Orthokeratology Today: <br>Using Biometry to Guide Ortho-k Decisions</br>

By
CHERYL CHAPMAN, OD, FIAOMC, FAAO, DIPL ABO
May 1, 2026
4 min

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Objective:

To emphasize the importance of axial length measurements in monitoring myopia progression and guiding orthokeratology treatment decisions, highlighting its role in both assessment and intervention.

Approach:

Key Findings:

Stable refraction does not guarantee stable myopia; axial length is a more reliable indicator of myopia progression.
Normal axial length growth in untreated myopic children can exceed 0.20 mm per year, indicating a need for monitoring.
Effective myopia control interventions can reduce axial elongation to approximately 0.10 mm to 0.15 mm per year, demonstrating the impact of treatment.

Interpretation:

Axial length measurements are crucial for assessing myopia progression and should guide treatment decisions in orthokeratology, directly influencing patient outcomes.

Limitations:

Fluctuations in axial length measurements due to seasonal and diurnal variations can complicate assessments.
Single axial length readings may not provide a complete picture; trends over time are more informative, and strategies should be in place to address variability.

Conclusion:

Regular monitoring of axial length, aligned with clinical milestones, is essential for effective myopia management in orthokeratology, necessitating a proactive approach to treatment adjustments.