Jan 21, 2017

Managing Ayd's Myopia with Ortho-K

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What is the main difference in the two photos below?

The answer is pretty obvious, no?

Spectacles! Or rather, it's the lack of it for the past 6 months.

Unfortunately, myopia runs deep in my family. I started wearing spectacles in Primary School and the wifey trumps me by having a degree greater than 800. All these doesn't bode well for the monkies and in Ayd's case, he started developing myopia when in Primary 2. Since then, his degree has been steadily increasing.

Then I came to know about Orthokeratology, or Ortho-K for short.

Ortho-K is a non-surgical, reversible process that uses therapeutic lenses to shape the cornea while the patient sleeps. Ortho-K lenses function as "orthodontics for the eye" - something like braces, but for the the eye - and provide clear vision without the use of contact lenses or glasses in the day.

That's right, all the child needs to do is to wear specially-designed cornea moulds, which look like hard lenses, to sleep every night. The lenses reshape the corneas and by the time the child removes them in the morning, he/she can see clearly without glasses.

Of course, the perfect vision is not permanent. The myopia slowly returns after 12 hours from the time of removal so one will need to wear the Ortho-K lenses again at night for them to work their magic again. Over time, the perfect vision will be last longer throughout the day and for some people, they can even enjoy perfect vision for 2 or more whole days!

Sounds amazing!

As I did more research online, I found out that Ortho-K comes with risks too, predominantly the probability of scarring and eye infections if the procedure was not done properly.

And that was precisely the first thing I asked Titus WuOptometrist and Orthokeratologist at Titus Eye Care (TEC). Titus is currently one of only two accredited Fellows of the International Academy of Ortho-K in Singapore while his clinic is also the first in Singapore to sub-specialize in Ortho-K for children and adults.

It turns out that just like wearing normal contact lenses, hygiene is paramount. Hands and lenses must be cleaned thoroughly to prevent eye infections. Also at TEC, the Ortho-K lenses are customized for each individual cornea - no two lenses are the same... which helps to keep the risks minimally low. 

This was 1.5 years ago. Yes, we first saw Titus back in July 2015 when Ayd was having myopia of 100 degrees.

Back then, Titus kindly checked on all of the monkies' eye health and while Ash's and Ale's eyesight were perfect (and still are, thank goodness!), he suggested to monitor Ayd's vision for the next one year.

Fast forward to July 2016 and and his myopia had increased by close to 100 degrees. In a short span of one year!

With the eyesight of myopic children tending to increase rapidly during the ages of 7 – 15, myopia can increase as much as 100-200 degrees per year. Which means that Ayd may have a more than 500 degrees by the time he reaches Secondary School! And this is an irreversible process. Sigh.

Together with Titus, we discussed the merits of starting Ayd on Ortho-K so as to curb his myopia.

Top-most benefit of Ortho-K will the slowing down, or even halting his myopia condition completely. And of course, the tangible benefit of Ayd being able to snorkel and see everything underwater clearly. Or at least that was what he hoped perfect vision would allow him to do. Heh.

And so in July 2016, his Ortho-K journey began.

And because the Otho-K lenses are customised according to each individual's eyes, Titus first performed an in-office corneal impression which profiled Ayd's corneas as well as allowed him to experience how it feels like with the Ortho-K molds in his eyes.

Turns out that he handled the foreign body sensation of the molds very well so a pair of molds was made to order specifically for his corneas. A few weeks later, the molds arrived and thus began the task of teaching Ayd how to put in and take out the lenses correctly.

Okay, I have to admit - I have NEVER worn contact lenses in my entire life. I find it rather scary to be pressing onto my own eyeball so I would imagine this will be the most daunting part of Ortho-K should a child decides to get started on the treatment.

And it definitely was not easy for Ayd in the beginning.

I remember on the first morning of putting on the lenses, he could not take them out! The wifey tried to help him but somehow, the lenses were still in his eyes. So I had to bring him down to Titus' clinic where his friendly nurse helped him out. We realised that he forgot a step prior to taking out the lenses and that made the difference.

But it did get better with time, and with more practice.

In the first month, Ayd took about 15 minutes to put in the lenses at night and 20 minutes to remove them in the morning. Now after 6 months, he is so good at it that he only takes less than 5 minutes!

And he loves it! Because he gets to enjoy his daily school and weekends without the hassle of spectacles, he is more than happy to go through the night and morning rituals involving his Ortho-K lenses.

In fact, according to the regular check-ups by Titus, he is doing extremely well with regards to his myopia control. The molds are well-centred on both eyes, his eyes are pristine and healthy and his vision is 6/6 without any optical correction.

So now, he gets every Saturday off where he does not need to put on the Ortho-K lenses but hie eyesight still remains clear for 2 whole days!

