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The incidence of myopia (nearsightedness) has increased significantly in the USA since the early 1970s. Myopia affects 1 in 3 people in America, and 1 in 2 people in some Asian countries. Myopia affects a quarter of the worlds population. By 2020, it's estimated that 2.5 billion people will have myopia.
Paragon CRT® Brand Contact Lenses are used to treat myopia. CRT® Lenses are worn while you sleep to reshape your cornea overnight. Remove the lenses when you wake up and you'll have great vision all day without having to wear daytime contacts or glasses! Dr. Neff is certified by Paragon to fit their CRT lenses and has been fitting these lenses since 2010 as her chosen method of orthokeratology.
What is Orthokeratology?
This therapeutic contact lens gently and safely reshapes the cornea while you sleep to correct nearsightedness (myopia). Most commonly referred to as “Corneal Reshaping”, CRT offers a safe, non-invasive, non-surgical procedure that temporarily corrects nearsightedness up to -6.00 diopters, and mild amounts of astigmatism.
What is the difference between corneal reshaping and CRT?
Corneal reshaping is the process of using a therapeutic contact lens to reduce myopia by reshaping the corneal surface while you sleep. CRT Brand Contact Lenses is the leading product used for this therapy.
I keep hearing different names for CRT/Orthokeratology. Do they all mean the same thing?
Yes! Orthokeratology may also be known as: Ortho-K, Corneal Refractive Therapy, CRT, Vision Shaping Treatment, VST, Gentle Shaping System, Gentle Molding, The Gentle Vision Shaping System, GVSS, Corneal Molding, Wave Front Corneal Molding, Overnight Corneal Reshaping, and OCR.
Additionally, the treatment devices used to achieve corrected vision may be referred to as: Retainer Lenses, Vision Retainers, Retainers, Ortho-K Lenses, Corneal Molds, Molds, Wave Lenses, and CRT Lenses.
Who is a candidate for CRT?
CRT 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.
CRT is particularly appealing for people who participate in sports, or who work in dusty, dirty environments that can make contact lens and/or eyeglasses wear difficult, frustrating or dangerous.
How new is Paragon CRT?
Contact lens corneal reshaping is not a new concept. Previous corneal reshaping designs were only as successful as technology allowed. Paragon Vision Sciences has taken the recent advancements in computerized corneal mapping, computerized manufacturing, and oxygen permeable contact lens materials and produced a therapeutic contact lens design that is like no other. This has allowed Paragon CRT to become the one corneal reshaping modality that truly stands out and the first to earn FDA approval for nighttime Corneal Refractive Therapy. Dr. Neff has been certified to fit Paragon CRT lenses since 2010.
Is CRT FDA-approved?
CRT Brand Contact Lenses have been FDA approved for overnight wear since 2002 and are manufactured with a special contact lens material that provides exceptionally high levels of oxygen to get to your eyes while you sleep.This oxygen is important in supporting good eye health. In fact, the lens material used to manufacture CRT lenses was developed with information gleaned from three NASA Space Shuttle missions during the 1990’s.
How much will CRT cost?
Dr. Neff must first perform a comprehensive vision exam to determine if you are a candidate for CRT. This exam is $110 for existing patients and $120 for new patients. Our initial cost for orthokeratology with Paragon CRT Contact Lenses is $1200 for a spherical fit for prescriptions up to -1.75 diopters. The cost is $1500 for patients with prescriptions -2.00 up to -3.75 diopters and/or astigmatism. The cost is $1800 for patients with prescriptions of -4.00 diopters and higher and those with higher astigmatism. These prices include corneal mapping, the contact fitting and follow-up visits, insertion/removal and care training, contact fitting sets (to be returned to Dr. Neff at the following visit), temporary disposable contact lenses if needed, and the final CRT retainer contact lens set. At least half of the total needs to be paid at the time the CRT agreement is signed. The balance is due on the day of the initial visit. Due to the expense incurred by Dr. Neff for the equipment, fitting and materials involved in the fitting process, CRT fees are non-refundable.
