A mother wrote to me about her 13 year old daughter’s nearsighted problem.

“I just know the near sightedness has progressed.

I know when she is reminded to do an eye practice, there is noticeable

improvement. Though, with the demanding lifestyle of a student, requiring much

reading, computers etc...it just seems it's a bit of a losing battle. She is now once

again, completely dependent on her glasses from the moment she wakes in the morning.

She cannot see well enough even just a few feet in front of a mirror.

It seems that the orthokeratology would be a way to halt the progression of the myopia.

Also, giving her the much needed freedom from the eyeglasses.

I do so much agree with the 'work' that needs to be done especially on the

emotional level, but don't know how best to impart this to her. Perhaps that would

be the work with you via skype???....I have always felt the optimal way would be

the natural vision improvement, but don't feel there is the commitment/discipline that

is required in order to be successful.

I would greatly appreciate your advice and also opinion regarding the ortho-k.”

My Response. (By the way, Orthokeratology, or Ortho K is the use of special contact lenses that are usually worn at night, flattens the cornea through a remoulding effect, that on waking gives the person clearness of eyesight. Later, a retainer lens is used to maintain the flattening effect.)

As I consider the points you bring up in your letter I am guided to ask some questions.

i) Is your and ............’s only goal to have her be less dependent on her glasses during her day at school and extra activities? If yes, then Ortho K as is is also called, can be useful. If the Doctor is to use the FDA approved ‘sleeper lens’, then the effects of the curve design will result in her possibly having enough clarity of sight, that she could manage during the day without glasses or contacts. That is what the evidence suggests as possible. There are risks of bacterial infection, blurry vision, corneal swelling, and dry eyes.

ii) Is your other goal for our daughter to permanently reduce the wearing of glasses and/or contact lenses? If yes, then Ortho K only provides the superficial means to not wear glasses or contacts during the day. A quote from a respected Optometrist summarises it this way:

“If lens wear is discontinued, the cornea will simply return to its original shape within a few weeks. Failure to wear the retainer lens on an ongoing basis will result in the return to the pre-existing prescription. Combining Ortho-K with Vision Therapy enhances the benefits.” Stanley Appelbaum O.D.

Dr. Applebaum brings up an interesting point, that is to consider combining vision therapy with Ortho K. This approach has provided better results than Ortho K on its own. The question is, what kind of vision therapy. I am assuming he is saying Optometric Vision Therapy, which is different than natural vision improvement. In my book, The Power Behind Your Eyes, I introduced a new form of Vision Therapy, called Integrated Vision Therapy. I was referring to the total mind, body and eye approach, looking at the 'root cause' problem of nearsightedness

iii) Is your interest to look more deeply than the physical causes of your daughter’s Nearsightedness, prevent further deterioration and face the root cause of the condition? If so, then combining Integrated Vision Therapy with the Ortho K could be beneficial. What would this look like?

a) You would provide me with new Iris pictures of you and our daughter.

b) I would analyse the information to provide you feedback about the genetic influences that are contributing to her becoming more nearsighted.

c) I would request 4 to 6 sessions with you alone on Skype to discuss strategies for you to be a mentor for her in avoiding Myopic imprinting, like fear and other emotional behaviour in her life.

d) She would enrol in vision therapy with a Behavioural Optometrist in building up her functional vision skills, and/or have long distance sessions every two to three weeks with me in Integrated Vision Therapy. This would include building in rest period practices, integration vision games, use of the Eye C Chart for monitoring stress patterns through the eyes, and talking about her perceptions of life issues that are programming the inward retreat of her seeing.

I trust this provides you with a fresh perspective in making your decisions. Roberto Kaplan