Corneal Reshaping

Corneal Reshaping (Orthokeratology) in Birmingham

Corneal Reshaping: A Non-surgical Alternative to LASIK for Adults. An Opportunity to Slow the Progression of Nearsightedness in Children. Improves Your Vision While You Sleep!

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Corneal Reshaping (orthokeratology) is an FDA-approved, non-surgical method of correcting your vision. It works by wearing specially designed eye retainers that are ONLY worn while you sleep. The special design gently reshapes the front surface of your eye while you sleep. In the morning, the retainers are removed. Due to the new shape of the surface of your eye, you achieve clear vision without daytime contacts or glasses. If you, 1) are nearsighted or farsighted, 2) are tired of daytime contact lenses and glasses, 3) have a young child who is nearsighted and you want to slow the progression of their nearsightedness, 4) you are afraid of LASIK surgery, 5) you are tired of your reading glasses, then Corneal Reshaping is for you.
 
As an eye doctor, parents often ask the question: "Is there anything that can be done to prevent my child from getting thicker and thicker lenses in their glasses each year?"  Until recently, I could only tell the parent that their child's vision will continue to change until the eye stops growing. All we can do is wait and continue to give them thicker lenses to keep their vision clear. Nearsightedness was, and still is thought by many to be genetically pre-programmed, although new findings suggest that increased near work(reading and computers) and other environmental factors play a key role. Conventional wisdom has said that there is nothing that can be done to change the final outcome of their vision. That is, until now.

We can now offer this non-surgical procedure called Corneal Reshaping. This procedure has been shown in studies to slow the progression of nearsightedness in children. The exact mechanism of this slowing is still a subject of debate, but it appears that Corneal Reshaping affects the signal to the eye that causes the nearsightedness to progress thereby slowing it's progression.

Corneal Reshaping is not just for children. It is a non-surgical alternative to LASIK that works well in adults too. To date, Dr. Keriotis has treated patients with farsighted prescriptions up to +5.25 and nearsighted prescriptions up to -8.50 and astigmatism up to -2.50.

Please read the list of Frequently Asked Questions below which should answer most of your questions about this exciting procedure. 

Click the image below watch Dr. Keriotis explain how Corneal Reshaping corrects your vision and how it can slow the progression of nearsightedness in your child.

A corneal topographer is used to measure the eye to within thousandths of a millmeter in order to make a custom Corneal Reshaper.

Corneal Reshaping: FAQ from Your Birmingham Optometrist

What is Corneal Reshaping?

Corneal Reshaping, also known as orthokeratology, uses special, computer-designed Corneal Reshapers to gently and gradually reshape the front surface of the eye (the cornea). This change in the shape of the front surface of the eye corrects nearsightedness (myopia), farsightedness (hyperopia), astigmatism and presbyopia (need for reading glasses) allowing for clear vision all day long. The Reshapers are similar to conventional oxygen permeable contact lenses and they are unique in that they are worn only at night while sleeping. The Reshapers are removed upon awakening to provide clear vision without using glasses or daytime contact lenses! The Reshapers are comfortable and very easy to care for.

How does it work? 

The Corneal Reshapers are custom designed for each and every patient. We measure your eyes with a corneal topographer, a highly specialized computer. The topographer measures nearly ten thousand different points across the cornea. These points are mapped and analyzed by a computer showing the precise contour of your eyes resulting in a "map"(see below left) of the eye much like a topographic map of a mountain(see below right).These measurements are accurate to 1 thousandth of a millimeter! It is this degree of accuracy along with a special design software that uses this information to design your Reshapers to precise specifications. The Reshapers will gradually and gently reshape the front curvature of your eyes as you sleep, thus reducing your nearsightedness or astigmatism. The Reshapers must be worn nightly to maintain the effect on your vision.

 

Figure 1: A corneal topographic map(above left) shows the detailed shape of the front of the eye much like a topographic map of a mountain (above right) shows the varying terrain of a mountain.

I’ve never heard of Corneal Reshaping. Is it new?

