Monocular diplopia caused by ORTHOK night only Contact LENS?

Question

!!!Urgent -- Help!!!
My son had ORTHOKERATOLOGY night only Contact LENS (made by C&E GP Specialist) from Jan. 2001 to June 2007. He discontinued such ORTHOK lens on June 13, 2007 and suffers from the double vision (Monocular diplopia) especially the right eye. He has visited three doctors since June 16, 2007. and they told the reporter that after discontinued ORTHK lens, the status of his eye will be reverse in 1-2 weeks or several months. But after four full month of discontinued ORTHK lens, his double vision (Monocular diplopia) especially the right eye is progressive.
One post on FDA web site is similar to our case. That post link is http://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfMAUDE/Detail.CFM?MDRFOI__ID=274073. My son and parents worry about it very much and also he is suffering. I am trying to find the explanation/solution to this Monocular diplopia.
Thanks a lot.

Answer 1

Ortho K lenses create deliberate pressure on the cornea overnight, encouraging (forcing?) it to adopt a shape nearer to that required for zero refractive error.

It's always seemed to me like trying to change your shoe size by deliberately wearing shoes that are too small, but I admit to being old-fashioned and sceptical.

Time is going to be the principle healer here.
If the monocular diplopia is due to a local distortion of the cornea, as seems likely, then almost instant relief from the optical effects should be obtainable by the use of a rigid gas permeable contact lens in the day-time.
The drawbacks of this would be cost, as the lens might need refitting at fairly short intervals as the cornea changed shape, and slowing the final stabilisation of the cornea, as the cornea would be operating with the normal contact lens induced reduction in oxygen supply.

The optical benefit might outweigh the above. If stability or comfort is a problem, lenses do exist with a rigid centre and a soft skirt, but they are far from cheap.

The above is only general advice as much would depend on the actual measurements (topography) and condition of the cornea.

I've seen distorted corneas from badly fitting or overworn ordinary GP lenses that took six months to show a stable Rx after discontinuing their use, sometime requiring new spectacle lenses every month. But that was near the worst-case limit. Usually 1-3 months sufficed.

Optometrist, retired.

Answer 2

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