Orthokeratology is an invaluable tool in the fight against myopia progression in children. This fight against progression of myopia is important as we start to view myopia as a public health issue due the various health risks associated with higher myopia. Myopia intervention is the term we use to describe various methods aimed as slowing or stopping myopia progression. Myopia intervention is gaining more traction thanks to recent research that compared different methods to slow or stop progression of myopia in children.
I’ve touched on the the pivotal study, Efficacy Comparisons of 16 Interventions for Myopia Control in Children, in a previous post. I highly encourage parents to read that previous post as well as the study itself. It was this study that showed Orthokeratology was second only to low-dose atropine as the most effective control of myopia progression in children. Other studies support low-dose atropine as a very effective means of myopia control. But, orthokeratology is effective enough to be considered as a primary myopia intervention in children.
Orthokeratology uses a special, custom-made hard contact lens to flatten the cornea. The lenses are FDA approved to be worn in children. They are FDA approved to be worn overnight. The added benefit is that, due the reshaped cornea, glasses and contact lenses are not needed during the daytime to see clearly. The child wears the lenses while sleeping, takes them out in the morning, goes to school and sees great without glasses. While this is a major benefit, the studies show Orthokeratology is very effective at control the elongation of the eye. It’s this constant elongation of the eye in some children that is resulting in very progressive myopia.
In our practice, we refer to orthokeratology as CRT (Corneal Reshaping Technology) because it’s a bit easier to say and more descriptive. But, no matter what it’s called, it’s a very attractive means of myopia intervention. It’s keeping nearsighted children from getting more nearsighted year after year and the children don’t have to wear glasses or contact lenses during the day.
The number one question I get from parents about orthokeratology or CRT is “is it safe?” Yes, it is safe. Yet, any contact lens comes with some risks. In my recent post on contact lens wear and kids, I advocated daily disposable contact lenses as the safest contacts. That is because it takes away the risk of eye infections or complications due to lens hygiene. However, the orthokeratology lenses are meant to last for up to a year. Thus, diligent cleaning and lens hygiene are extremely important. Parents can and must play a very active role in that process. But, the children must be an active participant as well. If the lenses are cleaned and maintained properly, the risks for eye health issues are greatly reduced.
Not all children are candidates for orthokeratology. However, I encourage the parent of any child that is seeing worsening myopia to find an optometrist that is well experienced in fitting these specialty contact lenses. The optometrist will evaluate the child’s prescription, eye shape, progression of myopia, and other contributory factors to develop the right solution.
As always, I’d love to hear your feedback and/or questions!