What is Myopia (Nearsightedness)?

Myopia, also known as nearsightedness, is a common type of refractive error where close objects appear clearly, but distant objects appear blurry.

When you look at an object, light rays reflect off that object and pass through the cornea and the lens of the eye, which bend(or refract) the light and focus it on the retina at the back of the eye. If you have perfect vision, the rays focus directly on the urface of the retina. But in a myopic eye, the eyeball is usually too long from front to back. This causes light rays to focus at a point in front of the retina, rather than directly on its surface. This makes distant objects blurry.

Myopia can also be the result of a cornea that is too curved for the length of the eyeball or a lens that is too thick. For some people, their myopia may be caused by a combination of problems in the cornea, lens, and length of the eyeball.

The National Eye Institute (part of National Institute of Health) on Myopia

What Are the Symptoms of Myopia?

If you have myopia, you have trouble seeing things far away, but you can see nearby things clearly. This is why myopia is commonly called nearsightedness.

If you can see well enough to read what’s on your laptop or in a book, but you struggle to see what’s on the television or a movie screen, you may be nearsighted. Sometimes people with undiagnosed myopia will have headaches and eyestrain from struggling to clearly see things in the distance.

Why is My Child’s Prescription Getting Worse?

How Common is Myopia?

Based on a study published in 2008(link is external), experts at NIH estimate that at least 33 percent of Americans are nearsighted. According to a 2009 study(link is external) ,the number of Americans with myopia has increased significantly from the 1970s to the early 2000s.

The prevalence of myopia has also been increasing in many other countries around the world. It is particularly prominent among school-aged children living in urban areas in some Asian countries. In the past, people thought children might become myopic from spending too much time reading and writing, which require close-up vision, or from reading in poorly lit rooms.

Myopia can also be the result of a cornea that is too curved for the length of the eyeball or a lens that is too thick. For some people, their myopia may be caused by a combination of problems in the cornea, lens, and length of the eyeball.

More recent studies confirm that myopia (nearsightedness) especially in kids between 8-14 is growing at epidemic proportions.Recent studies(link is external) suggest that the increase of myopia in children could be related to a decrease in the amount of time they spend outdoors.

What Are the Treatments for Progressive Myopia in Kids?

Myopia control in NJ for especially for kids ages 8-14 can include the following:

  • Lifestyle changes such as reducing device use, taking frequent breaks while studying and increase outdoor play or activities
  • Orthokerotology (Ortho-K)
  • Atroprine Drops
  • Dual Focused Contact Lenses

Learn More About Myopia with Kids:

What is Ortho-K Treatment for Kids?

Orthokerotology (Ortho-K) is a non-surgical treatment plan using specially customized contact lenses to gently reshape the curvature of the eye to improve vision. This is an FDA approved non-invasive procedure that eliminates the need for glasses or daytime contact lenses. It improves vision by gently reshaping your eye WHILE YOU SLEEP using specially designed therapeutic contact lenses. You just put the specially fitted lenses in at bedtime, and when you awake, take out the GVSS lenses and you will have clear, sharp,natural vision for your waking hours.

This safe and effective treatment can correct near-sightedness (including high prescriptions), astigmatism and presbyopia (blurred near vision).

Benefits of Ortho-K

  • Slow down or stop the rate of progression of your or your child’s nearsightedness (myopia). Due to electronic devices, nearsightedness is getting worse especially in kids. By slowing the rate of progression of nearsightedness, you decrease the likelihood of serious eye complications in the long term.
  • Be glasses and contacts free during the day. Play sports, go to work, study and enjoy a better quality of life without the hassles of glasses or contact lenses during the day. Videos of real patients on Ortho-K:

Learn More About Ortho-K

What Are Atropine Drops?

Atropine belongs to a class of medicines known as Anticholinergic, Antispasmodic agents. Atropine drops in low concentration have demonstrated effectiveness in reducing the growth of myopia in patients. Applied in low doses once a day can help children manage their myopia. Currently Atropine drops have to be compounded at specialty pharmacies.

