We've been with Titus now for over 2 years. He is very professional with his work, always showing great care and empathy towards his patients. He takes a genuine interest in their progress and the health of their eyes, keeping a comprehensive record of their history. When you have 3 children all needing OrthoK lens, it is comforting to place them in the hands of a qualified and amiable practitioner, who is always patient to answer any questions. The quality of his lens is also top notch. When my kids with powers 300 and below miss a day of wearing, they could still see well the next day. Kudos and keep up the good work!
My daughter Christine has had myopia and very bad astigmatism since young. We had been skeptical about Ortho K, but decided to let her try it out 1 and a half years ago. Thanks to Titus and his team for their care and management, throughout this 1 and half years of wearing Ortho K lens, her vision has been perfect, and she has not had any problems with her vision at all. She has been able to do her dancesports without the hassle of wearing spectacles while training or wearing contact lens during competitions. Definitely a great improvement for her lifestyle and well being!
My daughter and I both started orthokeratology with Titus last year. My daughter's myopia has since then been well controlled, plus she is enjoying her activities without the burden of wearing glasses. Personally I feel my eyes are healthier. Titus gave us excellent and professional care, explained every detail to us and patiently answered my many questions. Will highly reducedommend this to anyone who is able to do this treatment. Thank you Titus and Marie for your help!
Singapore has one of the highest prevalence of myopia, up to 80% of the population is myopic at a certain point. Up to 65% of children before the age of 12 are myopic. The worst part is the rate of progression is staggering. We see an average increase of about 75 degrees per annum. If we do the math, multiplying the rate of increase with the number of years left till the child turns 18 where myopia stabilizes, the result is unfortunately irreversible. In addition, there is also the risk of other retinal problems especially once the child crosses -6.00 dioptres.
Orthokeratology treatment not only gives these children the freedom to experience what clear vision is like without relying on spectacles and contact lenses during the day, it has also been documented in the medical literature by several non-biased studies that it indeed retards myopia progression. We have treated many children and have seen great success controlling our patients’ myopia. The numbers speak for themselves.
Understanding the main mechanism of orthok
Titus Wu (邬颂仁)
Bsc.Optom (USA), M.Optom (Aust), FIAO
Titus graduated as an Optometrist in Singapore before completing his Bachelor degree in Optometry from Salus University (USA). He then went on to further his education and was awarded a Masters of Optometry from University of New South Wales (Aust). He was largely involved in advanced contact lens studies, advanced clinical optometry, ocular therapeutics and dry eye management. He also completed a preceptorship in LV Prasad, Hyderabad – India, one of the busiest eye institutes worldwide, where he concentrated on anterior and posterior eye complications, as well as advanced specialty contact lenses to treat cornea diseases.
Titus is an Associate Lecturer at Ngee Ann Polytechnic, guiding and supervising final year Optometry students with their clinical skills. Titus is also a member of the American Academy of Orthokeratology and Myopia Control (AAOMC), International Academy of Orthokeratology (IAO), Scleral Lens Education Society (SLS) and Singapore Optometric Association (SOA). His expertise in Orthokeratology allowed him to obtain his Fellowship from the International Academy of Orthokeratology (FIAO). Orthokeratologists who have successfully attained the rank of FIAO have demonstrated a commitment to excellence in the field of Orthokeratology.
His area of clinical interests include myopia control for children and cornea and vision rehabilitation. He has since devoted his practice to the field of specialty contact lenses and primary eye care.
Juanne Lee (李佩欣)
Bsc (Hons) Optom (UK)
Juanne graduated as an Optometrist with a Bachelor of Science in Optometry with First Class Honours at University of Manchester. Since then, she has been providing comprehensive primary eye care services which include prescribing spectacles, prisms, contact lenses, specialty contact lenses and diagnosing ocular diseases of all age groups. She has also successfully designed and fitted many myopic children with orthokeratology lenses.
