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CRT Q&A
What is Corneal Refractive Therapy?
Corneal Refractive Therapy ("CRT") is a non-surgical treatment that corrects myopia (nearsightedness) and astigmatism (out of round corneal surface) using the overnight wear of treatment lenses. The lenses gently reshape your corneas while asleep. Upon waking, and removing the lenses, you will experience clear and natural distance vision, without glasses or contact lenses throughout the day.
Are the changes permanent?
No, the changes are temporary. In fact, that is one of the unique benefits of CRT. CRT does not permanently change your eyes. Your corneas will revert to their original shape should you desire to discontinue treatment. Following a transitional phase, you will likely need to wear the treatment lenses every night to maintain the CRT effect. In some cases, long-term wearers have been able to skip a night or two and maintain clear vision. (top)
How long does it take for the treatment to become effective?
You will notice visual improvement after the first night of wear. We expect this change to quickly fade, however. Following the first night, the effect will become greater and last longer with every successive night of wear. It takes an average of 7-14 days to reach full treatment and maintain good vision during your waking hours. (top)
During the transitional phase (7-14 days), do I continue wearing my current lenses?
Every case is different and our doctors will advise you on the management of your vision during this transition phase. Generally, it does not involve the use of your current prescription, as vision will quickly improve. In some cases, temporary soft lenses will be provided during the transitional phase. (top)
How long can I wear CRT lenses?
Under the guidance of our doctors, Corneal Refractive Therapy can be used indefinitely. Remember if lenses are not worn as prescribed, your corneas will return to their original curvature and the need for standard visual correction returns. It is also possible that your eyes will experience natural changes in vision. Our doctors can easily adjust your treatment lenses to meet these needs. (top)
What happens to my vision when I skip a night of wear?
Visual acuity differences vary from patient to patient. Post-treatment vision can be compromised by not wearing treatment lenses as prescribed. If this happens, you should wear your lenses during that day to see clearly, and resume regular nightly wearing schedule. (top)
If I discontinue CRT, how long would it take for my eyes to return to normal?
Generally, the more myopia being reduced, the longer it will take for the corneal curvature to return to normal. For instance, if the pretreated correction was a -4.50 D, it would take a few days longer to return to normal than if the pretreated correction was -1.50 D. We expect your corneas will fully return to normal within one to two weeks, with most of the change occurring within the first few post-treatment days. There are no recorded permanent corneal changes post-treatment. (top)
Is Corneal Refractive Therapy painful?
No, the process is not painful. You may experience slight lens awareness initially. Amazingly there is no sensation during sleep and no sense of physical corneal changes... just improved vision, when the lenses are removed in the morning. (top)
Can I "loose" the lens in my eye while sleeping?
The diameter of the CRT lens is almost as large as the cornea itself. The chances of it dislodging whether eyes are open or closed, are minimal. There is a chance that during sleep, wearers may decenter the lens unknowingly but it should never be dislodged and is easily re-centered. (top)
Are CRT lenses difficult to insert, remove, or care for?
CRT treatment lenses are generally no more difficult to handle and care for than any other contact lens. Standard rigid gas permeable solution systems are appropriate for CRT lenses. We recommend that wearers instill comfort drops prior to insertion of the lenses and immediately upon waking. The lenses must be moving freely prior to removal. If a wearer has trouble removing their treatment lenses, re-wetting eye drops removal aids are available. (top)
What are the risks with wearing CRT lenses?
To date, we have not seen any serious complications from CRT. However, there is a small risk when any contact lens is worn, especially overnight. We do not believe that CRT lenses pose any greater risk than found with other contact lenses. CRT lenses are made from a polymer (plastic) that has been proven very safe for extended wear. In addition, the lenses will be removed during waking hours which allows unaltered access to oxygen and the natural flow of your tears.
Of note, there were no serious complications reported in the manufacturer's nine-month, FDA overnight study, or in the remaining six months of patient follow-up care. (top)
Can I see clearly with my CRT lenses on?
Yes... that is one of the great features of this product. Your vision will be perfectly corrected with the lenses in place. So, if you need to get up during the night to check on the baby, visit the bathroom, or handle an emergency, you won't have to "feel" your way around due to impaired vision. (top)
Who is eligible for Corneal Refractive Therapy?
CRT is an effective treatment for most people with mild to moderate amounts of myopia and astigmatism. Paragon CRT has been FDA approved to effectively treat up to 6.00 diopters (units) of myopia and 1.75 diopters of astigmatism. At this time, hyperopia (farsightedness) and the visual requirements to use reading glasses only are not correctable with CRT.
