At Handel Vision Clinic, we strive to help you manage myopia so that you or a loved one can see life clearly. We offer several management options for this common eye disorder, which can improve vision as well as slow the progression of myopia.
Our doctors carefully monitor each patient as they progress through myopia management and each case is reviewed every 6-12 months to ensure progress and efficacy in treatment.
We are proud to offer this evidence-based treatment that works to prevent the onset or reduce the progression of nearsightedness in our patients. Our dedicated team prides itself on staying at the forefront of eye care advancements so you can feel confident choosing us for your treatment.
Corneal molding is the process of fitting a specially designed contact lens that is to be worn while sleeping to temporarily reshape the front surface of the eye (the cornea). Similar to wearing a dental retainer from an orthodontist, the lens works overnight to gently and gradually reshape the cornea to help eliminate or reduce myopia. This provides clear vision upon awakening without having to wear glasses or contact lenses throughout the day!
The process of corneal molding may also be referred to as orthokeratology, Ortho-K, Corneal Refractive Therapy, CRT, Gentle Molding, Vision Shaping Treatment, VST, The Gentle Vision Shaping System, GVVS, or Gentle Molding.
Our doctors are part of an elite group who have been specially certified in designing and dispensing both the MOONLENS as well as Wave lenses. You may also hear corneal molding lenses be called Ortho-K lenses, retainer lenses, vision retainers, or CRT lenses.
The visual effects of corneal molding are temporary as the lenses must be worn nightly to be effective. However, the long term benefit is that it has been proven to slow myopia progression in children, resulting in a lower prescription and reduced risk of certain ocular diseases in their lifetime.
Corneal molding is also a great option for patients who would like to see clearly throughout the day without the assistance of glasses or contact lenses. For example, athletes, lifeguards, construction workers, and even patients with dry eyes or allergies can all greatly benefit from the freedom that comes with no daytime corrective wear.
These lenses slow the progression of myopia by creating a peripheral myopic distortion on the retina. This is a fancy way of saying that it makes light focus in front of the retina instead of behind it, which is what occurs in traditional myopia therapy (standard glasses and contact lenses).
Several studies have shown the effectiveness of this type of treatment, including the CANDY study(Controlling Astigmatism and Nearsightedness in Developing Youth) which concluded that corneal molding “does both significantly reduce and even stop the rate of change of nearsightedness and astigmatism in developing youth (ages 9-18).”
To learn more about myopia and the science behind myopia management, check out this video from Dr. Peter Wilcox, one of the optometrists behind the CANDY study:
Common corneal molding questions
Is it safe?
Yes! Corneal molding was approved by the FDA in 2002 and is safe as well as reversible. There is a slight risk of infection, as with any type of contact lens wear, but this can be treated by our doctors with antibiotic drops and avoided by following our recommended lens cleaning and disinfecting regimen that will be discussed at your visit.
Why have I never heard of this before?
Although corneal molding has been around for years, it is not nearly as common as being prescribed standard glasses or contact lenses. A successful fitting process requires specialized optical measuring equipment, advanced training and years of experience. We are proud to be one of the few practices who have been trained and certified to offer this elite style of myopia management!
Does this work on all prescriptions?
Corneal molding is approved for correcting mild to moderate amounts of prescription. Generally we are able to effectively correct up to -5.00 diopters (D) of myopia as well as lesser degrees of astigmatism.
Can adults have this treatment?
Yes! Although corneal molding is designed to help slow the progression of myopia throughout childhood, it can also be used for adults who would benefit from not having to wear daytime corrective lenses. This can be especially helpful to athletes, those who work in dusty or dirty environments, or anyone who wants to experience improved vision without undergoing surgery.
What if my child isn’t ready for contacts?
You may feel that your child isn’t ready for the responsibility of daily contact lenses just yet, but this doesn’t necessarily exclude them from a myopia management plan!
Many children excel with corneal molding lenses since they are only worn at night and they are able to handle the lenses in the comfort of their home. They are typically motivated by the idea of not having to wear their glasses and are less likely to lose or abuse their lenses compared to daytime lens wearers.
As with any type of contact lenses, corneal molding lenses require a certain level of responsibility, maturity and dexterity for healthy and successful wear. If it is decided your child is not a good candidate for any type of lenses at this time, we may still have the option of atropine therapy for managing their myopia!
What type of testing will be done?
Testing for myopia management is more extensive than what is performed at a standard annual eye exam. Each of the below tests is non-invasive, and your comfort is our top priority. We are happy to explain anything you or your child have questions about on the day of your consultation.