Juanne has received numerous awards namely University of Manchester Scholarship Award, Health Sciences Authority Gold Medal, Singapore Optometry Excellence Award given by Singapore Optometric Association and Essilor, Johnson & Johnson Singapore Award, Oculus Award and Alcon Award in the span of 2012-2014. In 2014, Juanne has also received a National Healthcare Group Eye Institute Book Prize together with Tan Tock Seng Hospital.
From 2015-2017, Juanne has served as honorary secretary of Singapore Optometric Association. She is currently a member of the American Academy of Orthokeratology and Myopia Control (AAOMC), The Scleral Lens Education Society (SLS) and Singapore Optometric Association (SOA). She is also an adjunct lecturer in Singapore Polytechnic where she supervises polytechnic students in their clinical practice.
Juanne has channelled time in giving numerous talks to the public and industry in the hope of awareness and leveraging the eye care standards in Singapore. Over at Titus Eye Care, Juanne will be focusing on myopia control for children and corneal and vision rehabilitation. Juanne is dedicated to provide personalized care to all her patients. She enjoys taking time to educate her patients about the eye and providing eye care tips to improve their quality of life.
Our customized Myo-Control Programme starts with capturing a detailed ocular imprint of the whole cornea. A personalized pair of Ortho-K lens is fabricated and designed to mould the cells on the surface of the cornea in such a precise way so that the focal point will fall perfectly on the retina.
During the day, your child will have unassisted clear vision while keeping his/her Myopia under perfect control. Patients can expect to achieve perfect vision in about 1-2 weeks although some patients have reported clear vision in as short as a few days. Our treatment consists of 4-6 visits over a 3-6 month period depending on the complexity of the case.
Your consultation with the consultants at Titus Eye Care is private time set aside for you to discuss all of your concerns and questions, directly, about any treatment you may be considering. We understand you may be concerned about the procedure for you or your child, as such our specialists will do a one-to-one consultation with each patient so that both of you are confident in your decisions, and that they can confirm the treatment and care that is most appropriate for you. Your consultation is designed to fully inform you of the procedure that you are considering, and to discuss any other available options or considerations that may apply for your best outcomes.
Orthokeratology, Cornea Refractive Therapy or Corneal Molding, is a non-surgical, reversible process using a unique therapeutic mold to reshape the cornea while you sleep. The best analogy for Ortho-K is “orthodontics for the eye”. The corneal shape is altered by gentle pressure from custom-designed corneal molds. The result is clear crisp vision without daytime contact lenses or glasses. It is an excellent mode of treatment for myopia control for children and an alternative to refractive surgery (LASIK) for adults.
This state-of-the-art therapeutic mold re-sculpts the corneal cells using the many unique curvatures of the mold. This creates a push/pull force beneath the mold’s surface. Thin layer sheer forces, created by the tear film beneath this therapeutic lens, flow across the corneal surface. This continuous action moves the cells from the center of the cornea to the periphery thereby changing the overall shape of the eye. This resculpted shape can easily focus light directly on the retina.
Yes. As a child with myopia grows, the length of the eye also grows. This causes the myopia to increase. Their glasses get thicker and thicker. This also increases their risk of a detached retina. Ortho-K acts like a brake and retards myopia progression. There is sufficient evidence in the literature that concludes that Orthokeratology indeed retards myopia progression significantly and more importantly, better than other treatment methods available. For more information on related articles, click (Articles). Children are thrilled with Ortho-K treatment. But imagine how they will thank you when they get older and learn how you were able to preserve their sight and lower their risk of eye disease.
This therapy is effective on nearsighted (myopic), astigmatic and farsighted patients. 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 is worn while you sleep. This greatly reduces any discomfort you may have experienced while using conventional contact lenses. You are also a great candidate if you need excellent vision without the use of contacts or glasses. Orthokeratology benefits pilots, police officers, military personnel and those with safety concerns such as, professional athletes, parents of small children, lifeguards and many others. Your child is a candidate if they have a tendency to lose or abuse their contact lenses/glasses, or if wearing them interferes with their active life. 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, snorkelling, scuba and more, Ortho-K is for you.
Good vision without specs or contacts for most of the day. Non- surgical procedure. It is reversible. It is modifiable. It does not hurt. It will retard myopia progression for children.