A spare pair of lenses may be ordered for $225 (half price!) on the day that the final pair of retainer lenses are picked up. Replacement lenses may be purchased later for $225 per lens.
CRT fittings for subsequent years require an annual comprehensive vision exam for $110 (many insurance plans cover this for a copay) and the CRT fit for $300 if there is no change and no new retainer lenses are needed. This price includes corneal mapping, the contact fitting, and the inspection and evaluation of your current CRT retainer lenses. If changes and/or new lenses are needed the price is $500 in addition to the comprehensive vision exam. This price includes the inspection and evaluation of your current CRT retainer lenses, corneal mapping, the contact fitting and follow-up visits, contact fitting sets (to be returned to Dr. Neff at the following visit), temporary disposable contact lenses if needed, and the final CRT retainer contact lens set. For spare pairs and replacement lens costs, see above.
Will my insurance plan cover corneal reshaping with CRT Brand Contact Lenses?
We are happy to file your in-network vision insurance for the comprehensive vision exam. In Focus Eyecare does not file vision or medical insurance for CRT services or lenses. You may be able to file for reimbursement from your insurance for a portion of you CRT services or lenses.
Can I use my flex spending money on the CRT lenses and the CRT fit?
Yes! Expenses such as corneal refractive therapy, laser vision correction, eyeglasses, and contact lenses are covered under this program.
Are there age-restrictions with CRT?
No. The FDA placed no age restrictions on candidates for Corneal Refractive Therapy with Paragon CRT. CRT is being successfully performed on children 12 years old and younger. Our youngest patient using Ortho-K lens is age 9! It can be a great option for children and teens that are active in sports activities or any other extra curricular activities.
Those who are older and presbyopic (requiring reading glasses or bifocals) may still be candidates for CRT. They may correct their distance vision with CRT and wear near-vision reading glasses for close work. At the doctor’s discretion you may be fitted in a monovision mode (one eye corrected for near vision and one corrected for distance vision).
Visual requirements due to age or activities can only be assessed after a thorough eye exam. You can ask Dr. Neff for her recommendation for your lifestyle needs.
How well will I be able to see with CRT?
The goal for CRT 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).
How long does it take to reach good vision?
Most patients have rapid improvement in the first few days of treatment and achieve nearly their optimum vision in 10 to 14 days.
I have astigmatism. Am I a candidate for corneal reshaping with CRT Brand Contact Lenses?
CRT is designed to correct myopia with up to 1.75 diopters of astigmatism. Dr. Neff can determine if you are a candidate for CRT.
How long will it take my eyes to adjust to wearing the lens?
When you apply your CRT lenses for the first time, you may have a sensation or feeling with the CRT lens in your eye, similar to an eyelash. This is a normal feeling more commonly referred to as “lens awareness.” As you blink, your eyelids may feel your CRT lenses during the first few days. This is quite normal and the sensation can be relieved by relaxing and closing your eyes (as you go to sleep). Over the short adaptation period of a week or less, the sensation of feeling the lens when you blink will diminish. This process of adaptation for CRT wearers is similar to that of someone wearing braces or new jewelry. At first the wearer is extremely aware of the “change;” however, over time CRT wearers adapt to the change very easily. If, however, you experience discomfort or “pain” from your CRT lenses, (greater than 2 on a scale of 10), you should remove the lens immediately and call Dr. Neff.
What should I expect during the 10 to 14 day treatment process?
It’s important to understand that during the short treatment process, old glasses or daytime contacts will no longer be the appropriate prescription. Managing your vision during the treatment process may involve re-insertion of the CRT lenses for part of the day, or your eye care professional may choose to use temporary soft disposable lenses. Dr. Neff will discuss the options for visual correction during that temporary period of time.
How many times will I need to come back for follow-ups?
