Basil H. Bloom BSc(Hons) FCOptom

Optometrist

Orthokeratologist.

Do you want to see all day without Spectacles or Contact Lenses?           ORTHOKERATOLOGY is the NEW Contact Lens alternative to Laser Surgery.

INSTRUCTION LEAFLET FOR ORTHO-K PATIENTS

The wearing schedule and frequency of review is extremely important in the successful control of myopia by Orthokeratology. Orthokeratology is intended to produce a change in corneal shape, which means, of course, that the lens fitting may change. Failure to follow instructions may mean that temporary corneal distortion may result from an incorrect lens fitting. This may necessitate restarting the whole procedure. Please therefore read the following instructions carefully.

It must be emphasised from the outset that there is a wide range of both corneal shape and rigidity. Some wearers' eyes will change significantly faster than others. In some cases ocular rigidity will allow almost no change in corneal shape and you will be advised not to proceed further.

Overnight Wear

This gives a fast and easy way of arriving at myopia correction.

The lenses can be worn on the first night after you receive them, inserted just before going to sleep. On waking, take note of comfort and vision when the lenses are in, so that you can inform me of these important factors.

You must be reviewed on that first morning, by me with the lenses still in, to ensure that the lens fit is optimal for overnight wear. This visit should be booked when receiving the lenses, and if necessary you should delay beginning the wear of the lenses if an appointment is not available the next day. At that visit, your vision and the lens fit will be assessed, after which the lenses will be removed, and the eyes examined to determine the amount of change which has been achieved. If vision is adequate, the lenses are left out from that time, and reinserted during the later part of the day only if acuity starts to decline. The lenses are again worn to bed on the second and subsequent nights, until the next review (usually 7-14 days later).

During the first few visits, we will be able to determine a suitable wearing schedule that gives  good unaided vision all day. You will continue to be reviewed and any changes to the lenses will be made where necessary. The final  pair of lenses  become the retainer lens.

Morning Inspection

It is essential that you check both eyes every morning to ensure that both lenses are moving slightly on blinking. Occasionally the lenses may be seen to be immobile or "bound". In this situation the lens must be gently loosened.

1. Instil a drop of Ocular Lubricant into the eye.
2. Press the edge of the Upper Lid onto the white of your eye, just above the contact lens.
3. Press your lower lid onto the white of your eye, just below the contact lens. This should used loosen the lens and allow tears underneath.
4. Put in another drop of Ocular Lubricant.
5. Leave the lenses in for a further half an hour before removal.

Adaptation

The aim is to achieve all-waking-hours wear as soon as possible. During the adaptation period your myopia will be  reduced for a  period after lens wear. This means that your current spectacle correction will be too strong. You may prefer to wait a little while, therefore, before reverting to spectacles or I can supply you with some Disposable Lenses to correct your vision. This initial period is usually between 2 and 7 days.

The greatest change to corneal shape occurs quickly, slowing down as treatment continues. The first lens therefore will tighten quite quickly as the cornea flattens. This is typically in one to seven days. It is essential that we see you if the lens feels tight; rides up and becomes fairly stationary; or suddenly becomes hard to remove. Please phone and change any appointment time so that I see you the same day or within 24 hours if this happens.

Long Term Retainer Wear

The degree of retainer wear is highly individual. Some patients need to wear retainer lenses every night and others every second or third night. Optimal daytime vision is often found if the lenses are left in for the first 1/2-1 hour after waking.

If vision is degrading slightly by evening the retainer lenses can be re-inserted and the lenses worn for longer the next morning before removing them.

Once successful long-term retainer wear is reached and in the event of a lost lens, the cornea will tend to return to its original shape. As the lenses are made specifically for you, you are advised to obtain a spare pair of lenses.  These are available at a reduced cost of £150.00 a pair. (In some cases where a special design lens has been used the cost may be slightly more.)

• Lenses lost during therapy are charged at a cost of £80.00 per lens.

• Lenses used during the corneal reshaping therapy period must be returned when finished with.

• Non-returned lenses will be charged at the same rate as lost lenses.

Fees & Charges

Please carefully read the separate sheet on fees and charges and ask if there is any thing you do not understand.

After-Care

As with any contact lens wear it is vital to ensure the health and integrity of the cornea at all stages. Over the first year many visits are involved. After the initial therapy an examination twice a year is considered essential to ensure ongoing safety of the eyes and good vision. 

In An Emergency

If you are concerned as to the safety of your eyes please contact me as soon as possible

Copyright © 1999 Basil H. Bloom Optometrist                                    
Last modified: June 26, 2005