'm so confused... Miyosmart or Ortho K for my 9 years old with -0.75? Your opinion is appreciated Thx

[@anilbhosale1433]

What is the price for mayopia _7. _5, ortho K contact lenses.

[@GrahamMiao]

Hello Natalie, thanks for the great explanation. My daughter the OrthoK treatment about 8 months ago and everything was good, until probably 2 months ago, when her left eye started to experience redness and a lot of eye rot in the morning, while the right eye is completely fine. As you said these are common side effects, but I'm not sure how to handle it. If she stops wearing it for 2 days all the symptoms go away; and then they will come back after wearing for 4 or 5 days. It is always the left eye; and she claims that there's no uncomfortableness or pain. Should she continue the treatment?

[@NanthawatKwansai]

ภาษาไทย..คนไทย

[@kotipalliramesh2497]

Mam can we go for ortho K lenses in myopia management who is having a power of -18.0 on both eyes

[@itsmeche3257]

Hi doctor,may i ask u if my son can reduce his vission if he used ortho k? His vision is -4 and -3..

[@soumyatkd7521]

If i will be using these lenses and then getting the number of my eye checked through machine. Will it be shown temporarily low. Will the machine show 0 refractive error if i have worn these lenses a night back in case of -2.5 cyl power

[@InsignificantChap]

Hey had u given that exam And where did u get ortho k Does they work perfectly

[@rakh01]

I am 13 with -6.25 eye prescription am I eligible?

[@cursemage]

Can orthok therapy will help me reversing myophia ?

[@MaiNguyen-go3fp]

If I have like -6.50 diopter can I get ortho-k? I heard it only up to -6.00 I don’t have -6.50 diopter my right is -4.50 and my left is -5.50 but I want to ask if it goes over -6.00 can still be able to get it?

[@drnataliechai5551]

Hi there - thanks for the question. To answer your question, the traditional 'maximum' is usually around -6.00 D. In saying that, personally, I have fit patients with orthok at that -6.50 and even -7.00 and was able to achieve functional vision. The patients knew that they were outside the parameters and understood that their vision will not reach 20/20. When I use it in myopia management, if the patient is the right candidate, I will do a 'partial' correction with orthok when the prescription is over -6.00 D and combine it with another strategy to compensate for the prescription 'left over' that was not corrected by orthok. I hope that answers your question? Let me know I can help you further.

[@gaynzz6841]

You will have 20/20 after waking up, but after 2-3 hours it will quickly drop

[@letscracklawexams6557]

Hii doctor I m 26 and have a prescription if -6 of both eye will I able to get ortho k lences

[@Sam_Smiles_]

Can -8 myopia use it?

[@khavanu]

Hello Dr Natalli. Is it possible for a kid to start this Ortho-k treatment and later get LASIK done when they get Older ? Also, How many cases for the infection are reported with overnight Ortho-k lenses for kids ?

[@drnataliechai5551]

Hello - thanks for your question. And yes, that is actually the 'end game' for a lot of the parents of my patients. That is indeed what orthok can do as well, is to keep the child's prescription as low as possible so that they are a better candidate for refractive surgery when they are eligible. So far *knock on wood* I've had none over the last 6 years of my practice. If you look at the literature, the overall risk remains very low and in one systematic review analyzing the safety profile of orthok, they reported the incidence was 7.7 cases per 10,000

[@sachinmore172]

Hi, where can I find this Ortho K treatment in India, specifically in Vadodara, Gujarat, India. I am having myopia (age 27) and don't want to go for surgical treatment.

[@drnataliechai5551]

Hi there, unfortunately I am not familiar with the scene if orthok in India at this time. You may need to call around the clinics to see if they would be able to further direct you

[@aditirathore6313]

Mam my eyes no. Is approx -6.0 in left and -5.0 in right may i get ortho k amd correct it till under -3.50

[@drnataliechai5551]

Based on your prescription, you are still good to move forward with orthok lenses (given that everything else is normal) It is definitely on the higher side of myopia so it may take a few nights of wear for full correction. I want to be clear that we are unable to make your prescription 'better' from what you have now. In a way, the 'damage' has already been done. Orthok. is used to slow down how quickly the prescription may change in the future. I hope that helps!

