Common Questions About CRT

1. What is CRT?

CRT is a specially designed oxygen permeable therapeutic contact lens used in Corneal Refractive Therapy. Corneal Refractive Therapy is a sophisticated, non-surgical process, which reshapes the cornea while you sleep. You remove the lenses when you awake and are able to go throughout the day without any other correction.

2. How new is CRT?

Contact lens corneal reshaping is not a new concept. Previous corneal reshaping designs were only as successful as technology allowed. New CRT has taken the recent advancements in computerized corneal mapping, computerized manufacturing, and oxygen permeable contact lens materials and produced a therapeutic contact lens design that is like no other. This has allowed CRT to become the one corneal reshaping modality that truly stands out and the first to earn FDA approval for nighttime Corneal Refractive Therapy.

3. Is Corneal Refractive Therapy Permanent?

No. It’s temporary. If you stop wearing the lenses regularly while you sleep, your vision will return to its original state in as little as 72 hours.

4. Can everyone wear CRT?

Not everyone can wear CRT. This lens is designed for individuals with low to moderate myopia (nearsightedness up to –6.00 diopters) with or without astigmatism (up to –1.75 diopters). CRT therapeutic lenses are not yet available in bifocal prescriptions for presbyopia (which requires reading glasses or bifocals). You may be fitted in a monovision mode (one eye corrected for near vision and one corrected for distance vision). You might still need reading glasses. However, since there are variations in patient physiology and visual needs, the decision for CRT, at any age, can only be made after a thorough eye exam. At this time, hyperopia (farsightedness) is not correctable with CRT.

5. How long does it take to reach good vision?

Most patients have rapid improvement in the first few days of treatment and achieve nearly their optimum vision in 10 to 14 days.

6. What do I do to see adequately in the period of time between when I start Corneal Refractive Therapy with CRT and when I achieve full treatment?

It’s important to understand that for a time after you have begun treatment, but before sufficient treatment is realized, your old glasses or contacts will no longer be the appropriate prescription. It may involve insertion of your CRT lenses for part of the day or some use of temporary soft lenses in different prescriptions as an option. We will discuss your options for visual correction during that transitional period of time.

7. Are there any risks involved with wearing CRT?

There is a small risk involved when any contact lens is worn. Corneal Refractive Therapy provides a risk that is no greater than other contact lenses. There were no adverse events reported in the CRT FDA clinical study.

8. Can I see with my CRT lenses in?

Yes. One of the great features of the Paragon CRT lens is that if you have to get up in the middle of the night, you will be able to see where you are going. Or if during the initial treatment phase you find you need some form of vision correction, you can put in your CRT lenses and see clearly.

9. How often will I have to replace my CRT lenses?

Generally speaking the CRT lenses will have to be replaced once a year. However, depending on factors such as protein buildup, how well the lenses are taken care of, etc., the lenses may have to be replaced more frequently.

10. How do I care for my CRT lenses?

Your lenses should be chemically disinfected after every use (not heat). Currently we are recommending Optifree by Alcon.

We teach patients to gently loosen, lubricate, and remove lenses in the morning. Adherence increases as lenses build up surface protein, so have them use enzyme and surfactant cleaners regularly. At first, we schedule follow-up visits in the morning to check for adherence and monitor the immediate effect when a lens is removed. After ten days, we want to see how the patient is seeing at the end of the day. We continue to alternate the follow-up appointments between morning and afternoon. The first week, we will usually see the patient at one day, four days, and one week. If all is well, we progress to two weeks, one month after that, and then six-month intervals.

11. How much does Corneal Refractive Therapy with Paragon CRT cost?

The cost for your initial fitting, professional care, follow-up and CRT therapeutic lenses varies. After your first year, the annual cost of CRT is about the same as wearing contact lenses or glasses. We offer optional payment plans, which they will be happy to review with you.

12. Is Corneal Refractive Therapy painful?

The therapy is not painful. Initially, you may have a slight awareness of the therapeutic lens. You will not feel the lenses when you sleep and there is no sense of physical corneal change…. just visual improvement when the lenses are removed.

