How Clinically Significant is Orthokeratology in Myopic Progression in Children?

The decade saw a rising clinical interest in treatments for myopic progression. Researchers and experts in the field have been digging deep into myopic control methods. Orthokeratology is an emerging and proven treatment for controlling myopic progression.


What is Orthokeratology?

Also, known as ortho-k this process is used to correct the problem of nearsightedness. A specially designed lens is used to temporarily reshape the cornea to enhance vision. It is often said to work similar to the braces for your teeth. Although there has been no solid evidence that this can work on improvising vision numerous researches are taking place to prove its significance. It is an easy and non-invasive way to improve vision, especially in children.

How Does Ortho-K Work?

The cornea is responsible for focusing the light on the retina. Hence, it is adjustable to the amount of light it receives. It has very flexible tissues. This flexibility forms the basis of this entire treatment.

  • The surface of the cornea is measured using a corneal topographer. After understanding the shape and curves of your eye, a lens is designed especially for your eye. 
  • The lenses flatten the surface of the cornea. Thereby, changing the direction of light as it enters the eye. 
  • It is suggested to wear these lenses at night so that it gets enough time to flatten the cornea. 
  • The orthokeratology lenses are sturdy and gas-permeable. So, it allows proper flow of oxygen overnight along with flattening the cornea. 
  • Once, you remove the lenses the cornea remains flattened for a small period. This corrects the vision without the usage of any glasses or surgery. 
  • But, if you stop wearing the lenses for a prolonged period, your cornea would return to its original shape. Hence, the refractive error would also return. So, you have to continue wearing the lenses to keep up with vision correction.


Effectiveness of Orthokeratology in Treating Myopia:

  • This technique has been particularly found useful for Children under the age of 6-9 years who experience an increase in their axial length greater than 0.20mm every 7 months or spherical equivalent in terms of myopic progression up to 1 diopter per year are suitable for ortho-k lenses. 
  • Ortho-k lenses have proven to slow down axial elongation up to 50% or at least 40-45%. 
  • Axial length correction is considered to be the most critical part of the treatment of myopic progression. Hence, axial length elongation is considered to be the baseline instead of the spherical equivalent. 
  • In a study of about 35 children, axial length elongation was found to be 0.23 + 0.25 mm in kids who wore ortho-k lens. Whereas, kids who wore spectacle showed an axial length elongation of about 0.48 + 0.26 mm. 
  • The study suggested that the kids wearing ortho-k lenses showed a reduction of about 50% in myopic progression. 
  • When a similar 5-year study was conducted on kids under the age of 8-12 years, myopic progression ameliorated to 50% in the very first year of the treatment. 
  • However, it was noticed that in the last 3 years of the study, there was no drastic change or reduction in myopic progression in the mentioned group. This suggests that the longer the treatment, the effect of ortho-k lenses decreases in the due course.

How Safe it is to Get Orthokeratology Treatment for Children?

The most common problem with children when it comes to ortho-k lenses is maintaining good hand hygiene. Contact lenses are bound to lead to several microbial and bacterial keratitis infections. Such, infections can even lead to lifelong vision impairments. Hence, you must consult with your doctor before going ahead and opting for ortho-K treatment. 


There are several incidences which show the effectiveness of this treatment.  So, if you are looking forward to getting these lenses for vision correction for your children, you can feel free to consult an ophthalmologist and get details about orthokeratology.

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