LASIK eye surgery may not be right for your child.
Other options, like Ortho-K, may be a better fit.
The increasing epidemic of childhood myopia—or nearsightedness—is a concern that is affecting about 42% of American children. Myopia develops when the eyeball grows excessively long or when the cornea, the transparent front part of the eye, takes on an unusual shape, a condition known as astigmatism. As a result, distant images such as classroom whiteboards become blurry for your child.
Single-vision lenses (glasses or contacts) are commonly used to restore distant vision. However, these lenses do not slow the progression of myopia. This limitation is a significant concern as myopia, left untreated or unattended, could escalate to more severe eye problems such as early cataracts, macular degeneration, glaucoma, and retinal detachment.
Furthermore, the drawback of single-vision lenses is their requirement for frequent replacement. For most children dealing with myopia, it is typical to have their glasses replaced with increasingly stronger prescriptions until they hit their early 20s—the age when myopia generally ceases to progress.
However, there is a promising alternative to vision correction surgery for children, known as Orthokeratology, or Ortho-K. We have seen countless Ortho-K success stories in pediatric patients at Lang Family Eye Care. We are passionate about spreading the word to parents about alternatives to LASIK that may bring your child the quality of life they deserve. Here, we aim to answer many frequently encountered questions so you can make an informed decision about the right steps for your child.
What is LASIK?
LASIK is a type of refractive surgery that uses a laser to correct vision problems caused by refractive errors, resulting from an improper bending of light by your eyes.
If your child’s cornea or lens is wrongly shaped, his or her eye won’t be able to refract light properly, and the image it sends to the brain will appear blurry.
LASIK reshapes the cornea using a laser, improving how light rays are focused on your retina. It can efficiently treat myopia (nearsightedness), hyperopia (farsightedness), and astigmatism. In some instances, it may completely eliminate the need for corrective eyewear.
LASIK is an outpatient procedure that begins with numbing the eyes with drops, placing an eyelid holder and suction ring to restrict movement, creating a thin flap in the cornea, and then reshaping it using a laser. Once the cornea is reshaped, the flap is folded back into place for healing.
LASIK eye surgery does have a high success rate—around 90% of recipients end up with vision between 20/20 and 20/40—without glasses or contact lenses. However, it’s worth mentioning that LASIK is not recommended for every age group. LASIK cannot correct presbyopia, an age-related loss of close-up vision that affects many patients over 40. It is also not generally advised for children and young adults under the age of 21.
What is Ortho-K?
Orthokeratology, more commonly referred to as Ortho-K, is one of the most effective LASIK alternatives that uses specially designed contact lenses to reshape the cornea and improve vision temporarily. These specially designed lenses flatten the cornea’s center, altering the path of light as it enters the eye. The lenses, usually worn overnight and removed during the day, are rigid and gas-permeable. This allows for the effective reshaping of the cornea and the necessary passage of oxygen to maintain eye health. The mechanism can be likened to orthodontics for your eyes. Ortho-k is primarily used to alleviate near-sightedness (myopia), typically addressed by eyeglasses, regular contact lenses, LASIK, or PRK.
Ortho-k is especially beneficial for children with fluctuating vision. Because vision can change well into adulthood, vision correction surgeries such as LASIK are not recommended until vision is stable. These lenses might initially feel uncomfortable to your child, but they usually become more comfortable over time. When the desired corneal reshape is achieved, a retainer lens is used to maintain the improved vision.
The effects of orthokeratology can take up to two weeks or longer to fully manifest, though significant improvement can occur within days. In most clinical trials, patients using FDA-approved Ortho-K lenses achieved 20/40 vision or better.
Other types of vision correction surgery
Aside from LASIK, your Lang Family Eye Care eye doctor may discuss several other types of corrective eye surgery with you.
Refractive Lens Exchange
Refractive lens exchange surgery (RLE) works by replacing your eye’s natural lens with a permanent, prescription-corrective artificial one known as an intraocular lens (IOL).
Like a contact lens or prescription glasses, the IOL possesses a vision prescription specially tailored to your eyes. It functions just like your eye’s natural lens would, refracting or bending light as it enters your eye. Many individuals notice that they no longer require glasses or contacts post-surgery, or if they do, it is typically for specific tasks such as reading.
RLE is sometimes recommended for severe myopia (nearsightedness) or hyperopia (far-sightedness), which generally excludes individuals from laser vision correction. Alternatively, if you have presbyopia (age-related farsightedness), RLE may be an option.
Typically, the most suitable candidates for RLE are individuals aged 40 or older. This age group generally experiences fewer complications post-surgery. Moreover, RLE is most beneficial for those beginning to develop presbyopia. We most likely will not recommend RLE for your child except in unique circumstances.
Photorefractive keratectomy (PRK)
Photorefractive keratectomy (PRK) uses the precision of laser technology to treat various vision conditions in adults and children. PRK varies from other types of refractive surgeries as it reshapes the cornea using a laser. This correction focuses the light rays more efficiently onto the retina, significantly improving vision. The procedure can effectively treat myopia (nearsightedness), hyperopia (farsightedness), and astigmatism, thus enhancing the quality of life for patients.
In the United States, PRK is the most commonly performed refractive procedure in children. The risks associated with flap dislocation are eliminated in PRK, and children typically recover faster and experience less discomfort than adults undergoing the procedure.
The ultimate goal of PRK is to correct the refractive error, dramatically improving vision clarity. If your child has dry eyes or thin corneas, PRK may be an ideal choice since these conditions may disqualify your child from other procedures. However, remember that PRK is a surgery requiring longer recovery than Ortho-K.
Benefits of Ortho-K compared to Laser eye surgery and LASIK
Orthokeratology is an innovative and non-invasive treatment option with numerous advantages over LASIK.
