Orthokeratology (OOK) is system where a patient wears a gas permeable lens at night, causing a flattening of the cornea, leading to improved visual acuity during the day without the need for glasses or contact lenses. The improved vision with these night lenses is temporary, and the patient must continue to wear these lenses at night to achieve good vision during the day.  One can liken this approach to "braces" for the eyes. Some people see this as a safe alternative to LASIK surgery.  Orthokeratology has occasionally had severe side-effects, even blinding complications.


In this month's Ophthalmology, Van Meter, et al. discuss:  Safety of Overnight Orthokeratology for Myopia: A Report by the American Academy of Ophthalmology.  This article reviewed the published literature to evaluate the Safety of Overnight Orthokeratology (OOK) for the treatment of myopia.  They found the prevalence and incidence of complications associated with OOK have not been determined. Complications, including more than 100 cases of infectious keratitis resulting from gram-positive and gram-negative bacteria and Acanthamoeba, have been described in case reports and case series representing observations in undefined populations of OOK users.

The article concluded:

Risk factors for various complications cannot be determined. Because OOK puts patients at risk for vision-threatening complications they may not encounter otherwise, sufficiently large well-designed cohort or randomized controlled studies are needed to provide a more reliable measure of the risks of treatment and to identify risk factors for complications.

My feeling on Orhto-K is "I don't get it".  If you  are going to wear contacts at night where there is an increase risk of infection, why not wear them to see with during the day?  If you don't want to wear contacts, then wear glasses.  If you don't want to wear glasses, get LASIK!!

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