What Is Custom Accelerated OrthoKeratology?
Can you imagine the joy of waking up in the morning and not having any
dependency on glasses or contact lenses for the rest of the day? You would be free
to enjoy many activities that you may otherwise avoid because of your glasses or
contact lenses. No more glasses getting in the way because you are too active. No
more contact lenses irritating your eyes because of dryness or smoky environments.
Custom Accelerated OrthoKeratology (CAOK) is the medical, non-surgical alternative to refractive
surgery. CAOK uses very special custom designed contact lenses to
gently reshape the cornea into an improved shape
to reduce or correct myopia, hyperopia, astigmatism, and presbyopia (the I can’t read
after forty syndrome). The main intent of CAOK is to be free of both contact lenses and
spectacles for the majority of, or all of the waking hours. While this is ideal for
sports enthusiasts, police persons, fire persons, and pilots, other potential candidates
would be people who work in dusty, dirty or dry environments or anyone who would just
like freedom from corrective lenses during their daily activities. Since CAOK has been
shown effective at both addressing progressive myopia, and their active lifestyles, children
make ideal candidates.
View samples of what can be achieved with custom Orthokeratology designs right here.
How Does CAOK Work?
In some ways, CAOK is similar to the use of dental braces by an Orthodontist to straighten
crooked teeth. The main difference is that if a tooth position is corrected for some time,
it will retain the new position. The cornea is highly elastic, however, and returns to its
original shape. For this reason, retainer lenses are worn typically at night during sleep,
or in rare instances, part of each waking day. Retainer lenses are prescribed after the ideal
corneal shape or maximum change has been achieved.
CAOK Vs. Refractive Surgery
CAOK has several advantages over refractive surgery (PRK, LASIK, LASEK, etc.).
CAOK; has no surgical risk; has no down time - you have clear vision from the time you
start the procedure; does not involve post-operative pain; does not have the potential to
leave hazy vision that can be experienced by patients following laser surgery; causes no
damage to Bowman's membrane (the tough protective layer just under the corneal surface);
does not exclude children and in fact children make excellent candidates; can be done even
if your vision is continuing to change; always does both eyes together; and above all, the
procedure is REVERSIBLE while the Excimer laser is not! This reversibility gives two
large advantages to AOK compared with surgery. 1. There’s no possibility of having a
permanent bad result. 2. Since your eyes will continue to change even with a “perfect” surgical
result, you will need prescription eyewear at some time in the future. To the contrary, AOK
can address these changes by simply updating the retainer lenses. As easily as updating a
pair of glasses, your visual freedom is restored and maintained.
How Do I Get Started?
The procedure begins with a comprehensive eye exam along with a topographical mapping
of the corneas. Topography is painless and is done with a sophisticated computerized
instrument called a Corneal Topographer. These measurements are state-of-the-art, and
provide detailed analysis of the corneas. Dr. Maller will then use these detailed
measurements to custom design and manufacture lenses to an accuracy of 1 micron
(1 million microns = 1 meter). Every eye is unique and so every lens that is custom
designed this way is totally unique. It is a one-of-a-kind lens "built from the
ground up" to address your unique eyes. Unlike many of the approaches currently available for
Orthokeratology, utilizing this method means that there is no pre-made design that Dr. Maller
would try to best fit to your eyes. Dr. Maller will instead, custom design the very best possible lens for your
unique eye which improves comfort, speed and accuracy of results, and ultimately the best quality of vision
possible. These lenses are made from highly oxygen permeable rigid material (allows cornea to breathe),
which will gently reshape the cornea towards improved shape. This reduces the prescription while
dramatically improving unaided eyesight.
What Can I Expect And How Fast Will I Notice Results?
After the comprehensive eye exam and topography is done, Dr. Maller will custom design and have the lenses
manufactured and shipped into the office. You will return for a very special fitting session.
The lenses will be applied to the eye and then examined to ensure that the perfect fit has been attained.
You will then sit comfortably and relaxed in the reception area with your eyes closed for about
two hours. Many patients will bring an IPOD to listen to music. Some patients have actually fallen asleep
during this time. After the two hour period, you will again be examined. At this time the lenses will be removed
and your uncorrected vision will be tested. Most people will already have between 90% - 95% of their visual
acuity corrected. The changes are so fast that some people have come in with 20/200 vision and during this
two hour period improved to 20/20. You may be able to drive home while not wearing any optical devices - possibly
for the first time in your life. You will get to enjoy your new-found vision for the rest of the day while wearing
no optical devices of any kind, although the sharpness will probably fade a little later in the day. That night
you will put the lenses on just prior to sleep and wear them throughout the night. The next morning upon awakening,
you will take the lenses off and notice that the quality of vision is improved compared to the previous day. The
sharp vision should last most of this first day. Each day thereafter the vision will continue to sharpen while maintaining
sharp vision for more hours of each day. Most people are daytime free of any optical devices within
the first few days and do not need to wear glasses or contact lenses during any of their waking hours.
Although the vision is excellent very quickly, the improved corneal shape stabilizes at a slower pace
over the next couple of months. The program length varies between three and six months depending upon the
amount of prescription and the rates of change. After treatment and and maximum results are achieved,
retainer lenses are worn to maintain the new corneal shape. Due to this very advanced custom design, the first
pair of lenses often become the retainers. Failure to wear the retainer lenses on an ongoing basis
will result in the return to the pre-existing prescription. Retainers may be prescribed during day
or night although almost all CAOK wearers only sleep in lenses. The retainer wearing schedule is based
on the individual’s lifestyle and specific eye needs. Not all CAOK patients wear lenses every night.
For example, some CAOK patients may only wear their retainer lenses every other night. While wearing the
CAOK lenses, you will normally have clear vision and be very comfortable.