Orthokeratology uses overnight contact lenses to reshape the cornea, providing clear daytime vision and inducing peripheral myopic defocus to slow myopia progression
Target Population
Children typically aged 6 years and older with myopia ranging from -0.75 D to -5.00 D and up to -1.50 D corneal cylinder
Care Setting
Optometry or ophthalmology clinics with structured follow-up and monitoring
Key Highlights
Orthokeratology (OK) is a reversible therapy that slows myopia progression while providing clear vision during the day.
OK efficacy includes a median 1-year axial length progression reduction of approximately 0.17 mm and 0.30 mm over 2 years.
Patient selection should consider refractive error, lifestyle, hygiene, maturity, and ability to comply with lens care.
Guideline-Based Recommendations
Diagnosis
Assess myopia degree and corneal cylinder to determine OK candidacy.
Evaluate behavioral factors including hygiene practices, ability to follow instructions, sleep habits, parental involvement, and child maturity.
Management
Fit orthokeratology lenses using computer-aided or trial-lens methods to optimize fit and efficacy.
Instruct children to wear lenses 6 to 8 hours nightly, ideally 8 hours.
Educate on proper lens hygiene: hand washing before handling, daily lens cleaning, daily solution replacement, avoiding tap water, and regular case replacement.
Provide checklists for lens care to support compliance.
Monitoring & Follow-up
Schedule regular follow-up visits to monitor corneal health, lens fit, and myopia progression.
Train staff to triage symptoms of complications promptly.
Re-educate families if lens wear time or hygiene practices decline.
Risks
Potential complications include redness, pain, irritation, blurred vision, and discharge.
Higher risk of lens binding and decentration in high myopes.
Immediate cessation of lens wear and clinical evaluation if complications arise.
Patient & Prescribing Data
Children with progressive myopia, typically aged 6 years and older, with myopia between -0.75 D and -5.00 D and corneal cylinder up to -1.50 D
OK provides effective myopia control with lifestyle benefits for active children or those who prefer not to wear glasses or daytime contact lenses; success depends on compliance with wear time and hygiene.
Clinical Best Practices
Use simple, clear explanations and visuals to educate parents and children about OK and myopia management.
Set expectations that OK is a medical therapy requiring follow-up and compliance.
Empower children with responsibility for lens care appropriate to their maturity.
Support families with printed and online educational materials.
Monitor and address behavioral factors impacting treatment success.
