Orthokeratology or Corneal Molding

Vision Correction Without Surgery

Orthokeratology, also commonly known as corneal refractive therapy, vision shaping treatment, corneal molding and Ortho-K is the gentle reshaping of the cornea to correct Myopia (nearsightedness), Hyperopia (farsightedness), Astigmatism, and Presbyopia (bifocal) .

History of Ortho-K

Orthokeratology is known by numerous names and the technique has change greatly over the years.  Various forms of Ortho-k have been practiced for about 40 years.  The technique first involved using progressively flatter lenses to flatten the cornea causing the patient to become less nearsighted.  This early method required months to show results and the patients had to wear their lenses during part of each day or wore them on alternating days.

Corneal Molding has evolved into a method where over 80% of the patients achieve success with the first lens.  Good results typically take less than a week.  The process is accomplished while you sleep using a computer designed reverse geometry contact lens.  The lenses are inserted at bedtime and removed in the morning.  The lenses, also known as vision retainers, safely and gently reshape the cornea changing the eye's focus.  Most patients will have good vision throughout the day. Some patients may only need to wear their lenses on alternate nights to maintain good vision.

Preventing the Progression of Nearsightedness in Children

Numerous recent studies have shown that orthokeratology lenses can prevent the progression of myopia (nearsightedness) in children (opens in new window).  Why is it important to prevent the progression of nearsightedness in our children? The incidence of myopia, in the United States, increased by 66% in the last 30 years. Currently, a multi-center FDA sponsored study is in it's fourth of five years and thus far the preliminary results are confirming that OrthoKeratology does indeed effectively prevent the progression of nearsightedness.

How Does it Work?

Orthokeratology is accomplished by using a specially designed contact lens called a reverse geometry lens that gently flattens the cornea by pushing the central epithelial layers that reside directly over the pupil towards the periphery as shown by the corneal topography images below. This movement of corneal cells causes the center of the cornea to be thinner thus moving the focus of light closer to the retina. Orthokeratology refocuses the light on the retina in the same way as LASIK and PRK.


FDA Certified Training Required of Eye Doctors to fit Overnight Orthokeratology Lenses

The traditional methods of fitting the reverse geometry lenses used in modern Ortho-K do not follow traditional contact lens fitting methods. Because of this difference the FDA restricts the use of these lenses to only those doctors that have been specially trained in their use. This is an additional requirement that has never been used for contact lenses, however, it is much like the requirement for the additional training required of physicians that use the excimer laser for LASIK and PRK.

This special provision has never been used for contact lenses, although it has been used for other ophthalmic devices such as excimer lasers for refractive surgery procedures.

Overnight Orthokeratology is FDA Approved

Post_OrthoKeratology_Corneal_Topography.jpgPost Orthokeratology Corneal TopographyOnly a handful of orthokeratology lenses have been approved for overnight orthokeratology by the FDA

What are My Options?

Expect your eye doctor to consult with you regarding the wide range of options that area available to you. He or she will help you focus on which option or options best fulfill your visual needs.


This is the most common, safest and simplest option.  All contact lens wearers should have a pair of glasses that they can fall back on when they can't or should not be wearing their contact lenses.

What Should I Expect

Patients interested in Ortho-K start with an eye exam.  After a comprehensive eye exam, including an Ortho-K consultation, corneal topography is done.  These are topographical maps of the cornea. Everyone's topographical map is different, much like our fingerprints.

Corneal topography shows us irregularities in the cornea and is essential to designing contact lenses that will mold your cornea.  Corneal topography also allows us to diagnose corneal diseases such as keratoconus. Specular microscopy is also performed which allows us to see that the corneal cells are healthy.

The corneal topography data is then used with the refractive data to design a gas permeable contact lens that will flatten the cornea, resulting in clear vision.

When we receive your contact lenses we verify the lens order and call you to schedule a time to dispense you contacts and teach you how to insert, remove and care for them.

When you pick up the lenses Dr. Marino will verify that they fit as expected and determine when you will be seen next.

Patients wear their lenses at night, while sleeping, and remove them in the morning.  

Schedule an Orthok Consultation online with Dr. Marino

or call us at 305.233.2040 and See What Option is Best for You