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How Safe are Ortho-k Lenses?

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Thinking about orthokeratology in NYC? Learn more from our eye care experts

When orthokeratology, better known as ortho-k, was first introduced in the 1960s, the technique wasn’t regarded as highly successful. However, science has advanced by leaps and bounds since then – and the safety and efficacy of ortho-k has improved significantly. Unfortunately, many misconceptions that date back to the early days of orthokeratology are still circulating. Our eye care professionals are here to set the story straight with the facts about ortho-k in NYC.

What is orthokeratology?

Ortho-k is a method of vision correction that temporarily corrects myopia or astigmatism in adults or slows the progression of myopia in children. It involves wearing specialized, gas-permeable contact lenses while you sleep.

As you doze, the ortho-k lenses reshape your cornea, which is the clear part of your eye over your pupil. The cornea is responsible for refracting light back on to the retina, and an irregular cornea leads to blurry or double vision. Ortho-k treatment gently molds your cornea into a regular shape, and when you remove the lenses in the morning, your vision will be much sharper – eliminating the need to wear prescription glasses or contact lenses for nearsightedness.

Who gets orthokeratology?

In general, ortho-k is recommended for:

  • Patients who are not good candidates for LASIK
  • People who want vision correction for myopia, without eyeglasses or daytime contact lenses
  • Sufferers of dry eye and/or allergies who have trouble wearing regular contact lenses
  • Children and adults who are extremely active in sports
  • Children whose parents are interested in slowing their myopia progression

Are ortho-k fittings very complicated?

We regularly perform comprehensive fittings for orthokeratology in New York City. While the sessions may take longer than a regular contact lens fitting, the process is relatively simple and has a high success rate after the first attempt. In fact, by using advanced wavefront technology, we can map your eye’s corneal surface precisely and efficiently, ensuring a custom-tailored design that is safe and effective.

Is it safe to reshape the cornea with orthokeratology?

The FDA has declared that ortho-k lenses are safe for use by people of many ages, including young children and adults – as long as the specialized contact lenses are made from certain highly gas-permeable materials. The risks of ortho-k are very similar to the risks of wearing any type of contact lenses.

There is an old myth that ortho-k works by squishing your eyes. But presently, the modern, advanced ortho-k process is designed to use hydraulic forces and the eye’s natural fluids beneath the contact lenses – and not on the application of pressure to the cornea (which is what was done way back in the 1960s). Now, when you choose our optometry practice for orthokeratology in NYC, we optimize your eye safety by using the most advanced techniques possible.

What risks are associated with ortho-k?

Every year, about 1 million Americans visit their eye doctor for treatment for an eye infection. Wearing ortho-k lenses has been linked to an increased risk of bacterial and microbial eye infections. The primary cause of these infections is inadequate hygiene. In other words, a majority of eye infections from ortho-k occur because the wearer didn’t wash his or her hands properly or disinfect the contact lenses correctly. If you’re interested in ortho-k in NYC, we can’t stress enough how critical it is to keep your hands and contact lenses clean!

How do I know if orthokeratology is right for me?

This question can only be answered after a comprehensive eye exam performed by a qualified eye doctor. No treatment is right for every individual, and you need a professional evaluation to assess your candidacy for orthokeratology. Contact our eye care center to book a consultation for orthokeratology in NYC.

COVID-19: Protect Your Eyes From Too Much Screen Time

You and your children are likely spending more time on mobile devices and computer screens than ever before. Too much time spent staring at screens can cause computer vision syndrome, or digital eye strain, in certain people. While not serious, this condition can be very uncomfortable, potentially causing:

  • Headaches
  • Eyestrain
  • Blurred vision
  • Dry eyes
  • Insomnia
  • Tiredness

Below are some useful tips to help you and your children avoid computer vision syndrome:

Blink more!

Staring at a screen strains the eyes more than reading printed material because people tend to blink 30-50% less. This can also cause your eyes to dry out. Be mindful of blinking and make it a habit when focusing on a screen, as it will keep your eyes healthy and lubricated.

Follow the 20-20-20 Rule

Give your eyes a break every 20 minutes by looking at an object located 20 feet away for 20 seconds. Doing so will allow your eyes to relax and will give both you and your eyes some rest.

Keep your distance

Your eyes work harder to see close up than at a distance. Try keeping your monitor or screen at arm’s length, or about 25 inches away.