You must be prepared for 4-6 visits over a 3-6 month period depending on the complexity of the case. Continued lens wear is essential or the cornea will revert to its original shape. The degree of success to achieve 20/20 vision is high but cannot always be guaranteed, especially for complex cases. You must follow instructions implicitly for the best results.
You have Presbyopia and this can be corrected with monovision therapy. This 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.
In addition, we have the technology to do multifocal corneal molding to manage both your distance and near problems.
Dry eyes are usually not a problem while you sleep as there is little tear evaporation in a closed eye, and Ortho-K lenses are only worn while you sleep. If your dry eyes are a problem while you sleep, supplementing your natural tears is a simple option. Orthokeratology provides a dry-eyed person with excellent vision with no compromise to their eye health or comfort. If you have dry eye disease due to severe arthritis or a collagen-vascular disease, you may not be a candidate. However, a comprehensive exam will give us a better idea of your chances for success.
Conditions that are contraindicated for Ortho-K treatment are rare. More importantly during the consultation, establishing the expectations of the patient in terms of lifestyle, comfort, vision, safety and more will be discussed in detail to ensure we will achieve the result that is deliverable. If there are any underlying conditions that may prevent us from achieving the best result, we will treat the condition first prior to Ortho-K treatment.
Whether you are a good candidate depends on other factors such as the health of your eyes, your age, your pupil size and your expectations. High astigmatism is normally more complex in the design and fit. This is because conventional molds will not sit well with perfect centration on the cornea. When we custom design a mold for your cornea, we will be able to achieve perfect centration on the cornea however, we would like take a step further and reduce almost all of your cornea astigmatism. We have had fantastic results from our patients with high astigmatism but as mentioned, it will depend on the individual case and a consultation will allow us to give you a more accurate gauge on what to expect.
No. We can fit children as young as six. And, there is no upper limit on age either.
Definitely! These therapeutic molds are worn at night while you sleep. This greatly reduces any discomfort you may have experienced while wearing contact lenses during the day.
Yes, it is possible to have LASIK surgery after orthokeratology. But because Ortho-K lenses reshape your cornea, you must stop wearing the lenses for a period of time (usually several months) so your eyes can return to their original shape and stabilize. Be sure to tell your LASIK surgeon that you have worn Ortho-K lenses, so they can advise you how long you should wait before having the surgery.
No. Ortho-K molds are not normal contact lenses and cannot be classified as one. These molds require a great deal of knowledge in the designing, fitting and review process. It is therefore very important to go to the right Orthokeratologist who has the proper certification and accreditation by the Orthokeratology academy. This is the list of members and fellows of the American Academy of Orthokeratology and Myopia Control in Singapore. http://www.orthokacademy.com/singapore
Ortho-K is a significantly longer process than a regular contact lens fitting. It requires a series of office visits and potentially multiple pairs of lenses. Also, GP molds used for Ortho-K are more costly than most contact lenses. Therefore, fees for Ortho-K are higher than fees for regular contact lens fittings. Ortho-K prices are based on the Orthokeratologist’s skill, training, patient’s refractive error and complexity of individual cases. A preliminary comprehensive eye examination including corneal topography is necessary to determine if you are a suitable candidate for treatment and an experienced orthokeratologist will be able to answer specific questions pertaining to you individual case.
The practice of Ortho-K requires a great deal of technical skill, specialised equipment and considerably more office time and is therefore more costly to the patient. Many Optometrists do not consider myopia control worth the time and effort. Some believe myopia progression is no big deal or that nothing can be done. If an Optometrist is not trained in Ortho-K, or did not look into the current research on myopia treatment, he or she will not recommend it as an option during an eye exam. It is easier to offer contact lenses, glasses or refractive surgery to correct vision.
Ortho-k is the only treatment that allows the patient to be spectacle free or contact lens free during the day. That means the patient is able to see clearly without any other optical correction. In addition to that, we have seen excellent results for myopia control with an average of 70% to 100% control for those under the myopia control program.
