Although laser eye surgery has become a low risk and easy-to-execute procedure, it is still invasive.

Gary Rodney, the Founder of Smart Vision Optometry and a leading Smart Vision Optometrist at Eyes InDesign Mosman, discusses an alternative non-invasive surgery to correct and improve vision.

Smart Vision Optometrists resource to non-invasive surgeries in their practice.

Many patients do not qualify for eye laser surgery, as they may have irregular corneas, or other conditions, such as inflammation, and bacterial infections often caused by poor hygiene. Additionally many patients are worried about eye surgery given the burning of the inner layers of myopia correction surgery can have permanent negative effects. Many “laser surgeries involve the burning of the matrix of the inner layers of the corneal tissue to flatten and reshape the cornea to correct vision, however this is not always a once-off fix, because the underlying issues of what caused them to become short-sighted in the first place has not been addressed and so the process may need to be repeated and burnt again,” says Rodney.

Laser surgery, such as LASIK, is invasive to the eye and can cause damage or injury to the eye, such as cornea damage, and may cause other complications such as eye infections and permanent dry eyes.

Invasive surgeries are no longer the only option for vision correction, as smart vision optometrists offer non-invasive methods and procedures.

Smart vision optometrists use vision therapy, therapeutic spectacle and contact lenses to improve comfort, enhance performance and optimise visual development.  Visual therapy is a “non-invasive method used to improve and manage different eye conditions,” says Rodney. This technique involves exercises that help improve the visual system.

Orthokeratology (Ortho-K)

Orthokeratology, also referred to as corneal reshaping treatment, is “a non-surgical vision correction alternative,” says Rodney. Corneal reshaping (CR) is a therapeutic process which reshapes the cornea using reverse geometry contact lenses. This flattens the cornea to reduce nearsightedness.

There is “no age barrier to this procedure as it is safe for both children and adults,” says Rodney. The non-surgical vision correction procedure can correct refractive errors such as mild to moderate and even large (in some cases) myopia, hyperopia and astigmatism. Ortho-K is safe and effective for children as it has been proven to treat myopia effectively. Evidence based practice has made the process very safe provided a minimum standard of care is followed. Thus includes regular checks with your orthokeratologist, tap water never used on the lenses or case at any time, hydrogen peroxide disinfection, 12 monthly lens replacement, and a perfectly fitted lens from an experienced orthokeratologist. The procedure is not effective on certain shaped corneas. “Ortho-K is also suitable for sportsmen and women, swimmers, and simply those who do not wish to wear glasses or contact lenses,” says Rodney.

Like refractive surgeries, Ortho-K gives clear unaided vision, however it has no surgical risks and is reversible. The most important part for children though is the proven effectiveness against minimising myopia progression. So it has a large preventative effect.

The Ortho-K gradually reshapes the front surface of the cornea to reduce myopia, hyperopia and astigmatism. The vision retainer is similar to contact lenses, but are worn at night while sleeping.

While asleep, “the lens uses the force of the eyelid and tear fluid beneath the lens to reshape the top of the cornea,” says Rodney. Upon awakening the patient’s vision remains clear throughout the day, without using contact lenses or glasses.

“This procedure is non-surgical vision correction is painless and reversible,” says Rodney. Ortho-K does not permanently change the shape of the eye. “The eye shape will revert to its original state within one to two weeks if the lenses are no longer worn,” says Rodney. However, improvements are visible the day after, and the procedure stabilises after a week. The process for high myopia, astigmatism and hyperopia, can take up to two to four weeks to achieve full correction.

The Ortho-K lens “offers relief from problems associated with contact lenses, such as dry eyes, and dust that may get trapped in and under the contact lens,” says Rodney.

Smart Vision Optometry clinics are located in Sydney. Book a Smart Vision Comprehensive Vision Skills Assessment or Advanced Eye Health Test for any child or adult by calling the Mosman clinic (02) 9969 1600 or the Bondi clinic (02) 9365 5047, alternatively book an appointment online.

Orthokeratology, or Ortho-K, is designed to guide the eyeball into its optimal shape for focus, potentially reducing myopia or astigmatism. There’s even conclusive evidence that Orthokeratology can slow the progression of myopia in children, a finding that Gary Rodney finds particularly satisfying. 

Strange as the idea of wearing contact lenses by night may sound, Ortho-K has been around for a while, and it has been stringently tested. The notoriously careful FDA in the United States found that 65 percent of patients selected for the treatment achieved 20/20 vision, with over 90 percent achieving a rating of 20/40 or better. 20/40 is considered as being “slightly” nearsighted – a person who may or may not decide to wear glasses. 

The Process

It all begins with an eye examination by an optometrist who has studied the field of orthokeratology – better still if they have been accredited to be a Fellow of Orthokeratology. If an initial examination indicates that Ortho-K can help, he or she will map the cornea’s surface using a corneal topographer. It’s contact-free, much like any other eye test, and the information it gathers will be used to make customised contact lenses.

“Usually, your lenses will flatten and mould the cornea somewhat,” says Gary. “The lenses are hard, but not uncomfortable, especially once you’ve grown accustomed to wearing them.” In the morning, after you remove your contact lenses, the cornea remains flattened for the day, allowing for clearer focus without glasses. “It is just like when you remove a finger ring that has been worn for a while there is an indentation that stays on the finger for the next day. That’s orthok but ion microns of shape change. In most instances, it takes about two weeks to achieve the full shaping process for which each set of lenses is designed,” says Gary. In a complex scenario, the person will go through three sets of lenses since shaping the cornea is a gradual process.

Having reached the desired shape, the cornea can’t be left to itself. It’s best for most people to keep wearing retainer lenses every night, or at least most nights, in order to enjoy being able to see without glasses by day. 

Sleeping with Contact Lenses Can Have Benefits

Gary Rodney says that kids and people with active lifestyles often benefit form Ortho-K. “For example, you shouldn’t surf with contacts, and unless you’re going to get prescription surfing goggles, you can’t do it with glasses either,” says Gary. “Kids, on the other hand, like rough and tumble, and glasses or contacts are less practical by day.”

And, of course, some people don’t want to wear glasses, and either don’t want to, or can’t, wear contacts by day. From a practical perspective, using Ortho-K lenses has a similar effect to glasses or contact lenses. They correct vision but don’t have a permanent effect if one stops wearing them. However, it is used at night, and there are a lot of personal and practical reasons why people choose this option instead of opting for glasses, regular contacts, or surgery to correct their vision.

Most tantalising of all is the possibility that Orthokeratology could slow the progression of myopia, especially in children. “There’s a rise in myopia,” says Gary, “and Eyes in Design is particularly interested in myopia control, particularly in children. Helping them to see better for longer would be the ultimate goal Eyes in Design would like to achieve.”

HEAR: Ultra106.5FM Interview with Gary Rodney – Covid and Myopia: What you need to know!

For more information on Orthokeratology and Smart Vision’s approach to myopia management, or to book an appointment, visit the Smart Vision website: Optometrists Sydney: Optometry Services For Children and Adults | Smart Vision; for specific information about Myopia treatment and prevention visit Myopia Prevention: Solutions, Control And Treatment In Sydney; and for detailed information about Myopia Treatment visit Orthokeratology In Sydney: The Non Surgical Alternative.

To book an appointment for a thorough eye check-up, click here or Call the Bondi clinic on (02) 9365 5047 or the Mosman clinic on (02) 9969 1600.

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