Corneal Refractive Therapy (CRT): Frequently Asked Questions

Dr. Stuart Spind in Glen Burnie, MD is certified to prescribe Paragon CRT.  His careful selection process permits more than 90% of his patients undergoing CRT to leave with their initial therapeutic lenses on their first day rather than needing to to order them. CRT Brand Contact Lenses are FDA approved therapeutic contact lenses used to gently reshape the cornea while you sleep to correct nearsightedness (myopia). Most commonly referred to as “Corneal Reshaping or Orthokeratology”, CRT offers a safe, non-invasive, non-surgical procedure that temporarily corrects nearsightedness and mild amounts of astigmatism.

  Corneal Refractive Therapy (CRT): Frequently Asked Questions

 Why should I choose Dr. Stuart Spind for CRT?

Dr. Stuart Spind uses state-of-the-art technology to measure the change in corneal curvature, along with the change in nearsightedness. Finally, Dr. Spind carefully selects his patients undergoing this procedure, maximizing the likelihood of success. An honest assessment is the first step for obtaining desired treatment outcomes, and that's what Dr. Stuart Spind is known for.

Is there an minimum age requirement for CRT?

There is no lower age limit on the FDA approval for CRT, which makes this treatment available for carefully selected children.  The scientific literature supports contact lens treatment for some children as young as eight years of age.  Any child undergoing CRT must have the aptitude and responsibility to adhere to proper lens care and hygiene, and this requires a careful and honest assessment by both the parents and Dr. Spind.

How much does CRT cost?

CRT is very affordable and the cost includes all progress visits 3 months from the initial prescribing visit, training on contact lens handling and care, and the initial pair of CRT lenses.

Is CRT risky?

No. The FDA has validated the safety and efficacy of CRT. But like all forms of contact lens treatment, eye irritation is possible.  Most cases are minor and resolve on their own if CRT wear is stopped and there is appropriate professional care. Still, there are rare and isolated reports of serious eye infection with overnight corneal reshaping where improper lens care and hygiene were suspected. Dr. Spind's patients receive a complete review of the benefits, risks, and alternatives during their consultation so that it is possible for you to make an educated decision to undergo CRT.

Can I set up a flexible spending account (FSA) for CRT?

Yes, provided that you have access to an FSA through your employer.  An FSA allows you to allocate pre-tax dollars toward qualified healthcare expenses including CRT.

Does CRT prevent myopia for getting worse?

Currently there is no definite proof that CRT prevents or slows myopia progression.  In fact the FDA approval for CRT does not permit the manufacturer from making such a claim.  However there is mounting evidence suggesting that CRT indeed can reduce the natural rate of childhood myopic progression.  Dr. Stuart Spind has provided information about this in an article on myopia control.

How do I find out if I'm a candidate for CRT?

Call Dr. Stuart Spind at (410) 766-1683 and schedule an eye examination.  During your exam, Dr. Spind will provide a complimentary CRT consultation!

How Does Nearsightedness Develop in Children?

ScienceDaily (Mar. 1, 2012) - Myopia (Nearsightedness) develops in children when the lens stops compensating for continued growth of the eye, according to a study in the March issue of Optometry and Vision Science, official journal of the American Academy of Optometry.

The journal is published by Lippincott Williams & Wilkins, a part of Wolters Kluwer Health.

Using detailed information on eye growth and vision changes in children over time, the new research shows "decoupling" of lens adaptation from eye growth about a year before myopia occurs. Donald O. Mutti, OD, PhD, of The Ohio State University College of Optometry, is lead author of the new study.

Growth Imbalance Leads to Myopia…

The researchers analyzed repeated measurements of vision and eye growth performed over several years in children aged 6 to 14. The study focused on the growth of the two key parts of the eye affecting normal vision: the cornea, the transparent front part that lets light into the eye; and the lens, located behind the cornea, which focuses light rays on the retina at the back of the eye.

Myopia or Nearsightedness -- difficulty seeing objects at a distance -- develops in about 34% of American children as they grow. Vision professionals and scientists typically think of myopia as a problem occurring when the eyeball becomes too long (front to back) for the optical power of the cornea and lens.

However, it has been unclear how this imbalance develops in children who previously had normal vision. To answer this question, Dr. Mutti and colleagues compared changes in eye growth for children who developed myopia at different ages versus those whose vision remained normal.

They found that, in children without myopia, the lens grew thinner and flatter to maintain normal vision as the eye grew. This adaptation maintained a normal balance between the optical power of the lens and the increasing length of the eyeball. From age nine months to nine years, eyeball length increased by an average of three millimeters.

...As Lens Stops Responding to Increasing Eye Length

However, in children who developed myopia, the lens stopped changing in response to eye growth. Nearsightedness developed not just because of increases in the length of the eyeball, but rather because the optical power of the lens no longer changed as the eye grew.

