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Can you imagine improving your vision while you sleep? This sleep-time magic is not voo-doo, but rather something called orthokeratology. There is no surgery needed, Dr. Maller has been providing this service for more than 25 years for people aged 5-80, and this has more than 50 years of history showing it to be effective and safe. Orthokeratology can provide clear vision without glasses, contacts, or surgery.

Orthokeratology Art

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.  


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

"... no surgical risk"

CAOK has several advantages over refractive surgery ( PRK, LASIK, LASEK, RK, 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 corneal refractive surgical procedures are not! This reversibility gives two large advantages to CAOK 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, CAOK 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.


Is CAOK New?

Yes and no. Although OrthoKeratology has been with us for more than sixty years, new lens designs, better materials and better manufacturing of the lenses have resulted in a dramatic improvement in the rapid effectiveness of this procedure. With traditional Orthokeratology of years passed, we discussed results in terms of months and years whereas today we discuss modern CAOK's results in terms of hours and days.


How Do I Get Started?

The procedure begins with a comprehensive eye exam along with topographical mapping and tomographical imaging of the corneas. Topography is done with a sophisticated computerized instrument called a Corneal Topographer. These measurements are state-of-the-art, and provide detailed curvature and elevation analysis of the corneas. Corneal tomography provides images and detailed measurements of the entire corneal structure (in addition to the sclera, iris, and crystalling lens) to create a 3-dimensional virtual representation of your unique eye. Over 100,000 data points are collected through this advanced technology so the reconstructed model of your eye is very precise and accurate. Both the corneal topographer and corneal tomographer accomplish these sophisticated image captures by essentially taking quick photographs of your eye, so these procedures are non-invasive, painless, and all done very quickly. 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" with Dr. Maller specifying thousands of curves 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 NoBlur Orthokeratology™ Lens, which will be the very best possible lens for your unique eye. This ensures improved 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?

"20/200 to 20/20 in 120 minutes"

After the comprehensive eye exam and topography and tomography are done, Dr. Maller will custom design your unique NoBlur Orthokeratology™ Lenses. These will then be 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 lay down comfortably and relaxed in a private room with your eyes closed for about two hours. Many patients will bring an IPOD to listen to music. Many patients have actually fallen asleep during this time, which is not only fine, but encouraged, as the time will seem to pass even faster. 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 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.


What Are CAOK's Benefits?


Orthokeratology Academy of America and the American Academy of Orthokeratology and Myopia Control, Dr. Maller Interviews

Interview #1 - The president of the Orthokeratology Academy of America (OAA), Dr. Cary Herzberg, the President of the Orthokeratology Academy of America, interviewed Dr. Maller. The topics discussed were focused on the use of Wave technology to design totally customized designed lenses and the applications of these customized designs for Orthokeratology, Myopia Control, Keratoconus, and Post-Surgical Complications (poor results after PRK, LASIK, LASEK, RK, etc.). You can listen to the entire interview here on this podcast. (If your browser won't play the file, please click on the links below and then select 'open' to load the file into your media player.) Please listen to part 2 of this interview after listening to part 1.
Dr. Maller podcast - OAA Interview, Part 1
Dr. Maller podcast - OAA Interview, Part 2

Interview #2 - The president of the American Academy of Orthokeratology and Myopia Control (AAOMC), Dr. Paul Levine, interviewed Dr. Maller. The topics discussed were focused on the integration of the Oculus Pentacam and Wave technology to design totally customized designed Orthokeratology and Scleral lenses. The applications of these customized designs are used for Orthokeratology, Myopia Control, Keratoconus, and Post-Surgical Complications (poor results after PRK, LASIK, LASEK, RK, etc.). You can listen to the entire interview here on this podcast. (If your browser won't play the file, please click on the links below and then select 'open' to load the file into your media player.)
Dr. Maller podcast - AAOMC Pentacam Interview


Am I A CAOK Candidate?

So you don't want to wear glasses and you want the freedom surgery offers without the risk. CAOK is safe, rapid and effective. CAOK is not for every patient, however, because not everyone meets the criteria for CAOK. Call (954) 493-5052 today for an appointment to see if this exciting procedure would be right for you. This is contact lens "magic" at its finest.


Videos from Orthokeratology Patients, and More

The following videos are all candid comments from actual Orthokeratology patients.

Dr. Maller Orthokeratology Webinars.

From the Orthokeratology Academy of America.