13. Is Corneal Refractive Therapy or CRT FDA approved?

CRT has been approved by the FDA for overnight wear for the temporary reduction of myopia. Paragon Vision Sciences received the final written approval on June 13, 2002. The issuance of this approval is the culmination of the most extensive clinical study to date to establish the safety and efficacy of contact lens corneal reshaping in overnight use.

14. What is the difference between Corneal Refractive Therapy and CRT?

Corneal Refractive Therapy is the process of using a therapeutic contact lens to reduce myopia by reshaping the corneal surface while you sleep. CRT is the product for this therapy.

15. Are there age restrictions for Corneal Refractive Therapy with CRT?

No. The FDA placed no age restrictions on candidates for Corneal Refractive Therapy with CRT. CRT is being successfully performed on children 12 years old and younger. It can be a great option for children and teens that are active in sports activities or any other extra curricular activities.

Those who are older and presbyopic (requiring reading glasses or bifocals) may still be candidates for CRT. They may correct their distance vision with CRT and wear near vision glasses for close work. At the doctor’s discretion you may be fitted in a monovision mode (one eye corrected for near vision and one corrected for distance vision).

Visual requirements due to age or activities can only be assessed after a thorough eye exam. We will recommend what is best for you.

16. Are the CRT lenses difficult to insert or remove?

These lenses are generally no more difficult to insert or remove than any other similar contact lens modality. You may want to instill comfort or rewetting drops prior to insertion of the lenses and immediately upon waking. The lenses must move freely prior to removal. If you have difficulty removing the CRT lens, there are lens removal aids available to assist this process.

17. If I discontinue CRT, will my vision to return to normal?

There are no recorded permanent corneal changes post-treatment. Generally, the more myopia being reduced, the longer it will take for the corneal curvature to return to normal. For instance, if your pretreated correction was - 4.50D, it would take a few days longer to return to normal than if the pretreated correction was -1.50D.

18. 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 you with a document that states you are participating in a visual therapy program that eliminates the need for corrective lenses while operating a motor vehicle. The document should have an expiration date for this treatment and you should have your driver’s license updated with a new vision screening through your local DMV office to reflect this change, before the expiration date.

19. What happens if I lose or damage a lens?

Corneal Refractive Therapy is different than wearing regular contact lenses. If you discontinue wear for one night, your vision may be impaired the next day. Previously worn glasses or contact lenses may not help. Immediate replacement is necessary! Having a spare pair of lenses is strongly recommended.

20. Do benefit programs cover Corneal Refractive Therapy?

This is an elective procedure, and to the best of our knowledge is not usually covered by benefit programs. If regular contact lenses are covered under your vision care plan, Corneal Refractive Therapy may be partially covered. You should check with your benefits plan administrator.

21. I suffer from “dry” eyes, am I a candidate for Corneal Refractive Therapy?

Only your eye care professional can determine if you are a CRT candidate. Many patients with slightly dry eyes do well with CRT. Since you are wearing the lenses only while sleeping, the closed eye state minimizes evaporative loss of tears and can give dry-eye patients suitable vision without compromising the ocular surface.

22. I used to wear contact lenses, but stopped due to discomfort. Am I a candidate for Corneal Refractive Therapy?

CRT lenses are worn at night while you are sleeping. This greatly reduces any discomfort normally experienced while wearing contact lenses during the day.

23. I have astigmatism. Am I a candidate for Corneal Refractive Therapy?

CRT is designed to correct myopia with to 1.75 diopters of astigmatism. Each individual should be evaluated to determine if CRT is right for your visual requirements.

24. I wear glasses. Am I a candidate for Corneal Refractive Therapy?

The transition from wearing only glasses to CRT should not be a concern. About 18% of the patients in the FDA study were non-contact lens wearers. The dropout rate related to discomfort was only 3.9%.

25. How can I tell if I have the original CRT lenses?

Each lens is laser marked to assure you that you have the original CRT therapeutic contact lens.