By Dr. Gary White, WOAI.com Gentle Molding Expert
Gentle Molding is a non-surgical procedure used to correct nearsightedness, farsightedness, and astigmatism. The cornea, the outer window of the eye, is reshaped while sleeping with a molding lens at night. This reshaping of the cornea corrects the vision during the daytime to allow for clear vision without the need for glasses or contact lenses. This non-surgical procedure is very safe. It has the same risks as if wearing contact lenses, but at a lesser degree. The molding lens looks like a regular gas permeable contact lens. This makes it very safe and effective. They are comfortable to sleep with, and are easy to handle. The cornea will maintain the clear vision throughout the day until the molding lenses are worn again for sleeping. These molding lenses are custom fit for each eye. The custom fit is based on taking computerized measurements of the cornea and the exact prescription.
The Gentle Molding Procedure
The first step for the gentle molding procedure is to determine if the patient is a good candidate for the procedure. This is determined by performing a thorough eye examination. During the examination, we will take a series of measurements of the cornea to determine its shape, thickness, and size. We will also check thoroughly for any eye diseases or dystrophies that may disqualify the patient. Most of the time we do dilate the pupils to allow for a more thorough examination of the retina. We will also do a very thorough and precise refraction to determine the amount of prescription we need to correct.
Once this examination is finished, and the patient has been completely informed about all the aspects of the procedure, then we will order the first set of gentle molding appliances. These will be custom ordered for each eye for each patient. The gentle molding appliances typically take about one week to arrive at the office. The patient is then scheduled for an appointment to dispense the GMA’s (gentle molding appliances). At this dispensing visit the patient will be instructed on how to insert and remove the GMA’s. The patient will also be instructed on how to care for and handle the GMA’s. The doctor will examine the fit of the GMA’s a on the patient’s eyes at this dispensing visit.
The patient is scheduled to return to the office the very next morning as the first patient of the day. They are to return that next morning with the appliances still on the eyes. They will remove them at the office after the doctor has had a chance to evaluate the fit. The patient will have slept in those GMA’s for about 6 to 10 hours that night before coming into the office. After the doctor evaluates the fit at that morning visit, the patient will be rescheduled for another office visit, typically in about one week. If the patient is not fully corrected yet after just this one night of sleeping in the GMA’s, then they will be given some disposable soft contact lenses to wear during the day until they no longer need them. Most patients no longer need the soft contact lenses during the daytime within one week of sleeping with the GMA’s.
At the one-week visit, the patient has an examination to determine their refraction and eye health. By this time in the process, most patients are no longer wearing any correction during the daytime. They are just using the appliances at night to correct their vision. If the patient is not seeing 20/20 in the daytime, then we will re-evaluate the fit and make the proper adjustments to correct the vision.
The next office visit is typically in one month. This one-month visit is to evaluate the fit and check the refraction. As the cornea has been reshaped during this month of wear time, sometimes the GMA’s may become too tight. This usually starts to occur at around one month. That is the main reason for the one-month visit. We want to make sure the eyes are healthy and the vision is good and that the patient is starting to get into a routine. The patient should be much better at handling the appliances, wearing the appliances, and caring for them. They should be very excited and happy with their vision by now. They continue to sleep with the GMA’s on every night to increase the effectiveness and to stabilize the corrected vision. If everything is good still at this point, then we will reschedule the patient for their next visit in one month. The patient will continue to wear the GMA’s every night for at least 3 months. We will examine the patient monthly for the 3 months. At the end of this treatment period, the patient will continue to wear the appliances at night. They will now wear them as a retainer to maintain the correction. They will either wear the GMA’s every night, just one night per week, or some amount between these two. The next visit would be in six (6) months. After the six month visit, then the patient is just seen for their yearly examinations. The GMA’s will need to be replaced about every 2 to 3 years. When the GMA’s need to be replaced, we just order a new replacement. The patient does not have to do the whole fitting procedure again. Once the fitting is finished, then it is just a matter of maintaining the vision and eye health.
Dr. White is the WOAI.com gentle molding expert. You can email him at AsktheExpert@DrGaryWhite.com or call (210) 481-7100.
