[charlesbahn]

I'm an Ophthalmologist with fellowship training in cornea and glaucoma, which means that I am an MD and surgeon of the eye. I fit contact lenses, and care for contact lens problems, although that is not the primary focus of my practice. I have never fit a patient for CRT, among Ophthalmologists it is considered to be a poor procedure at best. But I have taken care of many patient with corneal molding problems from contacts. The practice of placing a contact lens on the eye that does not fit, to change the shape of the cornea, even with the newer, more oxygen permeable plastics, is mainly an Optometry practice. Most if not all Ophthalmologists consider it questionable if not malpractice.

Corneal molding occurs either intentionally as orthokeratology to change the refraction, or unintentionally in people who wear regular contacts for nearsightedness or farsightedness and just have a bad reaction to the contacts (or the contacts are fit wrong, ie too tight or too loose). Molding can occur with both hard (gas permeable) and soft lenses, regardless of the oxygen permeability of the plastic, although it is more common with the harder plastics (PMMA and gas permeable). Once the corneas become molded, stability and the tendency of the cornea to scar are problems as I stated above.

In my area (DC) I do not know of anyone, even Optometrists, that are promoting this. In my 25 years of working with the cornea, I can't imagine that it is a good thing long term.

But I suppose I could be wrong.