Nighttime Orthokeratology Lenses for Myopia in Children: Benefits and Risks

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Are there approved overnight orthokeratology lenses (rigid gas-permeable contact lenses for myopia treatment)? What is their effectiveness in treating myopia in school-aged children? Is their use recommended? What are the side effects? What brands are available? Can you recommend treatment clinics and provide information on related costs?

Tsai, 20~29 year old female. Ask Date: 2004/02/03

Dr. Hu Yusheng reply Ophthalmology

Dear Ms.
Tsai,
Corneal reshaping lenses, also known as orthokeratology lenses, are a type of contact lens designed to reshape the cornea's surface.
The principle behind these lenses is to redistribute the surface cells of the cornea, altering its curvature to achieve the desired refractive power.
This allows for wearing the lenses overnight, eliminating the need for glasses during the day.
However, this effect is temporary; if the lenses are not worn for 1 to 2 weeks, the original refractive error will return.
There are potential serious side effects, including corneal ulcers and corneal hypoxia.
Proper care and maintenance of the lenses are essential to minimize these risks.
Short-term side effects may include astigmatism due to improper fitting.
Currently, it has not been proven that these lenses can prevent the progression of myopia.
The cost of a pair of these lenses ranges from approximately $30,000 to $60,000 NT.
Therefore, it is important to weigh the aforementioned advantages and disadvantages before making a decision.
Sincerely,
Hu Yu-Sheng

Reply Date: 2004/02/03

More Info

Nighttime orthokeratology lenses, also known as ortho-k lenses, are specialized rigid gas-permeable contact lenses designed to be worn overnight. They temporarily reshape the cornea to reduce myopia (nearsightedness) during the day without the need for glasses or contact lenses. This method has gained popularity, especially among children, as a non-surgical option to manage myopia progression.

Benefits of Nighttime Orthokeratology Lenses
1. Myopia Control: Studies have shown that ortho-k lenses can effectively slow the progression of myopia in children. The lenses work by flattening the central cornea, which alters the way light enters the eye, reducing the eye's overall length and thus controlling myopia progression.

2. Convenience: Children can enjoy clear vision during the day without the hassle of wearing glasses or daytime contact lenses. This can be particularly beneficial for active children involved in sports or outdoor activities.

3. Safety: Ortho-k is a non-surgical option, making it a safer alternative compared to refractive surgeries like LASIK, which are not typically recommended for children due to their still-developing eyes.

4. Improved Quality of Life: Many children and parents report improved quality of life due to the freedom from glasses or daytime contacts, which can enhance participation in various activities.

Risks and Side Effects
While ortho-k lenses are generally safe, there are potential risks and side effects to consider:
1. Corneal Hypoxia: Wearing lenses overnight can lead to reduced oxygen supply to the cornea, which may cause complications if not monitored properly.

2. Infection: Improper lens hygiene or wearing lenses longer than recommended can increase the risk of eye infections, such as keratitis.

3. Discomfort: Some children may experience discomfort or dryness when first using ortho-k lenses, although this often improves with time.

4. Variable Results: Not all children respond equally to ortho-k treatment. Some may experience less effective myopia control than others.

Approved Brands and Recommendations
Several brands of ortho-k lenses are available, including:
- Paragon CRT: One of the most widely used ortho-k lenses, known for its effectiveness in myopia control.

- Bausch + Lomb Vision Shaping Treatment (VST): Another popular option that has shown positive results in clinical studies.

- Menicon Z Night: A newer lens that has gained attention for its design and effectiveness.

Recommendations for Treatment Centers
When considering ortho-k lenses, it is crucial to consult with an eye care professional who specializes in myopia management and orthokeratology. Look for:
- Certified Orthokeratology Practitioners: Ensure the practitioner is certified and has experience with ortho-k lenses.

- Comprehensive Eye Exams: A thorough eye examination is essential to determine if your child is a suitable candidate for ortho-k.

Cost Considerations
The cost of ortho-k lenses can vary widely based on the practitioner, location, and specific lens brand. Generally, the initial fitting and lenses can range from $1,000 to $2,500 for a year, including follow-up visits. It is advisable to inquire about the total cost, including any necessary follow-up appointments and lens replacements.

Conclusion
Nighttime orthokeratology lenses can be an effective and convenient option for managing myopia in children. However, it is essential to weigh the benefits against the potential risks and to work closely with a qualified eye care professional to ensure the best outcomes. Regular follow-ups and proper lens care are crucial to minimize risks and maximize the effectiveness of the treatment.

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