Yes and no. Corneal Reshaping also known by its more technical name, orthokeratology, has been around for nearly 50 years. However, due to technology limitations in diagnostic testing, reshaper designs and materials, orthokeratology would take months to complete and the results were unpredictable. For this reason, the procedure remained out of the mainstream of the profession as very few doctors and patients elected to participate in it. Recent technological advances in corneal topography, lens designs, lens materials and lens manufacturing have immensely improved the effectiveness and the popularity of the procedure.

Does Corneal Reshaping help stop my child’s eyes from getting worse?

This is the most exciting aspect of this procedure. Recent studies have shown that Corneal Reshaping is stopping or reducing the rate of progression of nearsightedness in children. It's a bit complicated, but here is a great presentation to explain how Corneal Reshaping is thought to control the progression of nearsightedness (It may take a moment to load. Click the arrows to advance.) More long-term studies are in progress to confirm this finding and the exact mechanism by which this happens, but in our opinion children with rapidly progressive nearsightedness should wear these lenses in an attempt to reduce myopia progression.

Dr. Keriotis' article on controlling nearsightedness has been chosen by Angie's List as the winner of their "Experts" article competition. Click the photo below to read about the options to control nearsightedness.

What’s the difference between LASIK and Corneal Reshaping? 

Both LASIK and Corneal Reshaping work by changing the shape of the front of the eye. This changes the way light focuses at the back of the eye resulting in clearer vision. (See Figure 2 below) While both procedures have the same end effect, they achieve their results in dramatically different fashion.

LASIK

  • LASIK is a surgical procedure. 
  • Tissue damage - In LASIK, the surgeon uses a micro-keratome (a special razor that shaves a flap of corneal tissue on the eye) and a laser to destroy the underlying corneal tissue and nerves to flatten the front surface of the eye. Therefore, with LASIK surgery, both nerve and corneal tissue are destroyed. 
  • Dry Eyes - It is well documented that LASIK results in the annoying side effect of dry eyes. While this may sound like a minor issue, ask anyone who suffers from dry eyes and they will tell you how troublesome it can be.
  • Non-reversible - LASIK and it's side effects are not reversible. While it's true that enhancements may be performed, this causes further thinning and weakening of the cornea. 
  • Weakened cornea - The "flap" that is made on the cornea does not heal with the same strength as the original cornea, and thus may dislodge with any kind of eye injury. The cornea is thinned by the laser creating a weakened surface prone to bulging and distortion of vision.
  • Limited to Adults - Good LASIK candidates need to have unchanged prescriptions for at least one year and should be 21 years of age and older.
  • Risk of Infection - As with any other surgical procedure, there is a risk of infection.
  • FDA Approved - approved by the FDA.

Corneal Reshaping

  • Corneal reshaping is a non-surgical procedure. 
  • No Tissue Damage - There is no cutting of the cornea, no severing of corneal nerves essential to maintaining normal corneal physiology, and no destruction of normal corneal tissue which helps maintain the eye's original strength. 
  • Suitable for Dry Eyes - Corneal Reshaping may work in all but the most severe forms of dry eyes. 
  • Reversible - Corneal Reshaping is modifiable and reversible, so if you do not achieve the results you desire, the reshapers may be either re-designed to improve the therapeutic effect or simply discontinued. If discontinued, the shape of your eye will gradually return back to it's original shape.
  • No Age Restrictions - Corneal Reshaping is ideal for patients of all ages, including children.  Corneal Reshaping can be performed even if your prescription has been increasing. 
  • Risk of Infection - As with all forms of contact lenses, there is a slight risk of infection.
  • FDA Approved - Corneal Reshaping has been approved by the FDA as both safe and effective.

Comparison of Corneal Reshaping and LASIK Results

 

Corneal Reshaping and LASIK

FIGURE 2 (above): Comparison of end results of Corneal Reshaping and LASIK. Compare the above images. They represent topographic maps of the shape of the cornea before and after Corneal Reshaping(above left) and LASIK(above right). Notice the central curved shape of both of the top left and top right images. These represent the shape and contour of the eye before the respective procedures are performed. In the bottom images, notice the central blue shaded areas in the center. This blue shading represents the flattened area of the cornea resulting from the given treatment. As you can see, the end result of both Corneal Reshaping and LASIK procedures is a central flattening of the shape of the eye. It is this flattening that reduces the nearsightedness and helps improve your vision.

