Vision without Glasses: a safer alternative to laser eye surgery

You'd love to throw away your glasses, but Lasik (laser eye surgery) scares you? At last, there's an alternative - orthokeratology! OrthoK involves the wearing of special lenses at night, which gently correct the shape of your eyes while you sleep, so you can see perfectly without glasses when you’re awake.

Ortho-K is ideal for people who can't wear ordinary contact lenses, but don’t want to take the risk of Lasik surgery. People who can’t tolerate daytime contacts can usually wear Ortho-K lenses without any problems. Because you only wear the Ortho-K contacts at night with your eyes closed, there's no problem with dryness, and no risk of dust and pollution getting in your eye. And unlike soft lenses, the Ortho-K lenses don't absorb the soaking solution, which is a boon if your eyes are sensitive to the disinfecting chemicals.

I'm one of those people who have sensitive eyes, and I started OrthoK about nine months ago. Even on the very first day, I was able to do without my glasses for several hours. By the end of the week, I was completely free of glasses, and have been ever since. It still feels strange to walk around and see the world, clear as a bell, without any spectacles on my nose!

Short-sightedness occurs when the eyeball is too long or the cornea is too steep, causing light to focus short of the retina. The Ortho-K lenses flatten the front of the eye, so that the light hits the retina in the right place – and voila, you can see perfectly without spectacles or contact lenses! Because the reshaping is so gentle, it wears off gradually, so you have to wear the lenses several times a week to keep the eye in shape. How often you wear them depends on the individual - some people only need to wear them twice a week, others every night.

I have to confess that when I started Ortho-K, I wondered if I'd made a big mistake. The small, hard lenses were tricky to put in my eye and horribly uncomfortable once they were in. When I tried them in the optometrist's office, I couldn't see a thing because my eyes were watering so much! But the optometrist told me to close my eyes and as soon as I did, I realised I could hardly feel the lenses. He also explained that because I would be wearing the lenses for several hours each night, my eyes would get used to them very quickly.

And he was right. The first couple of nights, I took several attempts to get the contacts in my eyes, then had to feel my way from bathroom to bedroom with my eyes closed because I couldn't bear the discomfort of opening them! And in the morning, my eyes were stuck together with gunk. But while I was lying in bed, it was easy to forgt about them and go to sleep - and within two or three days I could tolerate them enough to pop them in, then do other things such as brush my teeth or cleanse my face without wanting to scratch my eyes out.

Now. I'm so used to the lenses, I have even sat down and watched a late-night TV show while wearing them (I couldn't sleep that night!). That's not to say I'm not aware of them, but they're no longer uncomfortable with my eyes open. I now wear them on a two nights on / one night off schedule, and can even skip a night if I'm too drunk - er, I mean, tired.

You may wonder why I'm going to the trouble of wearing contacts every night when I could easily have Lasik surgery. I know several people who've had Lasik and loved it, but I also know someone who had complications and had to have a special implant put in his tear duct, which was enough to put me off the idea!

Of course, there are risks with Ortho-K too. As with anything you put in your eyes, there’s a risk of infection. However, it’s lower than the risk with daytime contact lenses, where you can pick up infections from contamination blowing into your eyes, from your fingers if you touch your eyes, or from make-up brushes or pencils. The only risky time with Ortho-K is when you insert and remove the lenses, and so long as you make sure your hands are clean and you use the right solutions, you shouldn’t have any problems.

There are still very few practitioners, though the number is growing all the time. Adding to the confusion is that some lens manufacturers have different names for Ortho-K, so the optometrists who sell them may use that terminology:

Paragon Vision Sciences - CRT (Corneal Refractive Therapy)

Bausch & Lomb - VST Process (Vision Shaping Treatment)

If Googling doesn't lead you to a practitioner in your area, it's worth trying the Optometry department at your local university as they are often involved in trials, due to the great interest currently being shown in the orthokeratology technique.

At a recent conference, Ortho-K came in for criticism because of the alleged higher risk of infection from overnight lens wear. Personally, I'm suspicious that the critics may have had a vested interest in bagging it (being Lasik surgeons or conventional contact lens practitioners), but let's look at the facts.

A higher incidence of infection has been found in studies wearing continuous wear soft contact lenses at night, not orthokeratology lenses. Both continuous wear and Ortho-K lenses are worn at night, but there the similarity ends.

Continuous-wear contacts are soft lenses. The risk of infection has always been higher with soft lenses than with rigid ones, because the soft lenses absorb fluid. Get some contaminated water on a rigid lens and you can rinse it off - get some on a soft lens and it will soak it up!

If you're of the older generation, you probably knew people who wore the old hard contact lenses during the day. Did you ever have to get down on your hands and knees to find a lens that had been dropped? Nine times out of ten, the wearer found the lens, licked it to moisten it, and put it back in their eye! I would never recommend doing such a thing, but many thousands of people got away with it, because the hard lens didn't absorb the saliva. Try doing that with a soft lens and you're at very high risk of severe infection - as happened to a well-known Australian boxer recently. He lost most of the sight in that eye.

The other problem is that continuous wear lenses are worn for several days and nights without a break. Clearly, if the lenses are contaminated when you put them in your eye, bacteria have days to breed! By contrast, your Ortho-K lenses are removed and disinfected for at least a day between each wear.

With anything you put in your eye, it's crucial to be very careful with hygiene, but at this point there's no evidence Ortho-K lenses are any different from daytime lenses.

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All text copyright Marisa Wright. Photos courtesy of photographers below.