Benefits of Atropine Drops

  • Atropine drops at low dose concentrations have limited side effects and can be used by the parent to apply in the child’s eyes at bedtime. Scientific studies show that they are effective at reducing the progression of myopia.
  • Parents can apply the drops for their children at bedtime. This treatment can be used on younger patients, rendering it a great option that helps slow the progression of myopia. This is especially the case when a young patient may not be able to utilize Ortho-K lenses or soft contact lenses to slow myopia progression.

Learn More About Atropine Drops

What Are Soft Lenses for Progressive Myopia?

Soft Lenses are an effective, non-surgical treatment to slow the progression of myopia in children, which ultimately means a reduced risk of developing sight threatening problems later on in life. Unique designs such as with dual-focused soft contact lenses have been proven to accommodate near targets and improve vision for children affected by early-onset myopia. The lenses are easy to insert and remove, and are safe for use in children. MiSight, NaturalVue are two of the most commonly prescribed soft lenses for myopia management.

Benefits of Soft Lenses

  • These contact lenses are designed to help eyes automatically focus when and where they need to, so vision is sharp at every distance. Daily activities can be completed without the need for glasses. The main benefit of soft contact lenses for myopia management and myopia control is that some kids can easily insert and remove them with appropriate training.
  • Parents are put at ease by this treatment as they can be integrated into their daily routines.

Learn More About Soft Lenses
for Progressive Myopia

What is Behavioral Change in Myopia

Studies have shown that there is a correlation of behavior in children with their increase in myopia. The correlation is with lack of outdoor play, increase in near work such as spending a lot of time online or on the handheld electronic devices such as iPad or phones. And so what we try to do as myopia management specialists at Hoot Myopia Care is to complement therapies with a Behavioral Coaching Program.

Children with myopia progression and their parents must also have commitment for naturally reducing myopia progression. Through video modules, we educate, instruct and inspire kids to increase outdoor play, reduce screen dependency and improve study posture. These are behaviors we can control. With dedication and commitment, each child enrolled in the behavioral coaching program as part of their myopia care program can become more confident and successful with their myopia management.

Benefits of Change in Myopia

  • Slow down or stop the rate of progression of your or your child’s nearsightedness (myopia). Due to electronic devices, nearsightedness is getting worse especially in kids. By slowing the rate of progression of nearsightedness, you decrease the likelihood of serious eye complications in the long term.
  • Be glasses and contacts free during the day. Play sports, go to work, study and enjoy a better quality of life without the hassles of glasses or contact lenses during the day. Videos of real patients on Ortho-K:

Learn More About Behavioral Change in Myopia

Frequently Asked Questions (FAQs) about the popular Ortho-K therapy

What is it called technically speaking?

Orthokeratology (Ortho-K) or Corneal Refractive Therapy (CRT).

I keep hearing different terms for Orthokeratology.
Do they all mean the same thing?

Yes! Orthokeratology may be also be known as: Ortho-K, Corneal Refractive Therapy,
CRT, Vision Shaping Treatment, VST, Gentle Shaping System, The Gentle Vision Shaping System,
Corneal Molding, Wave Front Corneal Molding, Gentle Molding.

Additionally, the treatment devices used to achieve corrected vision may be referred to as:

Retainer Lenses, Vision Retainers, Retainers, Ortho-K Lenses, Corneal Molds, Molds, Wave Lenses and CRT Lenses.At Monroe Eye Care, we use the terminology Ortho-K and utilize FDA approved Paragon Corneal Refractive Therapy (CRT)gas permeable lenses. Paragon lenses have been around the longest and have an excellent efficacy and safety record.

What is the Ortho-K Treatement Plan?

The Ortho-K Treatement Plan uses specially designed vision retainer lenses to gently and gradually reshape the front surface of the eye (the cornea) to eliminate or reduce nearsightedness (myopia) or astigmatism.

The principle is similar to the use of a dental retainer used by an orthodontist to realign crooked teeth.The vision retainers are similar to contact lenses and are usually worn while sleeping. They are removed upon awakening to provide clear vision without using glasses or contact lenses! The retainers are comfortable and very easy to care for.

