BCLA@Yours - podcast series podcast

BCLA CLEAR Episode 9 - Orthokeratology

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In the ninth instalment in the BCLA CLEAR podcast series Dr Melissa Barnett – a Fellow of the BCLA and Global Ambassador for the BCLA – interviews Dr Daddi Fadel about the BCLA CLEAR paper on orthokeratology. Orthokeratology (ortho-k) is the process of deliberately reshaping the anterior cornea by utilising specialty contact lenses to temporarily and reversibly reduce refractive error after lens removal. Modern ortho-k utilises reverse geometry lens designs, made with highly oxygen permeable rigid materials, worn overnight to reshape the anterior cornea and provide temporary correction of refractive error. More recently, ortho-k has been extensively used to slow the progression of myopia in children. Melissa and Daddi discuss just some of this in the episode.

The full report reviews the practice of ortho-k, including its history, mechanisms of refractive and ocular changes, current use in the correction of myopia, astigmatism, hyperopia, and presbyopia, and standard of care. Suitable candidates for ortho-k are described, along with the fitting process, factors impacting success, and the potential options for using newer lens designs. Ocular changes associated with ortho-k, such as alterations in corneal thickness, development of microcysts, pigmented arcs, and fibrillary lines are reviewed. The safety of ortho-k is extensively reviewed, along with an overview of non-compliant behaviours and appropriate disinfection regimens. Finally, the role of ortho-k in myopia management for children is discussed in terms of efficacy, safety, and potential mechanisms of myopia control, including the impact of factors such as initial fitting age, baseline refractive error, the role of peripheral defocus, higher order aberrations, pupil size, and treatment zone size.

Daddi Fadel DOptom, FSLS, FBCLA, FAAO, is a contact lens designer, a Pioneer of modern lens designs, and a specialist in contact lenses for irregular cornea, scleral lenses, myopia control, and orthokeratology. She has 20 years’ experience in optometry and specialty contact lenses. Daddi runs an optometric practice specializing in contact lenses in Italy where she personally designs and fits special customized contact lenses. She is internationally recognized as a key opinion leader, who has several peer-reviewed publications in the area of specialty contact lenses and is a speaker in national and international symposia, and also holds fellowships with numerous institutions.

BCLA CLEAR is an initiative that has drawn together thousands of research papers on many different aspects of contact lenses into one place. The findings were published in, Contact Lens and Anterior Eye, the BCLA's scientific journal, in April 2021 under ten reports. BCLA CLEAR was facilitated by the BCLA, with financial support by way of Educational Grants for collaboration, publication and dissemination provided by Alcon and CooperVision.

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