There are many benefits associated with the Ortho-K treatment. The more common benefits are for those who require myopia control where it has seen to slow down the progression by 70-100%. It is also great for those who are unable to wear contact lenses due to dry eyes and those who are not suitable to LASIK surgery.
With regard to lifestyle benefits, we see a huge improvement in many of our patients who are competitive sportsmen i.e. dance, swimming, water polo, tennis etc. They are normally able to perform better at their sports and are also more confident without having to worry about their spectacles falling off.
We recommend young children (from 7 years onwards) to consider starting Ortho-K if there is evidence of rapid progression and/or is under the high risk category of myopia progression based on the myopia profile assessment.
It is also recommended for adults who are keen to do away with their spectacles and/or are unable to wear day time contact lenses comfortably.
There will also be a group of adults who are either not suitable for refractive surgery or are worried about going through surgery. These patients might find Ortho-K beneficial to them.
Our youngest patient was 4 years old and our oldest patient was 67 years old when they commenced Ortho-K treatment.
In order to deem the patient suitable, we look at various factors to ensure it is safe to start and that we are able to meet the patient’s vision expectation as well. It is important to go through a thorough consultation first in order to determine if the patient is suitable.
The risk of infection stated in the medical literature for Ortho-K is approximately 7 in 10,000 patients. This is a prevalence that is far lower than some other lens modalities. That being said, it is important to understand how infection occurs and ultimately, what needs to be done to prevent it.
In order for an infection to occur, there usually is a compromise in the eye surface, coupled with an introduction of micro-organisms (e.g. bacteria). Any delay in seeking medical assistance when the eye is not feeling comfortable can make matters worse.
There are 3 main points to prevent the risk of infection.
Custom design is not merely taking a lens and placing it on the cornea to assess the fit, making adjustments to the parameters to ‘fit’ the cornea. Custom designing is a complex process that takes into consideration multiple calculation points of the cornea, the individual cornea’s shape, size and elevation details, myopia profile of the patient, pupil size and many other crucial points, to design one lens/mold that will fit the individual cornea with accurate precision and equilibrium to produce a well-centred treatment zone, healthy eyes, clear vision and maximum myopia control efficacy. Why? Because every of our patient deserves it.
After we qualify the patient, the success rate for full treatment is 100% unless otherwise stated. We have treated patients in excess of -1000 degrees of myopia and -450 degrees of astigmatism. This is out of the normal range of treatment and this is because we custom design each mold according to each cornea.
However, more importantly, the patient accounts for 50% of the success rate and this is because it will not be possible without the patient’s compliance and responsibility in taking ownership when handling their molds, in terms of proper insertion and removal as well as compliance in the care products.
We agree! Think of soft contact lenses as a sponge. They absorb moisture from the eye and can cause adhesion, swelling and corneal insult when worn to sleep.
Ortho-k on the other hand is a corneal mold. We refer to the term ‘lens’ for the ease of understanding. Ortho-k is different and it is approved for night use.
We want to stress again, Ortho-k is safe IF the procedure is done properly. It is safe if the lenses are fitted perfectly. It is safe if the patient is compliant to ensure the molds are sterile during each use. It is safe if the patient understands the difference between when the eye is normal and when the eye feels more uncomfortable than normal and seeks intervention in a timely manner.
At our centre, we take live images at every visit to show our patient the state of their eyes, the fitting of the molds and a vision check to ensure vision is clear. We believe in a transparent system and working together to make it a safe modality for everyone!
We understand you may be busy and want to minimise your waiting time in our clinic. As such we strongly encourage you to make a prior appointment with our staff either through call or email. We will then schedule a time for our specialist to meet you.
10 Jalan Serene
#02-15 Serene Centre
Tel: (+65) 6467 6338
Mondays - Fridays: 9:30am - 6:00pm
Wednesdays: 2:30pm - 6:00pm
Saturdays: 9:30am - 1:00pm
Sundays/Public Holidays - Closed
Lunch hour: 1:30pm - 2:30pm
We are conveniently located at Serene Centre along Bukit Timah.
If you require further directions to our office, please call us at (+65) 6467 6338.