Ortho-k lenses are prescribed for two purposes:

Ortho-k lenses are also called “corneal reshaping contact lenses” or “overnight contact lenses to correct or control myopia.”

There are different brands of gas permeable or “breathable” lenses which include Bausch + Lomb’s Vision Shaping Treatment (VST) and Paragon CRT (Corneal Reshaping Therapy). Both provide similar benefits.

How Long Does the Ortho-k Effect Last?

You should be able to see acceptably well without glasses or contact lenses for a day or two, sometimes longer. For best results, you should wear the ortho-k lenses every night.

What is the evidence documenting the safety of Ortho-K?

Myopia control studies involving Ortho-K Treatment Plan for Corneal Shaping Therapy (Ortho-K) include;

REIM Study (2003). Tom Reim OD,FOAA and colleagues initially published the potential of Ortho-K myopia control in 2003. This study reported that corneal reshaping patients experienced about a sixty percent reduction in the progression of myopia.

LORIC Study (2005). The Longitudinal Orthokeratology Research in Children(LORIC) the Hong Kong pilot study found a much slower rate of childhood myopia progression and eye length elongation (47%) among young progressive myopes who underwent Ortho-K corneal shaping compared to those who wore eyeglasses.

CRAYON Study (2007). The Corneal Reshaping and Yearly Observation of nearsightedness(CRAYON) study,conducted by Jeff Walline OD,FAAO at Ohio State University, confirmed previous studies that Ortho-K corneal reshaping contact lenses lower rates of myopia progression and eye elongation (57%)(Walline, 2008)

SMART Study (2015). Conclusions: The three year longitudinal study found that myopia progressed at a significantly higher degree in the Soft Contact Lens vs. Corneal Reshaping Contact Lens (Ortho-K) subjects..Efficacy, safety, and dropout rate of corneal reshaping in our sample population appears to be comparable to wearing Soft Contact Lens.

CRIMP Study (2010). Corneal reshaping inhibits myopia progression(CRIMP) is an Australian ten year retrospective study demonstrated control of myopia progression over a ten year time frame. Again the majority of Ortho-k corneal reshaping contact lens control group patients had a significant reduction in their myopic progression versus the group of patient not using Ortho-k corneal reshaping therapy.

Multifocal contact lens myopia control Walline JJ1, Greiner KL, McVey ME, Jones-Jordan LA

Which Vision Problems Can Ortho-k Correct?

Orthokeratology is most frequently used to temporarily correct myopia (nearsightedness). Generally, ortho-k can correct upwards of -6.00 diopters (D) of myopia.

Ortho-k also can correct lesser degrees of astigmatism, hyperopia and presbyopia.

The type and amount of refractive error that can be effectively managed with orthokeratology differ on a case-by-case basis. Your eye doctor will be able to give you more specific guidance after examining your eyes.

Who Is a Good Candidate for Orthokeratology?

Most people with mild to moderate myopia (with or without mild astigmatism) are good candidates for ortho-k.

Because the corneal reshaping effect is temporary, little risk is involved, and you can discontinue wearing the lenses at any time — provided you are willing to start wearing glasses or contacts again when your myopia returns!

Children and young adults who want to be glasses-free but are too young for LASIK or are not good candidates for refractive surgery for other reasons (dry eyes, for example) often are good candidates for ortho-k. People who participate in contact sports or work in dusty environments that can pose problems for contact lens wear also can be good candidates.

What Results Can You Expect From Ortho-k?

Eye care practitioners usually aim for 20/20 vision after ortho-k, but 20/40 vision (the legal minimum for driving in most of the United States) often is considered an acceptable outcome.

In the FDA clinical study for approval of Paragon CRT lenses, 93 percent of patients achieved 20/32 vision or better, and 67 percent achieved 20/20 or better. In the clinical study for FDA approval of one VST design, about 95 percent achieved 20/40 or better, and 73 percent achieved 20/20 or better. Both studies followed patients for at least nine months.