[@cherryash1635]

Hi Dr Chai I am 19 and have a prescription of R -4.50 +0.25 and L-4.75 +0.50 will i be able to get ortho K lenses

[@drnataliechai5551]

Hi there, based solely on your prescription provided - yes, you should be a candidate for OrthoK lenses given that your prescription has been stable! Your family eye doctor would be best able to let you know :)

[@xSolidSnake1988]

Hi Doctor, I've had lasik 15 yrs ago and im back -.75 . Can people with lasik use Ortho k?

[@gaynzz6841]

I'm sorry. It's almost criminal how ODs destroy people's vision with the minus lens.

[@kia8127]

Mam my vision for left eye is 0.75 and for right 0.50 how many days are required to get cure by using ortho k lenses

[@drnataliechai5551]

Hi there - that is a very light amount of myopia and you would probably notice a change overnight with orthok lenses. I do want to mention that it is NOT a cure. It temporarily corrects for your vision acting like a retainer

[@Allan-et5ig]

You're probably, provided no great astigmatism, a slam dunk for 20-20 within 3 weeks. I'm not a doctor!

[@mhademo1516]

Can myopia be detected while using ortho k

[@mhademo1516]

Please answer

[@drnataliechai5551]

Hi there, sorry for the delay in response. Yes, short answer. We can indirectly detect myopia while using orthok. The follow ups we have with our patients is to detect for that. We test for something called “over refraction” to see if there is a prescription overtop. I take it a step further where I use axial length measurements to see if the child’s eye is growing unnaturally. The simplest way is to also ask the patient’s perspective around how vision has been while wearing their orthok lenses. I hope that helps. Let me know if you have any further questions

[@brucefigueroa2476]

haopens to me .. dryness,, so i get eye muscle imbalance

[@drnataliechai5551]

Hello - yes, dryness is very prevalent even without contact lens wear. I hope you have found the necessary help you need!

[@Allan-et5ig]

drnataliechai - Doctor, love this video. We Ortho-K 'victors' love to talk about them. I'm far too old really to have a go. I tried them in California in 2014 (they were totally free to give credit) but the super-skilled doctor was so shocked they didn't work well he gave up on me. Still, I had two nights, yes nights when they are not supposed to work well where I was out-seeing 20-20 friends. I could see fine print on Bank of America sign they couldn't. Tried them again this year and miracle of miracles 20-25 right 20-15 left. For people who are candidates I'd say there are only two caveats, one quite serious - but not so serious people shouldn't go for it. . Results can be a little different day by day. Even on days when you didn't accidentally touch your eyes during sleep. Some days are good. Others are fantastic. . I can - again, miraculous - drive at night. But most folks I'm told need to get a pair of driving glasses where some power is taken off because Ortho-K works better during days for most. I'm an incredibly lucky excpetion, I'm told. While legal in most states, say your vision drops to 20-40 at night. NOBODY should be driving in my opinion at 20-40 on a dark freeway. Hope this wasn't too boring! Like I say (I looked through faulty glass at an eclipse when I was a kid) to have this kind of rock star vision restored without surgery is a miracle.

[@paololigorio4318]

MI PIACE ASCOLTARE TUTTO E TUTTI I CONSIGLI MA COME MAI QUESTA DOTTORESSA PORTA GLI OCCHIALI E NON HA FATTO NULLA DI TUTTO CIÒ X SE STESSA DATO CHE SI TROVA DI MESTIERE ED È NELL' AMBIENTE OCULISTICO NIN VI SEMBRA STRANO

[@otiebrown9999]

Tragically, it is not effective. You remain myopic, at $1,300 per year.

[@blinkxzzz3737]

Again with frames that are so ugly on you they dont love you back! You must like looking like your in your mid 60s