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Advanced Orthokeratology


(Ortho-K, Dreamlens®, Corneal Refractive Therapy (CRT)®, Vision Shaping Treatment (VST)®, Gentle Shaping System, Corneal Molding, Wave Front Corneal Molding, and Gentle Molding)


Dr. Toler has been fitting Advanced Orthokeratology contact lenses since 1999 and he has been fitting rigid gas permeable contact lenses in the Richmond Tri-City* area since his optometry school graduation in 1988.


* The Tri-Cities of Virginia (also known as the Tri-City area or the Appomattox Basin) is an area in the Greater Richmond Region, which includes the three independent cities of Petersburg, Colonial Heights, and Hopewell and portions of the adjoining counties of Chesterfield, Dinwiddie, and Prince George in south-central Virginia. Other unincorporated communities located in the Tri-Cities area include Ettrick, Fort Lee, and City Point, the latter formerly a historic incorporated town that was annexed to become part of the City of Hopewell.



In the most basic of terms Advanced Orthokeratology or Ortho-k is the science of changing the curvature or shape of the cornea to change how light is focused on the retina at the back of one's eye. Think of the cornea as the eye's equivalent of a watch crystal. It is a clear, dome shaped structure that overlies the colored iris, and it is pliable. Because the cornea separates the eye from air and the rest of the outside world and because it has a curvature that bends light towards the back of the eye, it is responsible for most of the eye's corrective power and contributes to various conditions such as nearsightedness (myopia), farsightedness (hyperopia), and the blur of astigmatism.

When you choose Ortho-k a few key tests must be performed. Chief among these tests is the determination that your eyes are healthy. Dr Toler will examine the retina and the health of the outside of the eye. The other key procedure is measuring the curve of your cornea. The information from your corneal curve plus the size of your cornea and the prescription needed to correct your vision are all used to design the retainer lenses or corneal molds needed to create the Ortho-k effect.

On the day you pick up your Ortho-k contact lenses, you will be instructed in how to insert, remove, and take care your contact lenses. The fit of your contact lenses will be evaluated and you will be scheduled to be seen after your first night of wear. On day 1, Dr. Toler will re-evaluate your fit and newly corrected vision. Throughout your initial fitting period, he will monitor your corneal health and the effectiveness of treatment. At certain times, your contact lens fit may be modified to achieve your goals.

Orthokeratology can produce results in a surprisingly short period of time. The length of treatment to achieve your goals can vary from patient to patient. Factors that can affect the speed of treatment include:

• your initial prescription

• corneal rigidity

• tear quality and quantity

• your expectations.

You may need to use your Ortho-K contact lenses every night to maintain their newly corrected vision although some patients are able to vary their wearing time to once every two to four nights. The reason for this is due to the flexibility of your cornea.

To get a sense of how this all works, just remove a ring from one of your fingers. You may notice an indentation where the band was. In a way, you've been doing "orthokeratology on your own finger". Over time if you stop wearing your ring this indentation will go away. Ortho-k has a similar effect on your cornea; stop wearing your retainers and your cornea and your vision will return to their original state before treatment.

And that's really the beauty of Orthokeratology; it is the NON-SURGICAL, NON-INVASIVE, FULLY REVERSIBLE alternative to laser refractive eye surgery!

Learn more about Ortho-K Video Link



Orthokeratology can be effective on some farsighted, some astigmatic, and most nearsighted (myopic) patients. Ideally, your prescription should be in the range of +2.00 to -6.00 with no more than -1.00 diopters of corneal astigmatism. In some cases, Dr. Toler will attempt higher prescriptions.

If you have been unable to wear contact lenses for any reason (discomfort, allergies, inconvenience, dryness, etc.), you are also a great candidate because this lens is so easy to use and it is worn only while you sleep. This greatly reduces any discomfort you may have experienced while using conventional contact lenses. Talk to Dr. Toler about the benefits of Ortho-K contact lenses.

You are also a great candidate if you need excellent vision without the use of contacts or glasses. Ortho-K benefits pilots, police officers, military personnel, and those with safety concerns such as professional athletes, parents of small children, lifeguards and many others.

Finally, if you just don't want to be bothered with wearing glasses or contact lenses during a variety of activities such as hiking, playing sports, swimming, skiing, camping, off-road driving, biking, snorkeling, scuba and more, Ortho-K is for you.



If you are over 40 your reading correction may be addressed with monovision Ortho-K (this last modality involves correcting one eye for great distance vision and the other eye for near vision; your brain automatically chooses the appropriate eye for the task).

Another alternative is to have both eyes corrected for distance vision and wear reading glasses whenever you want to do near work.


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No, unlike the age limits imposed on refractive surgery, Dr. Toler can fit young children, beginning around 12 years old. The parents determine maturity level and responsibility.



The cost for the initial 6-month Ortho-K program is about ¼ the cost of laser surgery. After the initial 6-month Ortho-K program replacement lenses are $150 -$200 with the life expectancy of 2-3 years with proper cleaning and follow-up care.