Reversibility
Unlike LASIK, Ortho-K is completely reversible. If you ever decide to stop the treatment, your child can simply stop wearing the lenses. Your child’s corneas will naturally revert to their original shape over time.
Dry Eye Treatment
For individuals suffering from dry eye syndrome, Ortho-K has a significant advantage. LASIK surgery can exacerbate this condition. Ortho-K, on the other hand, enables your child to enjoy clear daytime vision without wearing any eyewear, offering comfort to those with mild to moderate dry eyes.
Cost
On a practical note, Ortho-K is more cost-effective. While both LASIK and Ortho-K could save you money over the long term, ortho-k lenses typically cost about half as much as LASIK surgery upfront. The precise cost of Ortho-K lenses varies, and we will discuss your child’s individual situation during your consultation.
Myopia Management
Perhaps one of the most compelling benefits of ortho-k over LASIK is its ability to slow myopia progression (nearsightedness). Untreated myopia can increase the risk of developing severe eye conditions. Unlike LASIK, ortho-k has been clinically proven to slow myopia progression in children and young adults. This could prevent the need for cataract surgery down the line.
LASIK does not share this benefit; it merely alters the cornea’s focusing power without addressing the underlying eyeball elongation linked to myopia. Moreover, LASIK is recommended only for those whose eyes have stopped growing—typically people aged 21 and over. So, for teenagers and young adults wishing to reduce their myopia and potentially opt for LASIK later on, Ortho-K could be the ideal path.
Ortho-k for Children
Visual impairment can often hinder a child’s full participation and enjoyment of school, sports, and everyday life. However, orthokeratology offers a promising solution that equips your child with the power to see clearly without needing glasses or contact lenses.
Like in adults, pediatric ortho-k will involve contact lenses that your child wears overnight, reshaping the cornea while they sleep. As a result, your child can see clearly throughout the day without corrective lenses.
Studies have shown that orthokeratology may be effective in slowing the progression of myopia for children and adolescents. When Ortho-K is started at a younger age (6-8 years), it has an even greater success rate.
While clear vision is the utmost benefit of Ortho-K, its use extends beyond that. The overnight wear of lenses brings all lens care and cleaning inside the comfort of the home, making it easier for you to supervise and ensure proper lens hygiene.
FAQ About Ortho-K For Kids
As a parent, you may be understandably cautious about starting a new treatment to correct your child’s vision. We completely understand parent’s concerns—we’re parents too, and like you, we want the best for our kids! We help parents understand the process every day at Lang Family Eye Care. Here are a few of the most common questions we hear before parents choose Ortho-K for their kids.
Are Ortho-K lenses safe for children?
One of the biggest concerns we see from parents at Lang Family Eye Care is the safety and suitability of Ortho-K lenses for children. Research assures a high safety profile for Ortho-K, akin to the daily wear of soft silicone hydrogel contact lenses in children.
Moreover, Ortho-K lenses, being an overnight wear, can be an ideal choice for children who enjoy swimming or water sports, as the likelihood of contact with water and possible infection is low. However, it is crucial to ensure that water never comes into contact with any type of contact lens, including Ortho-K, to avoid the risk of infection.
At what age can children get Ortho-K?
There are no official age restrictions for orthokeratology. However, we generally recommend children be at least six years old before starting treatment.
Is Ortho-K better for children than LASIK?
The FDA has not approved LASIK eye surgery for kids, so Ortho-K is a great alternative. Although it has been performed in children, most refractive eye surgery providers will only operate on individuals 18 and older.
What are the risks of Ortho-K for children?
The most common side effects related to Ortho-K lens use are corneal edema, a condition involving swelling of the cornea, and corneal strain or stress. This is not solely associated with Ortho-K lenses, however, but can occur with any type of rigid contact lenses.
Discomfort or irritation from the lenses is another potential side effect, as are eye redness, dryness, and abnormal or increased tear production. The likelihood of these side effects is increased if the lenses aren’t cared for properly or if they’re worn for longer periods than recommended.
While these potential side effects may sound concerning, they’re typically quite rare and can be mitigated with proper contact lens hygiene and maintenance. It’s vital to ensure that lenses are cleaned regularly and stored properly, and that the recommended wearing schedule is adhered to.
Ortho-k for Myopia Control in Young Adults
Ortho-K lenses are becoming increasingly popular among young adults. Since Ortho-K lenses can correct vision while you sleep, young adults can enjoy a glasses and contact-free day, relishing unimpaired vision from the moment they wake up.
The ‘myopia control’ aspect of Ortho-K lenses is particularly beneficial for younger individuals, as the eye often grows faster than it should in these years.
Ortho-K lenses are proven to provide a 50% myopia control effect, meaning they can slow progression by around half. Research shows that nearly 40% of people in their 20s will experience myopia progression. Hence, it’s recommended to continue the myopia control treatment into early adulthood.
What to Expect During the Ortho-K Consultation
The process of fitting an Ortho-K lens is the same for children and adults, involving an assessment of the eye prescription and the corneal shape profile. Your Lang Family Eye Care eye doctor will educate your child on applying, removing, and caring for the lenses before starting the wear. Rigorous follow-up visits and measurements will ensure the effectiveness of the Ortho-K lens and any necessary adjustments.
Why Choose Lang Family Eye Care for Ortho-K?
At Lang Family Eye Care, we want our patients to feel fully informed and empowered about their eye health. Many clinics in the Waukesha area offer myopia management for children, but we are confident that you will notice a difference when you step into Lang Family Eye Care. We are experts at putting children at ease and making the visit fun and comfortable for everyone.
If you are interested in Ortho-K for yourself or your child, schedule an appointment to discuss your options. You will see a clear difference when you choose Lang Family Eye Care!
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