It is especially useful for individuals ineligible for or adverse to refractive surgery. In particular, CRT is an excellent option for teenagers and young adults who fall below the acceptable age for LASIK. (top)
Are there any age restrictions?
Eye health and the amount of necessary vision correction, not age, will determine your suitability for CRT. We have performed CRT on children as young as 9 years old. We have also worked with wearers needing a bifocal correction. While every case is unique, CRT is useful for any age group that wants to be free of contacts and eyeglasses during their waking hours.
Of note, CRT is a great option for active children and teenagers. While we don't completely understand why, children and teens appear to respond more quickly and aggressively to CRT. We recommend that you discuss your specific case with our doctors. (top)
I am currently wearing soft contact lenses. Am I a candidate?
Seventy five percent (75%) of patients that participated in the manufacturer's FDA clinical study, were soft contact lens wearers. It is normally difficult for soft lens wearers to convert to rigid designs. We have found the transition into CRT lenses to be rapid and uneventful. Clearly the advantages of CRT outweigh any brief, transitional lens awareness. (top)
I am currently wearing rigid contact lenses. Am I a candidate?
Generally, success rate with CRT is highest if wearers withdraw from their present rigid contact lenses and start "fresh." This allows the corneas to regain their normal shape and stability, allowing for accurate CRT measurements. (top)
I suffer from "dry" eyes. Am I a candidate?
Many patients with slightly dry eyes do well with CRT. When wearing lenses while sleeping, the closed-eye environment minimizes evaporative loss of tears. Upon waking, the lenses are removed offering dry-eyed patients good uncorrected vision without daily wear contact lens compromises. (top)
I have had refractive surgery in the past. Am I a candidate?
CRT lenses have not been specifically tested or approved for use following refractive surgery. (top)
I used to wear contact lenses but stopped due to discomfort. Am I a candidate?
CRT lenses are worn at night while you are sleeping. This greatly reduces any discomfort normally experienced while wearing contact lenses during the day. Also, the CRT lenses are larger in diameter and a thinner design, minimizing movement and promoting comfort. (top)
I wear glasses. Am I a candidate?
We have not found the transition from wearing eyeglass wear to CRT to be a concern. About 18% of the patients in the manufacturer's FDA study were non-contact lens wearers. (top)
My driver's license is marked that I need corrective lenses to operate a motor vehicle. What do I do about that?
We can supply documentation stating that you are under a visual therapy program. The document will have an expiration date for this treatment and will be renewable with your yearly treatment evaluations. (top)
How long do the lenses last?
We anticipate that your lenses will need to replaced yearly. Even though the lenses are durable, they can become contaminated, scratched or warped through normal wear. During your treatment evaluations we will evaluate the condition of your lenses and make recommendations. (top)
What happens if I loose or damage a lens?
CRT is a different visual condition than wearing regular contact lenses. If lens wear is discontinue for one night, vision may be impaired the next day. Previously worn glasses or contact lenses may not help. Immediate replacement is necessary to maintain the CRT effect. Having immediate access to spare lenses is strongly recommended. (top)
How much does Corneal Refractive Therapy cost?
The cost of the initial screening, treatment evaluation, lenses, and 6 months of treatment services starts from $749 per eye. Additional charges might apply, depending upon your fitting complexity, and would be discussed with you prior to initiating the treatment.
The cost for CRT is roughly half of the typical charge for LASIK, and we offer payment plans that can reduce CRT fees to very affordable monthly payments. The annual cost after the initial fitting is not much greater than wearing traditional contact lenses or glasses, (i.e., lens care solutions, replacement fee if lost/damaged, or unscheduled office visits). (top)
How much will Corneal Refractive Therapy cost following the first year?
Once you have been successfully fitted with CRT lenses the ongoing care and costs are substantially reduced. In following years, we recommend evaluations every six months to ensure a safe and effective treatment. In addition to a yearly comprehensive exam, these evaluations and new lenses are expected to cost $249 per eye. (top)
Do benefit programs cover Corneal Refractive Therapy?
CRT is an elective procedure and to the best of our knowledge, is not usually covered by benefit programs. You should check with your benefits plan administrator. If regular contact lenses are covered, Corneal Refractive Therapy may be partially covered. (top)
OK, I'm interested. How do we get started?
If you have had an exam within the last year we suggest that you simply schedule a free CRT consultation. Our doctors will review your specific needs, suitability for CRT, and answer your questions. Should you desire to move ahead, we will schedule a CRT fitting evaluation.
If you haven't had an exam within the last year, we suggest that you schedule a comprehensive eye evaluation. With this information at hand, our doctors will then review your case and share with you their opinions. (top)
