HOLYOKE You'll see without glasses or contacts.
That's the promise laser eye surgery touts in TV and radio commercials and newspaper and magazine ads.
It's a blessing for some. For others the cost -- often close to $1,500 per eye -- or just the thought of someone cutting into their eye may put that blessing out of reach.
But what if there was an alternative way of going glasses-free, one that didn't involve cutting the cornea of your eye?
A method that temporarily corrects nearsightedness (and farsightedness) in adults -- and possibly halts the progression of nearsightedness in children -- without surgery, and at a lower cost?
Such a method does exist. It's called Orthokeratology, or Ortho-K.
This method corrects nearsightedness, farsightedness -- and in some cases, astigmatism -- by using contact lenses to reshape the eye's cornea.
The difference is that with Ortho-K, patients wear these specially-fitted corrective lenses at night, while they sleep.
Dr. Alfred Hutt, a board-certified ophthalmologist and optometrist with a practice at 10 Hospital Drive in Holyoke, has been fitting patients for Ortho-K correction for the past two years.
In that time he has fitted 50 patients -- including three children ages eight, 10 and 12 -- with Ortho-K lenses.
All but one patient -- whose eyes seem to be resisting the reshaping process -- have had success with the procedure. In the case of his young patients, Hutt said the corrective lenses have stopped the progression of their nearsightedness.
"It was only three patients," Hutt cautioned. "But this is the period of life when we expect nearsightedness to increase."
How Ortho-K works
Hutt said corneal reshaping through the application of contact lenses is nothing new.
"Years ago, when contact lenses were first being fitted, [practitioners] noticed that patient's corneas were flattening and there was a temporary correction of their vision," Hutt said.
The problem with this early correction was twofold: results were not predictable and the lenses were not oxygen-permeable, preventing overnight wear.
"But when oxygen-permeable lenses came out, the corrective lenses were redesigned and Ortho-K came into its own because the results were predictable and long-lasting," Hutt said.
Patients being treated with Ortho-K wake up with clear vision. That clarity regresses over the course of the day as the eye's shape reverts, necessitating the use of the reshaping lenses again the next night.
When a patient comes in for Ortho-K, Hutt said he first measures his or her eyes' refraction, which determines the degree of correction necessary for vision without glasses.
Most cases of nearsightedness can be corrected with Ortho-K, he said, but not all.
"There's a limit to the degree of nearsightedness that can be corrected, as there is with Lasik," Hutt said.
If the patient presents with correctable vision, Hutt fits him or her with reshaping lenses,.
"Either a trial set, or we order the correct correction," he said. "We put the lens on the eye and see how it fits by putting fluorescent dye drops in the patient's tears."
The drops, he said, are a common dye used in routine eye care. They allow the ophthalmologist to see the fit of the lens against the patient's cornea and make any necessary corrections to the fit.
"Then the patient goes home, sleeps with the lenses and comes in the next morning for a re-check," Hutt said.
Most patients require two pairs of lenses over the course of treatment, and periodic re-checks. Hutt said his fee for the Ortho-K lenses is $1,300. This does not include the cost of the eye exam.
"The good thing about Ortho-K is that the change is not permanent, you can adjust the correction," Hutt said. "The bad thing is that patients must wear the lenses every night."
But, he added, after weeks, sometimes months, of daily wear, patients can switch to wearing the lenses every other night.
Who can benefit from Ortho-K
Hutt said he has 50-year-old patients who enjoy the freedom of being able to drive or play golf without their glasses (though he said, most still need glasses to read at that age). He said Ortho-K is also an advantage for younger athletes who are daily contact wearers.
"Hockey players, soccer players, football players . wearing soft lenses is unpredictable. It's easy to get something under the lens, or have the lens shift during play," Hutt said.
The young patients for whom Ortho-K has arrested the progression of their nearsightedness is another advantage of the procedure for young patients. Hutt said this is especially important because laser eye surgery is "contraindicated in children. Parents must watch their children's nearsightedness increase every year before they are old enough for the corrective surgery.
"Now the nearsightedness advance can be halted or limited with Ortho-K at the early signs of nearsightedness," he said.
Hutt also said he has two patients who have come to him for Ortho-K after laser vision correction because their vision has regressed after the initial surgery.
"You can't keep taking away more tissue . the cornea gets thinner and thinner," Hutt said.
Hutt stressed that he understands the appeal of the laser vision correction for some people. He even looked into performing the surgery when it was initially introduced.
"I think it has become safer than it was initially," Hutt said. "But it is still surgery, and it is inevitable that, no matter how good the surgeon, some patients will have problems, and will have problems for the rest of their lives." That, he said, is not a risk he's willing to take with any patient's eyes.
"[Ortho-K] is something that is an alternative, and a safer alternative," Hutt continued. "Here, if an eye changes and needs more correction, we change the lenses. With laser eye surgery, you need more surgery."
For more information on Ortho-K and the correction of vision, visit www.allaboutvision/com/contacts/orthok.htm or contact Hutt at 536-0006.