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We were unable to process your request. Please try again later. If you continue to have this issue please contact customerservice@slackinc.com.<\/strong> <\/p>\nBack to Healio<\/button><\/p>\n<\/div>\n<\/div><\/div>\n<\/p><\/div>\n<\/p><\/div>\n<\/div>\nKey takeaways:<\/h2>\n\nAdolescents wearing ortho-K lenses had significantly lower tear film instability and greater meibomian gland loss.<\/li>\n Regular follow-up and close monitoring of ocular surface health are needed.<\/li>\n<\/ul>\nWearing orthokeratology lenses to control myopia progression may pose risks to ocular surface health, including loss of meibomian glands and tear film instability, according to a study published in Contact Lens <\/i>&<\/i> Anterior Eye<\/i>.<\/p>\n
\u201cContact lenses have several advantages, but they act as foreign bodies on the eye and can alter the normal structure of the tear film,\u201d Xiao-Di Yang<\/b>, <\/b>of First Affiliated Hospital of Zhengzhou University, China, and colleagues wrote. \u201c[Orthokeratology] lenses are corneal contact lenses worn overnight. … Several studies have examined their effects on the ocular surface. However, the longest follow-up duration reported by these studies was 2 to 3 years.\u201d<\/p>\n
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Image: Adobe Stock<\/i>
Yang and colleagues conducted a cross-sectional study of 60 adolescents, 30 of whom had worn orthokeratology lenses for at least 5 years (mean duration, 5.75 years) and 30 of whom wore spectacles. They matched the patients demographically and compared visual acuity, meibomian gland loss, corneal fluorescein staining, tear meniscus height and noninvasive tear breakup time.<\/p>\n
According to the results, orthokeratology wearers had significantly lower tear film stability and greater loss of meibomian glands in the lower eyelid compared with non-wearers.<\/p>\n
The loss of meibomian glands in the lower lid increased by 4.044% for each 1 D reduction in myopia. Losses were greater in boys than girls after adjusting for other factors (P <\/i>= .003).<\/p>\n
Wearers of orthokeratology lenses also had significantly thinner tear film lipid layers (P<\/i> = .008) and lower noninvasive tear breakup time (P<\/i> = .04) on average, further indications of compromised ocular surface health.<\/p>\n
Yang and colleagues noted that while none of the orthokeratology wearers experienced \u201cmarked ocular discomfort,\u201d the results still show that \u201cthe degree of [orthokeratology] correction is a factor affecting the safety of wear.\u201d<\/p>\n
\u201cThe specific reasons and mechanisms require further investigation,\u201d they wrote. \u201cThese findings highlight the importance of regular follow-up during lens wear. They also emphasize the need for wearers of [orthokeratology] lenses and ophthalmologists to monitor ocular surface health closely.\u201d<\/p>\n
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Perspective<\/h2>\n Back to Top
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This study highlights the ocular surface considerations of orthokeratology (ortho-K) lenses, which still require more investigation to determine if they are reversible. Most practitioners would expect some level of tear film disruption and tear breakup time with any contact lens wear, whether ortho-K or soft lenses. In contrast to daytime wear gas permeable or soft lenses, fewer practitioners might consider ortho-K\u2019s impact on meibomian gland loss due to reduced lens-lid interaction in a closed eye environment. Yet this association was notable in the lower eyelids and in patients with higher myopic correction. Despite this, the study notes that there was no difference in dry eye symptoms for ortho-K wearers vs. non-wearers. <\/default:p>These results may lead ortho-K fitters to recommend prophylactic dry eye treatments or incorporate meibography into routine testing, even when patients are not yet symptomatic. Often, we pay extra attention to make sure we avoid central staining with ortho-K, but these results suggest we should focus more on the lids and meibomian glands. This may also factor into how we consult patients and parents when choosing myopia management treatments. <\/default:p>Limitations include a small sample size and solely Chinese population, as anatomical differences may limit generalizability to other ethnicities.<\/default:p><\/p>\n\n
Jeffrey Kong, OD, FAAO<\/strong><\/p>\n\nHerbert Wertheim School of Optometry, UC Berkeley<\/span><\/li>\nThis perspective is powered by the American Academy of Optometry Communications Committee.<\/span><\/li>\n<\/ul><\/div>\n
Disclosures: <\/strong> Kong reports being a sub-investigator for CooperVision.
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