Following the initial contact fitting visit, the patient will be scheduled for at least the following visits after the CRT retainer contacts arrive. If changes need to be made to the contacts, some of these visits will be repeated.
Monday, 11:00 – Contact fit evaluation and insertion, removal & care training with the new retainer contacts (30-60 minutes)
1st morning after wearing new retainer set (must bring CRT contacts)
1 week after wearing new retainer set (must bring CRT contacts)
1 month after wearing new retainer set (must bring CRT contacts)
2 months after wearing new retainer set to check contact fit (must bring CRT contacts)
Is corneal reshaping with CRT Brand Contact Lenses permanent?
No. It’s temporary. If you stop wearing the lenses regularly while you sleep, your vision will return to its original state in as little as 72 hours
Are there any risks involved with wearing CRT Brand Contact Lenses?
When any contact lens is worn, there is a small risk involved. However, it is not expected that CRT Brand Contact Lenses will provide a risk that is greater than other contact lenses that are worn while sleeping. During the CRT FDA Clinical Study, there were no serious adverse events reported.
View the Paragon CRT Package Insert.
How often will I have to replace my Paragon CRT lenses?
Generally speaking the Paragon CRT lenses will have to be replaced once a year. However, depending on factors such as protein build-up, how well the lenses are taken care of, etc., the lenses may have to be replaced more frequently.
Is corneal reshaping with CRT Brand Contact Lenses painful?
No, it is not painful. Initially, you may have a slight awareness of the CRT lens in your eye. You will not feel the lenses when you sleep and there is no sense of physical corneal change…just visual improvement when the lenses are removed. In the FDA study, only 4% of the patients discontinued use due to discomfort, meaning 96% found the comfort quite acceptable!
My driver’s license says I need corrective lenses to operate a motor vehicle. What do I do after being fitted with CRT lenses?
Upon request you may be supplied with a document that states you are participating in a visual therapy program that eliminates the need for corrective lenses while operating a motor vehicle. The document should have an expiration date for this treatment and you should have your driver’s license updated with a new vision screening through your local DMV office to reflect this change before the expiration date.
What will happen after I use the CRT lenses after one night?
When you awaken the next morning, you may notice that your eyes feel a little dry. This is normal. Follow your eye care professional’s instructions on using rewetting drops to moisten your eyes, before both applying and removing your lenses.
Dr. Neff will, very likely, have you return to the office the morning after wearing your CRT lenses for the first time. After a brief follow-up examination to determine how well the lenses positioned on your eyes while you slept, your CRT lenses will be removed and you’ll be asked to read the eye chart.
Depending on the results of your first morning follow-up examination, Dr. Neff may instruct you to continue wearing your CRT lenses each night for the next 7 to 10-days, and then see you for another progress appointment. However, if your lens didn’t stay in a centered position on your eye the night before, or your eye care professional wants to improve the fit of your lens to deliver enhanced results, you may be given a new lens for the right eye, left eye, or a new pair of lenses for both eyes. Following Dr. Neff's instructions during the first 7 to 10-day treatment period will determine the level of success you have with CRT Contact Lenses.
As you progress throughout the initial 7 to 10-day treatment period, you will notice your vision staying clear for longer periods throughout each day. For example, on the first day after removing your lenses at your eye care professional’s office and receiving a satisfactory report, you may be able to see clearly for several hours.
It’s important to remember that once you start wearing CRT Brand Contact Lenses for Corneal Reshaping, you will be gradually reducing your prescription by gently molding your cornea each night as you sleep. This means your old daytime contacts or glasses will be too strong and you should not wear them, unless otherwise instructed by your eye care professional. If, however, you decide to stop Corneal Reshaping with CRT, your prescription will gradually go back to what it was before you started reshaping your cornea overnight. Once your corneas are back to their original shape, wearing an alternative vision correction device should not be a problem, but as always, talk to Dr. Neff for her recommendation.
Set up an appointment with Dr. Neff or talk with our knowledgeable staff. Call 803-802-6522 or email us.
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