What to Expect When You Begin Ortho-k

The eye doctor will begin by measuring the curvatures of your corneas using an instrument called a corneal topographer— a painless procedure that takes a few minutes and produces a topographical map of your eye’s surface.

Your doctor might use an in-office inventory of lenses for fitting your eyes with ortho-k lenses the same day corneal topography measurements are taken, or she may order custom ortho-k lenses for fitting at a later date.

You may need a series of temporary lenses to see properly until you reach the desired prescription.
In most cases, up to three pairs of lenses are required to achieve the maximum vision correction effect.

When you begin to wear ortho-k lenses, you will likely have some awareness of the lenses on your eyes until you fall asleep. With time, the lenses typically become more comfortable immediately upon insertion.

How Long Does it Take for Maximum Ortho-k Effect?

This depends on many factors, especially the amount of nearsightedness (and possibly astigmatism) you have when you begin the ortho-k process.

Some people can have excellent vision after a day or two of overnight ortho-k. But for higher prescriptions it can take two weeks or longer for maximum correction.

Until your eyes are fully corrected, you might notice blurred vision and glare and halos around lights.In some cases, you may need to wear glasses (with a lesser prescription than you originally had) during the ortho-k process. Also, in some cases, mild glare and halos might persist even after maximum ortho-k correction.

Is this New?

No. Reshaping the cornea with contact lenses to improve vision isn’t new; some eye doctors have practiced it for decades. However, before FDA approval for overnight wear, the procedure had limited appeal. Now with safe, more oxygen permeable materials, the process has grown in effectiveness, safety and popularity.

Click Here to See Ortho-K in the News.

Is it Permanent?

No. It is temporary. If you stop wearing the lenses regularly while you sleep, your vision will return to its original state in as little as 72 hours.

Is it safe?
Ortho-K lenses have shown to be safe and effective. With proper hygine, lens use is safe for children and adults and is an excellent alternative for children who are just first becoming nearsighted. Studies have demonstrated that it is safe and effective for children and adults. However, there is a small risk of infection or abnormal blood vessel growth involved when any contact lens is worn. The risk is minimized by adhering to scrupulous disinfection and care procedures, by wearing your night time lenses only as instructed and by coming in for regular progress checks.

Have there been long term studies on Ortho-K?

Actually, Ortho-K has been in practice for 40 years and FDA approved for kids since 2002. There has been an avalanche of studies supporting its efficacy for myopia control and lifestyle benefits for children. The longest study documented was a 5 year study with great results. Also, there are more ongoing long term studies underway

Here’s the link for that study: http://iovs.arvojournals.org/article.aspx?articleid=2128645

In addition, here’s a National Institute of Health study documenting
the safety of Ortho-K lenses: http://www.ncbi.nlm.nih.gov/pubmed/17975424

Will my vision gradually go back to the way it was
if I discontinue Ortho-K lenses?

Yes, if you ever decide to discontinue Ortho-K lens wear, your vision will gradually go back in about 3 days to a couple of weeks. You can resume your wearing your eyeglasses.

Does Health Insurance Cover the Myopia
Control with Ortho-K in NJ?

Unfortunately, health insurance considers both surgical (LASIK) and non-surgical Myopia Control vision improvement do not cover this procedure. However, vision insurance may cover a portion of the costs through material benefits. Please speak to our myopia control coordinator, Summiya Shine by calling our office (609) 235-9770.

How much does Ortho-K cost?

The entire Myopia Care program includes all of the professional visits (which can be from 8-12) for two years and two sets of retainer lenses. This does include all the tests. Fees depend on the prescription and a number of other factors. Kindly make an appointment with Myopia Control specialist in New Jersey, Dr. Shefali Miglani to learn more.

Call (609) 235-9770 and set up an appointment to learn more about Myopia Control in NJ.

Download FAQs in PDF, please click here.

How to Get Started

  • 1

    Select one of our Myopia Management Doctors near you.

  • 2

    Meet with the doctor to do a consultation to see if your child is a candidate for the Myopia Care Program.

  • 3

    Begin the Myopia Care program supported at every step by the doctor and Hoot's clinical care team.

"Your action right now can help
ensure your child's future vision."