The imbalance occurred rather suddenly: about one year before the children became Nearsighted. For at least five years after the development of myopia, the eye kept becoming longer but the lens stopped flattening and thinning.

In contrast to the lens, changes in corneal growth showed little or no relation to the development of myopia. The cornea is responsible for about two-thirds of the optical power of the eye, and the lens for the remaining one-third.

The study provides vision professionals with an important new piece of information on why some children develop myopia. However, what's still unclear is why the lens suddenly stops adapting to continued growth of the eye. More research will be needed to answer that question -- one possibility is that an abnormally thick ciliary muscle within the eye forms a mechanical restriction preventing the stretching that thins and flattens the lens as the eye continues to grow.

http://www.sciencedaily.com/releases/2012/03/120301113258.htm

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The above story is reprinted from materials provided by Wolters Kluwer Health: Lippincott Williams & Wilkins, via Newswise.

Note: Materials may be edited for content and length. For further information, please contact the source cited above.

Cornea Gene Discovery Reveals Why Humans See Clearly

ScienceDaily (Dec. 12, 2011) — A transparent Cornea is essential for vision, which is why the eye has evolved to nourish the Cornea without blood vessels. But for millions of people around the world, diseases of the eye or trauma spur the growth of blood vessels and can cause blindness.

A new Northwestern Medicine study has identified a gene that plays a major role in maintaining clarity of the Cornea in humans and mice -- and could possibly be used as gene therapy to treat diseases that cause blindness. The paper is published in the Proceedings of the National Academy of Sciences.

"We believe we've discovered the master regulator gene that prevents the formation of blood vessels in the eye and protects the clarity of the Cornea," said lead author Tsutomu Kume, associate professor of medicine at Northwestern University Feinberg School of Medicine and a researcher at Feinberg Cardiovascular Research Institute.

The existence of the gene, FoxC1, was previously known, but its role in maintaining a clear Cornea is a new finding. Working with a special breed of mice that are missing this gene, Kume and colleagues found abnormal vascular formations, or blood vessels, streaking their Corneas and blocking light.

When Kume discovered the Corneal blood vessels in the mutant mice, he called a collaborator at the University of Alberta in Canada, Ordan Lehmann, MD, professor of ophthalmology and medical genetics.

Lehmann found that his patients who have a single copy of this mutated FoxC1 gene -- and who have congenital glaucoma -- also have abnormal blood vessel growth in their eyes.

"The exciting thing is by showing the loss of FoxC1 causes vascularization of the Cornea, it means increasing levels of the gene might help prevent the abnormal growth of blood vessels, potentially in multiple eye disorders that cause blindness," said Lehmann, a coauthor on the paper. "That's the hope." One possible use might be in corneal transplants, he said, where the growth of new blood vessels onto the transplanted cornea is a major problem.

Kume next plans to test the gene therapy in mice to see if injecting FoxC1 inhibits the formation of blood vessels in the cornea.

The research is funded by National Institutes of Health and Canadian Institutes of Health Research.

http://www.sciencedaily.com/releases/2011/12/111212153121.htm

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The above story is reprinted from materials provided by Northwestern University. The original article was written by Marla Paul.

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Contact Lenses Provide Extended Pain Relief to Laser Eye Surgery Patients

ContactContact Lenses Provide Extended Pain Relief to Laser Eye Surgery Patients

Scientists are reporting development of ContactContact lenses that could provide a continuous supply of anesthetic medication to the eyes of patients who undergo laser eye surgery -- an advance that could relieve patients of the burden of repeatedly placing drops of medicine into their eyes every few hours for several days.Their report appears in ACS' journal Langmuir

.

Anuj Chauhan and colleagues explain that more than 1 million laser eye correction procedures are performed each year in the U.S. The surgery enables most patients to see clearly without eye glasses or ContactContact lenses. The procedure known as LASIK is the most common type of laser eye surgery, but complications can develop if the patient undergoes trauma or is hit very hard at any time after the procedure. Photorefractive keratectomy (PRK) doesn't have this complication, and that's why it is preferred for athletes and those in the military. A downside to PRK, however, is a longer period of pain after surgery. To ease their pain, PRK patients place drops of several medications, including anesthetics, into their eyes every few hours, which can interfere with daily life and increase the risk of drug overdose. PRK patients receive a special "bandage ContactContact lens" after surgery to help the outer layer of the eye heal.

The researchers tested whether anesthetics loaded onto this type of lens could release the drugs over time automatically. They found that adding vitamin E to the lenses extended the time of release of three commonly used anesthetics from just under two hours to up to an entire day -- or a few days in some instances. The vitamin E acts as a barrier, keeping the anesthetics on the eye, right where they are needed. The researchers say that, in the future, these lenses could serve as bandage ContactContact lenses after PRK surgery while also delivering necessary pain medications.

The authors acknowledge funding from the University of Florida.

http://www.sciencedaily.com/releases/2012/01/120118112001.htm

The above story is reprinted from materials provided by American Chemical Society.

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