Lighting matters

Make sure that your surrounding light is similar in strength to the light emanating from your screen. Contrasting levels of light, such as looking at a bright screen in a dark room, can strain the eyes.

Take breaks from the screen

You may want to stipulate ‘screen free’ time for yourself and/or your children, such as during meal times or for several hours throughout the day. Engage in hobbies that don’t require a screen, such as drawing, reading books, doing puzzles, playing an instrument or cooking (among many others).

Don’t use devices before bed

Studies show that blue light may affect your body’s circadian rhythm, also known as the natural wake and sleep cycle. Stop using screens one to two hours before bedtime or use nighttime settings to minimize blue light exposure.

Although it may require a bit of planning to protect your family’s eyes during this stressful time, ultimately, it’s all about balance — and what works for you and your family may differ from others.

Learn how to protect your child’s eyes

There are several options for myopia control. Not all eye doctors are trained in childhood myopia control. Find out your options for treatments.

From all of us at Eye Q Optometrist at New York City & Scarsdale, we wish you good health and please stay safe.

Farsighted and over 40?

It’s a drag being Farsighted and over 40! Most Farsighted (hyperopic) patients see great their first 30-40 years, but then it smacks them in the face. When you are Farsighted and around 40, your eyes have to work very hard to focus. The closer you look the harder it gets. Since hyperopes are not use to wearing glasses or contacts from a young age, this is really a big change for them. The good news is that now some of our happiest patients can see great again, Far and Near after removing Multifocal AOK retainers. Once again they have regained their glasses and contact lens free vision. These retainers have been available for Nearsighted patients for a while, now our Farsighted patients can enjoy the freedom as well.

If you think smoking and high blood pressure are bad …

In today’s post you will see a controversial point which supports some of my previous posts about Nearsightedness being a risk factor for certain sight threatening eye diseases. I will be sharing a note I received from the very wise doctor Richard L. Anderson, OD, FIAO. What you will read below is a comparison of cardiovascular disease to ocular disease and you will see how the risk factor (Myopia / Nearsightedness) has a significant “Odds Ratio, OR” for contributing to eye diseases such as glaucoma, retinal detachments, and maculopathy. This is one reason, I feel treating children early and preventing or slowing down the rate of their nearsighted progression is important.

It’s time to treat myopia as a disease process that is a threat to ocular health from a myriad of related disease processes. No longer can we treat myopia as an inconvenience to be compensated for with glasses or contacts. Myopia is a risk factor for other sight threatening diseases that is “far in excess of any identifiable population risk factor for cardiovascular disease.” That’s from a paper D.I. Flitcroft. (2012) The complex interactions of retinal, optical and environmental factors in myopia aetiology. (ABSTRACT) Progress in Retinal and Eye Research VOL 31 (2012) 622-660 doi: 10.1016/j.preteyeres.2012.06.004

What does this mean? It means that myopia as a risk factor for vision loss is worse than any risk factor known for cardiovascular disease. That’s from Flitcroft, not me.

Take a look at the tables – they even appear in the abstract in the link. An “Odds Ratio” of 1.5 means that the second factor is 1.5X as likely to happen if the first factor is present.

There is no “safe” level of myopia. Forget about the idea of pathological myopia starting at -6.00. It’s all pathological.

Myopia of -1.00 to -3.00 has an OR of 2.3 for glaucoma. Myopia of > -3.00 has an OR of 3.3 for glaucoma. Myopia of -.75 to -2.75 has an OR of 3.1 for retinal detachment Myopia of -6 to -8.75 has an OR of 21.5 for retinal detachment Myopia of -1.00 to -2.99 has an OR of 2.2 for myopic maculopathy

How does this compare to cardiovascular disease risk factors? Systolic BP of 150-159 has an OR of 2.2 for stroke risk. Systolic BP of >160 has an OR of 3.2 for stroke risk. Smoking >20 cigarettes a day has an OR of 2.9 for stroke risk. Systolic BP < 140 on Rx has an OR of 2.6 for myocardial infarction

What do I think?

Myopia is a disease.

The compensation of myopia by prescribing glasses is an outdated vision related service.

The treatment of myopia by the prescription of specific myopia control procedures is a medical service whose benefit is the reduction of sight threatening disease processes.

