Like millions of Americans plagued with nearsightedness, Daniel Mandel had required contact lenses or glasses to see clearly since his early teenage years. But that changed several years ago when the Glencoe man awoke one morning and just couldn't believe his eyes.
For the first time since childhood, Mandel could focus on the world around him with perfect vision and without the aid of contacts or corrective glasses.
Mandel's vision restoration was accomplished without surgery, but it wasn't a medical mystery. Before retiring the previous night, he had placed a special contact lens in each eye. As he slept, the lens applied gentle pressure to the cornea, which is the clear covering on the front of the eyeball. This caused the cornea to flatten and reshape so that light would again focus properly on the back of his eyes.
"It was just amazing," said Mandel, now a 21-year-old Harvard University senior. "My vision was better than it had ever been."
Mandel had been too young to try laser surgery to treat his myopia, so optometrist Dr. Barry Eiden suggested the less intrusive corneal reshaping (CR) therapy.
"You have to wear the special lenses every night," said Eiden, director of North Suburban Vision Consultants in Deerfield. When the lenses are removed in the morning, patients usually experience near perfect vision for the rest of the day. On the down side, the process is not permanent, and the corneas will revert to their original shape in one or two days. Although less expensive than laser surgery, the initial cost is still steep, around $1,000-$2,000, which generally covers all lenses and follow-up care for a year.
"Maintenance costs after Year One are similar to traditional contact lenses," Eiden said. "So it's still a great alternative for people who don't want laser surgery but want to be free from regular contacts or glasses."
The technology to reshape the cornea with contact lenses has been around since the 1960s, when it originally was known as orthokeratology. But vision correction with early lenses was unreliable, and the lenses could not be worn overnight.
"Cases of eye infections were also reported overseas due to poor hygiene and where non-FDA approved lenses were used," Eiden said. "The lens designs and materials have been greatly improved, and we now use computer software and corneal topography to map a patient's corneas and custom fit each lens."
With nearly 2,000 of his patients using the CR lenses, Eiden estimates that more than 90 percent are happy with the results. "Where there are problems, it's usually because a patient has sensitive eyes and just can't tolerate the lenses, which are harder then regular soft contacts," he said. "And just like any contact lens, proper cleaning and eye hygiene are essential; otherwise infections can occur."
Palatine optometrist Dr. Robert Gerowitz, another of only a dozen or so Illinois optometrists prescribing the CR lenses, said, "Out of some 80,000 optometrists in the U.S., only about 2,500 fit these lenses."
Gerowitz and Eiden are involved in an FDA study examining myopia in 300 youths ages 8 through 14. The five-year study began last January and involves 10 optometry clinics across the U.S., including five in Illinois.
"Our own clinical work suggests wearing corneal reshaping lenses can actually halt or slow down the progression of myopia in children," said Eiden, who developed the project with Dr. Robert Davis of Oak Lawn.
Some overseas studies support Eiden's theory, as do patients such as Mandel.
"When I first got regular contacts, my prescription would change each year," Mandel recalled.
"The corneal reshaping lenses seemed to stabilize my vision. Now it's like I'm seeing in high definition!"
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Web links for more information: Dr. Barry Eiden, North Suburban Vision Consultants, nsvc.com; Dr. Robert Gerowitz, allaboutorthok.net; American Optometric Association, aoa.org; Orthokeratology Academy of America, okglobal.org.