And speaking of regular check-ups, Titus has got to be one of the most patient and knowledgeable optometrist I have ever met. I feel he has a genuine wish to help myopic kids keep their myopia in check and not let it spiral out of control. Plus when it comes to kids, you know and I know that it is not the most pleasing thing in the world to explain about Ortho-K to them. Add coaxing them to put on the lenses correctly, and I think it is no easy task!

So one question remains... how much does the process cost?

The Ortho-K treatment starts from $2010 (Net Amount), with costs varying depending on the level of myopia. It includes:

- Initial Ortho-K evaluation, fitting and consultation
- ALL mold changes by the Orthokeratologist for the first 6 months to attain a perfect fit
- Two individual corneal molds
- All follow-up care for the first year
- All solutions for the first time
- All topography testing

Lenses have to be replaced after every 1.5 to 2 years.

If you are interested to find out more about Ortho-K for your child - or even for yourself, because adults can also go on the programme! - do fix an appointment with Titus to find out more. From the past 1.5 years of interacting with him, I feel perfectly safe with putting my monkies' eye health in his hands.

Now, Ayd is enjoying his daily freedom of doing sports and study activities without the need to squint his eyes. Of course, he is most happy when we go swimming because as he puts it, "I can see clearly through my goggles!"

And when he's happy, I am happy too.

Benefits of Ortho-K for children:
1. Halt myopia progression
2. Provides clear vision and freedom from any form of spectacles or contact lenses in the day (especially helpful for children who participate in water, contact and racket sports)
3. Non-surgical and reversible
4. Safe and effective.

Useful Information

Titus Eye Care
Address: 10 Jalan Serene Serene Centre, #02-15 Singapore 258748
Tel: +65 6467 6338
Opening hours:
Mondays to Fridays – 9:30 am to 6:00 pm
Wednesdays – 2:30 pm to 6:00 pm
Saturdays – 9:30 am to 1:30 pm
Sundays and Public Holidays – Closed
Lunch hour – 1:30 pm to 2:30 pm

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Unknown said...

Can share what is the cost?

Cheekiemonkies said...

Hi Yvonne, the cost is in the blog post.

Curious Mum said...

Hi Kelvin
Can you share the status of your son's eye sight? Has it progress deeper since your update in February?

Thank you.

Anonymous said...

Hi, can you update on Ay’s eyes since the write up of this post? I am interested in this program. Thanks so much!

Cheekiemonkies said...

Hi all,

Thanks for leaving your comments regarding updates on my son's Ortho-K journey. I have published a new post: http://www.cheekiemonkie.net/2018/02/ortho-k-year-review-singapore.html


Anonymous said...

Hi, how long did it take for your son to achieve the maximum benefits of Orthokeratology when he first started using them? Ie, how long did it take for his prescription to become 20/20?

Cheekiemonkies said...

About a year.

Unknown said...

Hi, it been another yr, is Ay still on Ortho k?

Putting in and out for a few years, will it scratch the cornea?

Cheekiemonkies said...

Yup, still on Ortho-K. Cornea is still perfect. He goes for quarterly reviews so that his eyesight and cornea health can be assessed regularly.

Anonymous said...

Thanks Kelvin

Sue said...

May i know how old was your boy when he first started wearing the lens?

Cheekiemonkies said...

Hi Sue,

He was turning 10 that year.

low said...

Hi Cheekiemonkie,

may i ask how long has your child wore Othok K lenses?
and the myopia progression is totally halted ?

I am most worried about cornea infection as i read that infection rate is higher in Othok k than usual lenses....
how to ensure zero risk in this aspect?

Cheekiemonkies said...

Hi low,

My son has been on Ortho-K since July 2016 - about 3.5 years.

Yes, the myopia progression has been totally halted. In fact, we just went for his review in Dec 2019 and his eyeball growth did not even grow at all for the past one year which means that his myopia did not go up.

Infection is a real concern for Ortho-K but so far, my son did not have the issue. Discipline is required as the child must always remember to wash hands before touching the lens.

Bridget said...

I understand ur son Ayd has been on ortho-k for almost 4 years. How often does he need to change the contact lenses? And each change will require to pay the full amount all over again is it?

Best regards

Cheekiemonkies said...

Hi Bridget, thanks for your comment. The contact lenses need to be changed approximately every 3 years but the time frame varies because it's dependent on whether the lenses are being taken care of during the years, and whether the lenses are still adequate in preventing the eyeballs from elongating. Yes, you have to pay for the lens change but probably minus the initial consulatation charges.

Life of a Wolf said...

hi, can i check. if your son wants to have perfect eyesight in the future, he has to continue wearing it forever?
i’m looking into ortho K for myself. but i’m thinking if i should get it since it’s more expensive than contact lens. sigh.

Cheekiemonkies said...

Hi Life of a Wolf,

Yes, that is correct. Ortho-K is not a permanent solution. Instead, it is to prevent a rise in myopia especially for kids in their growing years. When their eyeballs have matured and the tendency for myopia to increase has diminished, then they can stop Ortho-K and the low myopia will return.

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