- Axial length and retinal shape measurements
- Corneal topography and choroidal thickness measurements
- Cycloplegic axial and peripheral autorefraction
- Lifestyle questionnaire to determine the amount of time spent outdoors and doing near-work
- Ocular health assessment
- Discussion of the results
- Development of personalized treatment plan
How long does it take to see results?
In most cases, it typically takes about one to four weeks to achieve clear vision, but depending on your initial prescription, you may see an improvement in as little as one day! Our doctors may provide temporary soft contact lenses to use until we reach optimum daytime vision.
If you’d like to hear an honest review of the results, check out Dr. Handel’s daughter Maren discussing her first day experience with her corneal molding lenses!
What happens if we stop using the corneal molding lenses?
The clear vision that results from wearing corneal molding lenses is transient, meaning if you stop wearing them the front surface of your eye (the cornea) will return to its normal shape and you would need to return to wearing daytime glasses or contact lenses.
Since standard glasses and contacts do not slow the progression of myopia, if your child stops wearing their corneal molding lenses, their prescription will continue to worsen with time.
What will happen if we don’t do any myopia management?
If you decide that you’d like your child to stay with standard daytime glasses or contact lenses for now we have plenty of wonderful options! However, please remember that this form of treatment is temporary and that without preventative management, your child’s myopia will continue to worsen with time. Your child’s prescription by adulthood will be much higher than it would be with prevention, which increases their risk of developing certain ocular diseases later in life. This could also potentially result in drivers license restrictions and the inability to work certain jobs such as a pilot or a police officer. You may schedule an appointment with our Myopia Management team at any time, although the sooner preventative treatment begins the more successful it will be!
How do I know if I (or my child) am a good candidate?
If you can answer yes to any of the below questions, you may be a great candidate for corneal molding! Additional testing performed at your consultation will help us confirm your candidacy and treatment potential.
- Do your child’s eyes keep getting worse every year?
- Do you dislike the look or feel of glasses?
- Are you interested in LASIK but not yet ready or qualified?
- Is your child being bullied for wearing glasses and/or refusing to wear them?
- Would you like to hike, camp, swim, or exercise without having to wear glasses or contacts?
- Are you constantly losing or breaking your glasses?
- Do you (or your child) have a tendency to abuse or over wear your contact lenses?
- Are you tired of your glasses fogging up, sliding down, or getting dirty?
- Do you have dry eyes or allergies that prevent you from comfortably wearing your contacts?
- Would you like to help protect your child’s ocular health and avoid potentially blinding diseases in the future?
- Are you an athlete who is hindered by glasses?
- Do you work in a dusty or dirty environment that is always coating your contacts or glasses?
- Does your job require good vision without the assistance of glasses or contacts?
If you or your child can answer yes to any of these questions, call our office to schedule an appointment and mention you are interested in meeting with our Myopia Management team!
Specialty soft contact lenses
Another myopia management option involves the fitting of specialty soft contact lenses. This originally began by using soft multifocal lenses that have a certain design which creates the same type of peripheral myopic distortion that is created with corneal molding lenses. These lenses are still used as an off-label treatment for myopia management and children have been studied to show 25% less progression over two years than those in standard single vision lenses.
In addition to these multifocal lenses, our doctors are also certified to fit Coopervision MiSight lenses. This daily lens is the first soft contact that has been FDA-approved for myopia control and has been proven to slow myopia progression in children ages 8 to 12 at an average rate of 60% over 3 years.
These lenses work to simultaneously correct a child’s nearsighted prescription while also working to slow its progression. They must be worn throughout the day since they do not cause any type of eye reshaping like corneal molding lenses.
Atropine eye drops
A non-lens treatment option that is offered through our Myopia Management Center is a drop therapy called atropine. Atropine, at a very low concentration, is dropped into both eyes at nighttime. The mechanism by which atropine slows the progression of myopia is unknown.
This drop concentration is low enough to not create any significant side effects yet strong enough to help reduce the progression of myopia by 50% over 5 years. Atropine can mildly dilate the pupil and relax the focusing mechanism inside of the eye. It is a great option for younger children or those who are not quite ready for contact lens wear.
Since this method of treatment does not reshape the cornea, it still requires your child to wear their glasses throughout the day.
To learn more about these treatment options and discuss which method is right for your child, call our office and ask to schedule an appointment with our Myopia Management team!