Gentle Vision Shaping FAQs

What is Gentle Vision Shaping?

Gentle Vision Shaping (GVS) or Orthokeratology is a procedure in which a retainer, which looks like a small contact lens, is designed to be worn while sleeping to slightly change the shape of the front of the eye (cornea) so that no glasses or contact lenses are needed during the day. It is useful to think of GVS as temporary, non-surgical LASIK. After the first night of sleeping in the retainer, uncorrected visual acuity is greatly improved. All-day 20/20 acuity is achieved in 3-7 days in most cases. GVS is mostly used to help near-sighted children with or without astigmatism.

How long does sharp vision last with GVS?

After the first night of sleeping in the retainer, improved visual acuity will be apparent for several hours. With each subsequent night of GVS the time of improved acuity will increase with all-day clarity occurring in 3-7 days in most cases. No matter how long GVS is used, the effect is completely temporary and wears off after about a week, making it a very safe option for near-sighted children.

What are the benefits of GVS?

The most obvious benefit is that a GVS patient can go about their entire day without glasses or contact lenses. The last thing they do before bed is place the retainers on their eyes and the first thing they do in the morning is remove them. The more exciting benefit is that properly fit GVS retainers slow down the near-sighted child’s tendency to get more and more near-sighted by about 90%! In other words, most children who need glasses to see far away clearly have vision that deteriorates so that they need stronger and stronger glasses every year. GVS prevents the vast majority of this deterioration.

What is the process to get started with GVS?

Every GVS patient starts with a free consultation with Dr. Cook to see if they are a good candidate for GVS. The patient’s prescription, corneal topography, and ocular health are evaluated and there is plenty of time to ask questions. A retainer is then placed on the patient’s eyes so that they can experience GVS and so that Dr. Cook can evaluate the eyes reaction to the retainer. When everyone agrees to move forward with GVS, Dr. Cook uses specially designed computer software to design and order each retainer. The retainers arrive a few days later so that Dr. Cook can evaluate how they fit on the patient’s eyes. The patient then sleeps in them and follows up the next day, and then again a week or two later. If the vision is great, then the patient is seen every 6 months thereafter for followups. Occasionally, adjustments to the retainer designs are made to perfect the outcome as much as possible.

Are there risks with GVS?

As with any sort of contact lens wear there are some risks. The most common are temporary irritation of the eyes and occasional, mild blur. It should be noted, however, that children who continually require stronger and stronger glasses experience much more blur as their eyes become worse and their glasses no longer fully compensate them. The most serious risk associated with GVS is infection of the cornea, which occurs at the rate of once every 800 years of wear. Most of these infections can be fully resolved with prompt treatment. By comparison, letting a child get more and more near-sighted every year has its own associated risks such as increased risk of retinal detachment, glaucoma, and early cataracts, as well as reduced quality of life due to increased dependence on glasses and contact lenses.

How often do the retainers need to be replaced?

Retainers tend to require replacement every 18 months. Dr. Cook sees each GVS patient every 6 months and evaluates the retainers at each visit to determine if a replacement is necessary.