Seeing Is Believing: Correcting Vision While You Sleep

By Kaaren Valenta

Wouldn’t it be great if you could correct your vision while you sleep?

It might sound far-fetched but many people who have myopia (nearsightedness) have that option now because of new advances in vision treatment called orthokeratology.

Myopia is a vision problem experienced by up to about one-third of the population. Nearsighted people have difficulty reading highway signs and seeing other objects at a distance, but can see for up-close tasks such as reading or sewing. Usually the condition is corrected by glasses or contacts, but both have drawbacks for many patients including those of all ages who play sports or just hate to wear glasses. You can scratch your lenses, break the frames, or lose a contact.

Now, however, special contact lenses are available to wear while you sleep. They gently reshape the surface of your eye, the cornea, so you can see clearly even after you remove the lenses. The effect is temporary — usually enough to get you through a day or so, but you must wear the special lenses each night.

The first brand to receive FDA approval for overnight corneal reshaping — corneal refractive therapy (CRT) — was Paragon Vision Sciences. The contacts are fitted only by eye care professionals who have been through the company’s certification procedure. Bausch & Lomb has a near Vision Shaping Treatment (VST) and there are also others who have followed Paragon’s lead.

Dr Roger A. Moore, an optometrist whose office is on Church Hill Road, has been fitting patients with the Paragon CRT lenses since they were approved about two years ago.

“I had to go through a training program, then pass an exam to show competency,” Dr Moore said. “I like the Paragon CRTs. The company has a good support network if you have questions.”

The idea of reshaping the cornea is not new. Before the FDA approved the CRTs two years ago, some vision professionals had been using rigid lenses to accomplish the same effect as an “off-label” use.

“But they had to design the lenses themselves. It was unpredictable,” Dr Moore said. “The Paragon CRT is the first therapeutic contact lens to be proven to work and proven safe for overnight wear.

“The CRTs are firm lenses that are designed especially for each patient,” he said. “I do a topographical map of the cornea, which shows the curvature — where it is the most curved, where the least curved — across the whole surface. From that and their eyeglass prescription, I design an appropriate [CRT] lens for them. Then the company makes it.”

There are no age restrictions on using these gas permeable contact lenses. Whether they are right for children depends on the child’s motivation, hygiene, and maturity level, Dr Moore said.

“Firm lenses take some getting used to,” he admitted. “But the patients we’ve worked with have all been successful. There have been no failures. Not all have gotten 20/20 vision, but they’ve had a significant improvement.”

In the FDA clinical study for approval of CRT, 93 percent of patients achieved 20/32 vision or better, and 67 percent achieved 20/20 or better. Eye care professionals usually aim for 20/20 vision, but 20/40 vision (the legal minimum for driving in most of the United States) is typically considered acceptable.

The contacts are worn each night and cleaned during the day with solutions similar to other rigid contact lenses. They are replaced annually.

“This is a good way for people who are interested in Lasik surgery to test drive it,” Dr Moore said. “Based on the results, they can decide whether to have the surgery or stay with the CRT lenses.”

CRTs treat nearsightedness with or without minor astigmatism. Most patients who try CRTs see a dramatic improvement in the first few days; complete vision correction may take a week or two.

The cost is about a third of that of Lasik surgery.

“It’s about $1,400 for the whole process including two pairs of contact lenses. It involves several office visits during the first six weeks,” Dr Moore said. “After the first year, the follow-up cost is just the regular annual examination. A replacement lens, if you need one, is about $160.”