Any attempt to place myopia treatment in the realm of vision services makes no more sense than considering glaucoma treatment a standard vision exam.

Nearsightedness Linked to Open-Angle Glaucoma

From Reuters Health Information Nearsightedness Linked to Open-Angle Glaucoma Print This Print This Read this article on Medscape’s free mobile app. Download Now By Alison McCook NEW YORK (Reuters Health) Jul 01 – Nearsighted people may have nearly twice the average risk for glaucoma, according to a new meta-analysis. The study, reported online June 20th in Ophthalmology, focused on the link between nearsightedness and open-angle glaucoma, the most common form of the disease. Dr. Nomdo Jansonius at the University Medical Center Groningen in the Netherlands and colleagues pooled data from 11 previous studies that included tens of thousands of people. They found that, overall, nearsighted people were about 90% more likely to develop open-angle glaucoma. Those with higher levels of myopia appeared to be at higher risk of glaucoma. The findings only show that nearsightedness and glaucoma often co-occur, not that one causes the other. Furthermore, the studies the authors included were heterogeneous in terms of patient ages and different diagnostic criteria. “The results are, in a sense, an average,” and may not be applicable to every group of people, Dr. Barbara Klein of the University of Wisconsin-Madison, who worked on one of the studies included in the new review, told Reuters Health “A conclusion might be that persons with high myopia should have regular ophthalmic examinations,” Dr. Klein said. At this point, however, the U.S. Preventive Services Task Force says there is too little evidence to recommend for or against glaucoma screening. SOURCE: http://bit.ly/mUP30n Ophthalmology 2011.

A thank you to our Pediatricians!

Over the years I’ve seen many great changes in AOK. Recently I noticed what may be the most important ones, awareness and acceptance by pediatricians. As orthokeratology becomes more popular and new studies keep supporting it’s safety and benefits, I see more patients asking if they are candidates. As more and more pediatricians learn about orthokeratology more of their patients are being treated. This is great news! I’m encouraged to see this new trend. I hope to soon see the same public awareness of orthokeratologist as orthodontist.

Now AOK is available for Far Sighted patients as well

AOK for Hyperopia is now available. I have also launched our AOK for Presbyopia. These new designs will allow many patient over 40 years of age to continue to see in the distance as well as read up close without the need for reading glasses.

Top 5 questions about AOK you should have answered

1. Do you know that (a child’s) nearsighted progression can be controlled? Recent studies indicate it can be. If treated by an Orthokeratologist, nearsighted progression can be slowed or stopped entirely. These children are not given any drugs like atropine. They are treated with special AOK retainers (which look like small contact lenses). These lenses are used only during sleeping hours and are therefore very comfortable. I treat children of any age, myopia, however generally begins around 7 or 8 years of age.

2. Do you know the risks of becoming a highly nearsighted individual? As myopia increase so do the risks of sight threatening eye diseases. Theses diseases include Glaucoma, Macular Degeneration, Retinal holes – tears – or detachments. Preventing disease in adulthood starts with prevention in childhood. LASIK does not reduce these risks.

3. Do you know how to avoid wearing eyeglasses? Many children and adults are candidates for AOK. This treatment also allows patients to see clearly during the day without needing to use glasses or traditional contact lenses. When a patient wakes in the morning, their vision is clear through the retainers. However, the retainers are not left on the eyes. They are remove upon waking. The patient now has clear vision without any additional help from glasses or contacts. The vision stays clear all day long.

4. Is Advanced Orthokertaology (AOK) all the same? The short answer is No. The long answer is that AOK is very orthokeratologist dependant. Since AOK has become popular in recent years, more doctors have become FDA certified to treat patients. This is a short online course a doctor must pass in order to begin fitting patients. An experienced orthokeratologist has years of training in the field of orthokeratology and see’s AOK patients on a regular basis. Fellowship trained orthokeratologist have demonstrated advanced knowledge and proficiency in the field of orthokeratology, and are acknowledged by the International Academy of Orthokeratology. The outcome of the procedure in regards to the quality of vision and the continued health of the eyes is directly related to the doctors experience and skills.

