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Corneal Refractive Therapy (CRT)
20/20 Optometry - In San Ramon & San Mateo, CA

For those who have trouble with glasses or contact lenses, corneal refractive therapy is a safe, nonsurgical solution. We specialize in this treatment, which involves a custom­-made lens worn overnight, sort of like a retainer for your eyes. While you sleep, the lens gently reshapes your cornea, so when you wake up, you can see better. CRT is a great option for patients who have trouble with contacts or dislike glasses. It’s also particularly beneficial for active patients, adolescents involved in sports.

Imagine the convenience of correcting your vision while you sleep with safe, non-surgical CRT therapeutic lenses, and enjoy great vision 24 hours a day, without the hassles of glasses and daytime contacts! Our practice has a large number of successfully treated patients in CRT. Our leadership and experience with CRT combined with our state-of-the-art corneal mapping instrument, the Humphrey ATLAS CT System, offer you unparalleled CRT care.

The fundamental technology for Corneal refractive therapy (CRT) or Orthokeratology (Ortho-K) has been around for many years. The basic idea is that by wearing a rigid lens on the cornea overnight it will gently reshape the cornea thinner in center than on the periphery. The cornea retains that shape throughout the day and the patient enjoys clear vision without the use of glasses or contacts. A side benefit is that studies show CRT/Ortho-K lenses can help to slow progression of myopia (LORIC, CRAYON)

  • freedom from glasses and contacts during the day
  • made of highly oxygen permeable material during overnight wear
  • studies support CRT as a method of myopia control

Common Questions

How Corneal Reshaping Therapy works

The GP lenses for corneal reshaping therapy are applied at bedtime and worn overnight. While you sleep, the lenses gently reshape the front surface of your eye (the cornea) to correct your vision, so you can see clearly without glasses or contact lenses when you're awake. The effect is temporary – generally enough to get you through a day or two – so you must wear the reshaping lenses each night to maintain good vision during the day.

Currently, there are two brands of Corneal Reshaping Therapy approved by the FDA: Corneal Refractive Therapy (CRT) from Paragon Vision Sciences and Vision Shaping Treatment (VST) from Bausch & Lomb.

Who is a candidate for Corneal Reshaping Therapy?

Corneal Reshaping Therapy is frequently a good option for nearsighted individuals who are too young for LASIK surgery or for some other reason are not good candidates for vision correction surgery. Because it can be discontinued at any time without permanent change to the eye, people of any age can try the procedure, as long as their eyes are healthy.

Corneal Reshaping Therapy is particularly appealing for people who participate in sports, or who work in dusty, dirty environments that can make contact lens wear difficult.

What results can you expect from Corneal Reshaping Therapy?

The goal for corneal reshaping therapy is to correct your vision to 20/20 without eyeglasses or contact lenses during the day. In FDA trials of both CRT and VST lenses, more than 65% of patients were able to achieve 20/20 visual acuity after wearing the reshaping lenses overnight. More than 90% were able to see 20/40 or better (the legal vision requirement for driving without glasses in most states).

Success rates for corneal reshaping therapy tend to be higher for mild prescriptions. Call our office to find out if your prescription is within the range that can be successfully treated with corneal reshaping therapy.

How long does Corneal Reshaping Therapy take?

Though you may see some improvement in your vision after a day or two of overnight corneal reshaping therapy, it can take several weeks for the full effect to be apparent. During this time, your vision will not be as clear as it was with glasses or contacts, and you are likely to notice some glare and halos around lights. It's possible you may need a temporary pair of eyeglasses for certain tasks, like driving at night, until your vision is fully corrected by the corneal reshaping therapy lenses.

Is Corneal Reshaping Therapy comfortable?

Some people have comfort issues when attempting to wear gas permeable contact lenses during the day. But since corneal reshaping therapy GP lenses are worn during sleep, comfort and lens awareness are generally not a problem.

Cost of Corneal Reshaping Therapy

Corneal Reshaping Therapy is a significantly longer process than a regular contact lens fitting. It requires a series of office visits at our office in San Ramon or San Mateo, and potentially multiple pairs of lenses. Also, GP lenses used for corneal reshaping therapy are more costly than most regular contact lenses. Therefore, fees for corneal reshaping therapy are higher than fees for regular contact lens fittings.

Can I have LASIK after Corneal Reshaping Therapy?

Yes, it's possible to have LASIK surgery after corneal reshaping therapy. But because corneal reshaping therapy lenses reshape your cornea, you must stop wearing the lenses for a period of time (usually several months) so your eyes can return to their original shape and stabilize. Be sure to tell your LASIK surgeon that you've worn corneal reshaping therapy lenses, so they can advise you how long you should wait before having the surgery.

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