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Other names: Nor-qd, Ortho Micronor
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EYE CARE: BE CAUTIOUS OF ORTHOKERATOLOGY
The American Association of Ophthalmology (AAO) also warns about a possibly harmful system of tight-fitting contact lenses used to reshape the eye by someone hoping to eliminate the use of surgery, eyeglasses, or contact lenses forever.
Orthokeratology is a technique that appeals to the vanity of the nearsighted person who has worn spectacles all his life. Orthokeratology is untested, costly, and may in the long run prove detrimental, says the AAO. With the little formal research available on the technique, “it seems to be more a gimmick than anything else,” cautioned former president Dr. Alfonse Cinotti.
The gimmick is a promise of adequate vision without the burden of visual aids, a promise that appeals to myopic people who should have eye correction with lenses or surgery but refuse. Myopia has the eyeball misshapened; it is too long or too steep. Therefore, light that enters the eye has to travel a greater distance to hit the retina than it travels in the normal eye. Light and the image it carries falls short of focusing on the retina, causing myopia, which is an inability to see things at a distance.
In an attempt to correct this nearsightedness through the technique of orthokeratology, a series of increasingly tighter fitting contact lenses are used over a period of time in an effort to reshape the cornea. Supposedly, the tight fitting lenses flatten this soft tissue which covers the eye, making the eye shorter, so light focuses where it should, directly on the retina.
“But there is not enough scientific information about orthokeratology to say whether it’s useful or worthless,” said Dr. Burton Krimmer, the ophthalmologist from Chicago whom we also cited earlier. “So far there have been no control studies and most of the information is anecdotal – word of mouth.” Dr. Krimmer added that the dangers of orthokeratology appear to be greater than any values it has to offer.
“When contact lenses are too tight they disturb the transfer of gases in and out of the cornea. This disturbance can cause the cornea be become cloudy or even ulcerated -painful and harmful conditions,” Dr. Krimmer continued.
Corneal ulcers, which are similar to bedsores that occur when there has been pressure too long on one spot, are infections that can lead to the loss of the eye, explained Philip Hessburg, M.D., an ophthalmologist from Michigan. Dr. Hessburg charged that the underlying theory of orthokeratology, the permanent change of soft tissue with a temporary device, appeared to be unsound.
“To my knowledge, there is no evidence to show that we can permanently alter the shape of any soft tissue,” he said “if we could do so, we could correct protruding ears by taping them down at night or lift up the jowly chin with slings one sees sold near the backs of ladies magazines. We could destroy the bra and girdle industry if the use of their garments permanently molded soft tissue,” Dr. Hessburg assured.
Why then would anyone resort to orthokeratology? It has worked in some people who are slightly myopic, the AAO acknowledges. But these myopics probably don’t even have to wear regular contact lenses because their nearsightedness is so slight.
Orthokeratology also produces a temporary change in vision after a while. This might appeal to the person who wants to pass a job interview without any optical device, suggested Dr. Krimmer. He added, though, that people who are required to have perfect eyesight for their jobs, like pilots, may put themselves as well as other people in danger.
*39/127/5*