5. Is AOK the same as CRT? Corneal Refractive Therapy (CRT) is one type of Advanced or Accelerated Orthokeratology (AOK). AOK is not only CRT, it many include may different types of retainer lenses. CRT is a specific retainer design that is available in different parameters to fit many people. It is not a custom made lens using 1000’s of data points, therefore does not work as well as a custom made lens. In my practice I have a few patients in CRT and other pre-designed lenses, however most of our patients are in custom made retainers designed by me. First, I take a special picture (topography) of the patients eye. Every patient has a unique topography, it’s like a fingerprint of the eye. I convert and transfer the picture data to a computer program that allows me to design a custom retainer for each unique corneal shape. With over 10 years of custom designing lenses for my patients I have developed a strong understanding and preference for this method. I have had great success of taking over complicated unsatisfied CRT patients and refitting them successfully with custom AOK. There are many more questions you may have regarding AOK. Reading through my blog and visiting my website may answer them. If you have additional questions, please schedule an appointment for a consultation at either of my offices. Choosing the right doctor is the most important decision you need to make.

Cutting Edge Eye Care without the cutting!

April 28-May 1, 2011: Orlando, Fl. Abraham Zlatin, O.D. attended the Orthokeratology Academy of America educational conference. The OAA is an international organization of orthokeratologists who provide a nonsurgical alternative to refractive surgery for nearsighted eyes, astigmatism and hyperopia. Current research also shows that Ortho-K can slow myopic progression in children. The keynote address was given by Melbourne Hovell, Ph.D., M.P.H.-Graduate School of Public Health in San Diego-Myopia as a Public Health Concern. The international faculty of presenters covered topics including myopia control (including soft lens technology), corneal reshaping research, safety of corneal reshaping, progressive/hyperopic Ortho-K lens designs, new corneal reshaping technologies, post Lasik/ Keratoconus Ortho-K designs, lens designs for corneal rehabilitation, corneal cross-linking and Ortho-K in China.

President Dr. Cary Herzberg had the pleasure of announcing the inception of the new International Academy of Orthokeratology(IAO). The IAO brings together ortho-K organizations from the America (OAA) as well and Europe and Asia. This international organization will support, promote and advance corneal reshaping worldwide thru quality education and research presentations at meetings held around the world. The first meetings are planned for Europe (Fall 2011), China (March 2012) and Phoenix(April 2012). For more information about Ortho-K go to www.Eyeqdr.com

Nearsighted No More

The Nearsighted Epidemic

This is the start of my blog. Hopefully I will be able to open your eyes to a completely different way of correcting your vision. My goal is to educate as many people as I possibly can about the risks of nearsighted (Myopic) eyes and a ways to manage it. Many people only know about glasses, contact lenses or laser eye surgery (LASIK). There is, however another treatment; One that according to recent studies, may slowdown the progression of nearsighted eyes, while allowing you to be free of glasses and day time contacts. There is NO laser or surgery involved. Introducing, Advanced Orthokeratology (AOK). Other methods to manage the progression of nearsighted eyes include specialized myopia control contact lenses and medications such as Atropine.

One Question I hear is “Is it safe?”

Yes! Like with contact lenses, it’s always important to keep AOK molds clean and to wash your hands. On June 13, 2002, the FDA approved the marketing of Paragon CRT lenses, one form of AOK for nearsighted kids. The FDA also approved for marketing these overnight retainers for any age. The safety is well proven, with over 40 years of corneal molding history combined with today’s super high oxygen permeable materials. Another reason the safety is so high is that AOK is also reversible. Since it is non-invasive (not surgical) there is no permanent change to the cornea.

With LASIK or other laser eye surgeries if there happens to be a poor visual outcome, it usually requires more surgery and/or specialty contact lenses. Sometime even those solutions do not provide normal vision. Keep in mind this is rare but does happen with surgery. Unlike surgery, AOK is reversible and will allow a patient to return to an untreated condition over a one to two week period of discontinuing treatment. The risks of AOK are similar to contact lenses. Those who use tap water to take care of their lenses and do not disinfect them prior to insertion may develop eye infections. Some eye surgeons have used negative reports from other countries and used these uncontrolled reports in their studies. In the past, AOK patients in other countries were not necessarily examined by trained doctors certified in corneal molding. In addition, the few eye infections reported in foreign countries were a result of poor hygiene and unsanitary conditions not the molding procedure. AOK is a very gentle procedure that leaves your eyes feeling comfortable and clear.

