We have extensively updated our article on the Gentle Vision Shaping System
™ also known as Orthokeratology or Corneal Refractive Therapy, on the Total Eye Care website. I’d love to hear some feedback.
Comments Off on Updated Orthokeratology Information
Posted in contact lens, orthokeratology
Tagged accelerated ortho-k, Gentle Vision Shaping System, ortho-K, orthokeratology
In December 2009 we covered the results of a recent study Myopia Increasing Rapidly in The US Population. Recently National Public Radio’s Medical Detectives interviewed, Dr Susan Vitale, principle author of the study “1994-2004 National Health and Nutrition Examination Survey” and Dr. Don Mutti, an expert in myopia. It’s a good listen and only a little over 3 minutes.
With myopia increasing at such a rapid rate in our population will it be long before the use of orthokeratology to slow the progression of myopia in our children becomes the standard of care?
Photo courtesy of Flickr user Pink Sherbet Photography, D Sharon Pruitt
Posted in children, contact lens, orthokeratology, Refractive issues
Tagged myopia, nearsighted, nearsightedness, progression, study
A 66% increase in myopia is a huge change over a 30 year period. The new study tried to simulate the testing methods of the original 1972 study on nearsightedness in the US population. The 1971-1972 National Health and Nutrition Examination Survey found that 25% of the US population between the ages of 12 and 54 were nearsighted vs the 1994-2004 National Health and Nutrition Examination Survey’s finding of 41.6%. Increased nearsightedness was noted regardless of age, sex, race or education.
The authors concluded that it would be beneficial to identify behavioral risk factors that cause increased myopia. If risk factors for increasing myopia are identified we may be able to slow the progression.
The big question is “what caused this increased nearsightedness in the US population”? As eye doctors we are often asked what causes nearsightedness and the usual answer is that that we believe nearsightedness is a combination of genetics and environmental influences. In the last 30 years our society has become much more near centric. People spend hours glued to their computer monitors at work and home. Kids spend more time at near now then ever before with computer games, hand held games etc.
Finding ways to slow or halt the progression of myopia has been a longstanding subject of study in eyecare. The process of using special contact lenses to reshape the front part of a patient’s eye to prevent the progression of nearsightedness and to allow the patient to see without glasses is called orthokeratology. There are a number of different names for orthokeratology, orthoK, corneal molding, corneal reshaping and corneal refractive therapy are some of the most common names.
Almost a year ago the study, Controlling Astigmatism & Nearsightedness in Developing Youth (CANDY) showed that orthokeratology contact lenses reduced the progression of nearsightedness in kids between 9 and 16. The authors of the CANDY study found that the amount myopia in children that did not wear the overnight Corneal Refractive Therapy lenses increased at a rate of .37D per year while those children wearing the lenses progressed at only .03 diopters per year.
Another study, Corneal Reshaping and Myopia Progression published in the British Journal of Ophthalmology, conducted at the Ohio State University College of Optometry found that the eyes of the children wearing overnight orthokeratology lenses increased in length at a markedly slower rate than the studies’ non ortho-K lens wearers.
Lastly, the study Stabilization of Myopia by Accelerated Reshaping Technique (SMART) is in the first of its five years and this past summer released preliminary results showing that again, orthokeratology lenses appear to markedly slowing the progession of nearsightedness in children.
While the rate of nearsightedness in the US population has increased significantly in the last 30 years it is comforting to know that there are safe and effective methods of slowing the progression of myopia. Download a PDF of the study Increased Prevalence of Myopia in the United States Between 1971-1972 and 1999-2004
Image courtesy of Flickr member Foxtongue.
The first year of the Stabilization of Myopia by Accelerated Reshaping Technique (SMART) Study has produced some encouraging results in a recent announcement. According to Dr. Robert L. Davis, co principal investigator of the SMART trial, “The net effect of this contact lens fitting philosophy is to change the cornea shape for the sole purpose of reducing the amount of myopia as measured by change in refraction” . “The results of the SMART Study so far are very exciting,” said Dr. Davis. “The outcomes of this study may revolutionize how we manage young nearsighted patients from this point forward”.
The SMART Trial involves 300 patients between the ages of 8 and 14. The goal of the study is to see if having patients where overnight orthokeratology or corneal molding lenses will stop or slow the progression of nearsightedness. The SMART Trial is the largest of its kind. Other studies have also shown that preventing nearsightedness with ortho-K contact lenses is possible, such the CANDY Study. A study from Ohio State Unversity suggested that wearing Ortho-K lenses overnight actually prevented the eye from becoming longer. The SMART Trial has just completed the first year of the five year study. We will continue to keep an eye on this potientially ground breaking study.
Posted in children, contact lens, orthokeratology, Refractive issues
Tagged children, contact lenses, corneal refractive therapy, myopia, ortho-K, orthokeratology
In February, here in The Eye Doc Blog, we reported that The CANDY Study showed that OrthoKeratology contact lenses markedly slowed the progression of nearsightedness in children. The results of The CANDY study have now been confirmed in the British Journal of Ophthalmology, the new study, Corneal Reshaping and Myopia Progression, showed that children wearing corneal reshaping lenses, also known as ortho-K or orthokeratology lenses significantly reduced the rate of change of the length of the children’s eyes. The study participants wore the lenses for two years and ranged in refractive error from -0.75 to -4.00. The study concluded that previous reports of slowed eye growth following corneal refractive therapy were confirmed.
Read more about Orthokeratology and Corneal Refractive Therapy at Total Eye Care. Also view a video from ABC News about Ortho-K.
The archive summary of the study is available here.
I came across this video on orthokeratology . I believe it is from 2002, however it is still very relevant and the information still applies to how ortho-k is a safe, viable, non-surgical option to vision correction. Studies have also shown that overnight ortho-k may prevent or slow the progression of nearsightedness in children.
It’s good to see another study indicating that Orthokeratology Contact Lenses prevent the progression of nearsightedness (myopia). The Controlling Astigmatism & Nearsightedness in Developing Youth Study (CANDY) was based on a relatively small population (28 patients) and it would have been good to see the rate of myopic progression after removing the contact lenses over a greater period of time, however the data was compelling and warrants further study.
As eye doctors we are often asked if we can prevent the progression of nearsightedness in children. Clinically, we feel that the answer is probably yes, however there are relatively few studies that have investigated this common question. The CANDY Study backs up what we feel our clinical experience has taught us. The progression of nearsightedness in CANDY study patients was 0.37D prior to wearing overnight Ortho-K contact lenses. When the patients discontinued wearing their lenses they found that the patient’s refractive error, on average, had increased by only 0.03D.
An FDA sponsored study of 300 children started in 2007 and is expected to continue for 5 years. Hopefully, the FDA study will answer more of our questions. Additional findings from the CANDY Study found that the younger the child the more beneficial was the effect on controlling myopia and the technique was more convenient. A more comprehensive look at Orthokeratology including a link to the CANDY Study is available on the Total Eye Care website.
Posted in children, contact lens, orthokeratology, Refractive issues, Vision
Tagged astigmatism, corneal refractive therapy, myopia, ortho-K, orthokeratology