Check out this October 2013 video from Dr. Oz on the pitfalls of LASIK: Dr. Oz

Do all eye doctors perform Corneal Reshaping?

No. Please understand, Corneal Reshaping is NOT "just a contact lens fitting". Corneal Reshaping (orthokeratology) represents one of the most complex procedures in the profession. In fact, less than 1% of optometrists perform this procedure. The Reshapers are used to precisely mold and maintain the shape of eye tissue. Thus, Corneal Reshaping needs to be performed in a very exact and meticulous manner. Most doctors are unwilling to commit the time and resources necessary to become proficient at it. Corneal Reshaping requires additional education, certification and sophisticated equipment to be able to perform the procedure successfully. Dr. Keriotis is certified to fit the following Reshaping lenses: WAVE, Paragon CRT lens, GOV lenses, Euclid Emerald lens, and the DreamLens all of which are FDA approved as safe and effective.

Does Corneal Reshaping work on all prescriptions? 

There are limitations to Corneal Reshaping so, not everyone can benefit from the procedure.  The best candidates are those who have a nearsighted spectacle prescription of up to -6.00 diopters with up to -1.75 diopters of astigmatism. There are many documented cases that have been successful with much higher amounts of nearsightedness and astigmatism.  Farsighted prescriptions of up to +5.50 can also be corrected. Dr. Keriotis has successfully treated nearsighted prescriptions as high as -8.50 and farsighted prescriptions as high as +5.50 and astigmatism up to -2.50. Once we perform a full comprehensive exam, we can let you know if you are a candidate. The speed that the Corneal Reshaping occurs varies with each patient. Those with higher prescriptions take a bit longer than those with lower prescriptions.

I wear bifocals (or reading glasses). Can Corneal Reshaping work for my eyes?

Absolutely! There are different options available for those who need help with their reading vision.

When it comes to eyes, I’m very concerned, is it safe?

There is a small risk involved when any contact lens is worn. The risks with Corneal Reshaping are no greater than those of any extended wear, soft contact lens. Corneal Reshaping is very safe. Our program is designed to minimize risk and insure your success. We utilize FDA approved materials and lens designs to insure the health of your eyes. It is safe for children and adults and is an excellent alternative for children who are just first becoming nearsighted.

Dr Keriotis is now a Corneal Reshaping patient himself! Here what he has to say:

See What Our Patients Have to Say About Corneal Reshaping. 

Hear about our latest success story and this patient's experience with Corneal Reshaping by clicking the video below.

Hear our patient's experience as she discusses Corneal Reshaping by clicking the video below.

Hear a parent's perspective on her child's Corneal Reshaping experience by clicking the video below

Think your child is too young for Corneal Reshaping? Click the video below to hear what the mother of one of our younger( 8 year old ) patients has to say.

Does Corneal Reshaping work for adults too?

Absolutely. It can improve vision in adults as well. It is an excellent non-surgical alternative to LASIK surgery.

Does health insurance or discount vision plans cover this procedure?

Unfortunately, health insurance considers both non-surgical Corneal Reshaping and surgical LASIK vision improvement to be cosmetic and therefore, do not cover this procedure.

Does Corneal Reshaping qualify for Reimbursement Accounts, Medical Savings Accounts etc.?

Yes, Corneal Reshaping does qualify for employer sponsored Health Care Reimbursement Accounts and many patients take advantage of this benefit.  

If I discontinue Corneal Reshaping Therapy, will my vision to return to normal?

Yes, unlike LASIK which is a permanent, irreversible procedure, your eyes will gradually return to their pre-treatment level when you stop wearing the reshapers. Generally, the more myopia being reduced, the longer it will take for the corneal curvature to return to normal. For instance, if your pre-treated correction was - 4.50D, it would take a few days longer to return to normal than if the pre-treated correction was -1.50D.

Interested? Call (205) 979-EYES(3937).

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