This sounds perfect!

Nothing is perfect. AOK works well when fit properly by an experienced Optometrist. However there are times it just doesn’t work well enough. The good news is, those times are very rare and the solution is simple, just stop using the retainers. AOK is amazing I must say. The happiest patients I have are the ones that have found this incredible way of seeing. Seeing the awe on their face when they read the eye chart for the first time with out glasses or contacts, is my favorite part.

LASIK for Kids?

Not exactly… Nearsighted children are not allowed to have refractive surgery. However, AOK is safe and effective for kids of all ages. The benefits of AOK are similar to LASIK, in that the patient is free of glasses and contact lenses. If you have been reading my blog this is not new information. You also now know that AOK helps slow the progression of nearsightedness. The question is, is there anything that can be done to prevent nearsightedness before it starts? We do know that Myopia has been increasing in the USA at an alarming rate. One hundred years ago 5% of us were nearsighted; today it’s over 30%. This is a progressive disease affecting 1.6 billion children and adults worldwide. We expect myopia will increase to 2.5 billion by 2020. Educating parents and children about vision is the first step to controlling this epidemic. I am willing to speak to groups of parents, teachers, children and businesses to bring awareness to this growing problem. If there are any schools, PTA’s or other organizations interested in scheduling a lecture please contact me.

8 Tips to Relieve Winter Dry Eyes

Whether you live in a climate with cold winter weather or you are planning a ski trip up north, winter can be a challenge if you suffer from dry eyes. Dry, cool air, cold winds and even drier indoor heating can cause eye irritation, burning, itchiness and redness, and sometimes even excessively watery eyes as more tears are produced to compensate for the dryness. Many people have a chronic feeling that they have something in their eye and some even experience blurred vision. These symptoms can be debilitating!

Dry eyes is one of the most common complaints eye doctors get from patients during the winter season, especially in the cooler climates. That’s why we’d like to share some tips on how to relieve dry eye discomfort, and how to know when your condition is serious enough to come in for an evaluation.

Tips to Relieve Winter Dry Eyes:

  1. Keep eyes moist using artificial tears or eye drops. You can apply these a few times each day when the eyes are feeling dry or irritated. If over-the-counter drops don’t help or if you have chronic dry eyes, speak to your eye doctor about finding the best drops for you. Since not all artificial tears are the same, knowing the cause of your dry eye will help your eye doctor determine which brand is best suited for your eyes.
  2. Use a humidifier to counteract the drying effects of indoor heaters or generally dry air.
  3. Point car vents or indoor heaters away from your face when the heat is on. Try to keep your distance from direct sources of heating, especially if they blow out the heat.
  4. Drink a lot! Hydrating your body will also hydrate your eyes.
  5. Protect your eyes outdoors with sunglasses or goggles – the bigger the better! Larger, even wrap-around glasses as well as a hat with a wide brim will keep the wind and other elements out of your eyes. If you wear goggles for winter sports, make sure they fit well and cover a large surface area.
  6. Soothe dry eyes using a warm compress and never rub them! Rubbing your eyes will increase irritation and may lead to infection if the hands are not clean.
  7. Give your eyes a digital break. People blink less during screen time which is why extensive computer use can lead to dry eyes. Follow the 20/20/20 rule by taking a break every 20 minutes to look 20 feet away for 20 seconds and make sure you blink!
  8. For contact lens wearers: If you wear contact lenses, dry eyes can be particularly debilitating as the contact lenses can cause even further dryness and irritation. Contact lens rewetting drops can help your eyes feel better and may also allow you to see more clearly. Not all eyedrops are appropriate for use with contact lenses, so ask your optometrist which eyedrop is compatible with your contacts and cleaning solution. If rewetting drops don’t help, consider opting for glasses when your dry eyes are bad, and speak to your optometrist about which brands of contact lenses are better for dry eyes. Many people find dry eye improvement when they switch to daily single use contact lenses.

Chronic Dry Eyes or Dry Eye Syndrome

Dry eye syndrome is a chronic condition in which the eyes do not produce enough tear film, or do not produce the quality of tear film needed to properly keep the eyes moist. While winter weather can make this condition worse, it is often present all year round. If you find that the tips above do not alleviate your discomfort or symptoms, it may be time to see a optometrist to see if your condition requires more effective medical treatment.