At the ARVO (the association for research in vision & ophthalmology) and the BCLA (British Contact Lens Association) meetings, orthokeratology remained a topic of high interest. Myopia progression, and the relatively slow pace of it in children undergoing corneal reshaping, is one of the most exciting new developments in our field - a finding that now has the attention of the soft lens industry and the glasses industry. For the latter, the Vision Cooperative Research Centre in Sydney even received the 'excellence in innovation award 2011' for the development of myopia reducing glasses. At ARVO, Helen Swarbrick presented a poster showing that overnight orthokeratology inhibits axial length growth and myopia progression over a 12-month period, whereas standard (R)GP lens wear showed axial length growth. Crossover of the effects at 6 months reinforced the promise of this, the research showed. The Boston Update Newsletter (downloadable as PDF) features a full article with Helen Swarbrick on 'building confidence with orthokeratology.' Meanwhile, concern, especially from the ophthalmology field, remains over the safety of the modality.  A very good 'point of view' discussion can be found on the New Zealand Optics website, which reports a case by an optometrist with a reply by an ophthalmologist that raises excellent points. In the end it comes down to 'good old' common sense. In lens wear, we always calculate risk factors (whether it be male wearers, sleeping in lenses, swimming in lenses, allergies, etc). Orthokeratology is invariably connected with a few of these. Adding more risk factors (such as bad compliance, for instance) may overheat the system, and careful selection of patients plus intensive aftercare seems important in this modility. 

Pauline Cho and Sin Wan Cheung of Hong Kong, report on taking care of (R)GP lenses, and their assecoires. When using lens cases, especially cylindrical lens cases, care for these  can be more challenging. The (R)GP lens solution is more viscous than soft lens solutions, hence simply 'emptying' the lens case is not enough: debris and biofilm will remain. It is recommended to rinse out the old solution daily with tap water or distilled water. Then, rinse thoroughly, and place all items on a piece of tissue paper to let it air-dry. Do not cap the wet chambers, is advised. In case of the cylindrical cases, fill each chamber of the lens case half full and shake vigorously for 10 seconds to dislodge accumulated particles and/or micro-organisms. For weekly care of lens cases, soak the case in boiled water for 10 minutes, and frequently replace the case - once every month to three months maximum according to the authors. They also recommend to avoid accessoires, such as suction devices, because of the risk of contamination.

Contact Lens Spectrum February 2011