Is Ortho K a Good Alternative to LASIK?

January 16, 2018

Orthokeratology, sometimes called Ortho K, is IMHO a dangerous pseudo-technology that can at least cause permanent corneal warpage and at worst cause blindness or the loss of an eye!

The practitioners of Orthokeratology would have you believe that the risks of Orthokeratology are not greater than the wearing of any other rigid contact lens.  However, rigid daytime wear contact lenses do not include the risk of sleeping in any contact lens.  This risk is related to reduced oxygen supply to the cornea which can cause corneal edema, abnormal reshaping of the cornea, and/or blood vessel invasion of the normally avascular cornea.

Some of these practitioners promote Orthokeratology to slow down the progression of progressive myopia in children.  In my opinion, the risks outweigh the benefits and there are no valid scientific studies that prove the thesis of progression reduction.  They tend to be the same practitioners who promote “Vision Therapy”, a pseudoscience that has been proven time and again to have no lasting effect on improvement of vision in children.

Ortho K Side Effects

The common side effects listed in a review of Orthokeratology include corneal swelling and staining, pain, redness, tearing, irritation, discharge, abrasion of the cornea, distortion of vision.  Rarer side effects include permanent corneal scarring, decreased vision, ocular infections, corneal ulcer, iritis, neovascularization.

The contraindications to the use of Orthokeratology are rather obvious and are listed on the FDA website as:

  • Acute and subacute inflammations or infection of the anterior chamber of the eye.
  • Any eye disease, injury, or abnormality that affects the cornea, conjunctiva or eyelids.
  • Severe insufficiency of tears (dry eyes).
  • Corneal hypoesthesia (reduced corneal sensitivity).
  • Any systemic disease which may affect the eye or be exacerbated by wearing contact lenses.
  • Allergic reactions of ocular surfaces or adnexa which may be induced or exaggerated by wearing contact lenses or use of contact lens solutions.
  • Allergy to any ingredients, such as mercury or Thimerosal, in a solution which is to be used to care for contact lenses for Orthokeratology.
  • Any active corneal infection (bacterial, fungal or viral).
  • If eyes become red or irritated.

A recent report from NPR.org details the experience of a 9-year-old who developed a fungal ulcer of his cornea requiring a corneal transplant to save his eye.  He will no longer be able to play any sports, which was the reason the family chose Orthokeratology to begin with! He will need anti-rejection medication for the rest of his life!