Ortho-K Fitting: Is Your Child Suitable for Myopia Control?

Have you ever wondered if there’s a way to deal with your child’s myopia that goes beyond the usual prescription glasses?

Ortho-K contact lens fitting might just be the answer you’re looking for. But does Ortho-K really work, or is it just hype?

Before we get in too deep, let me introduce myself. My name is Dr Jotinder Khosla. Together with Dr Papadopoulos, we and the team at Optometrist Parramatta strive hard to make sure our patients enjoy better vision and healthier eyes. Orthokeratology (Ortho-K) and myopia control are two areas of optometry that I am particularly passionate about.

As an experienced optometrist, I’ve seen firsthand the positive impact that Ortho K (orthokeratology) can have on a child’s vision. Unlike conventional methods, Ortho-K involves the use of specially designed hard contact lenses that are worn overnight. These lenses gently reshape the cornea, correcting myopia so that during the day, your child can see clearly without needing any eyewear.

Now, you might be thinking, “Can’t my child just wear glasses?” It’s a valid question. Glasses have, for a long time, been the go-to solution for myopia. However, we understand now that advanced myopia significantly increases the risk of developing vision-threatening conditions later in life, such as glaucoma, cataracts, and retinal detachment. This is where Ortho-K offers a compelling opportunity. By controlling the childhood progression of myopia, Ortho-K can reduce the long-term eye health risks.

So if you’re considering Ortho-K for your child, the first step is to make an appointment with a professional optometrist to discuss Ortho-K fitting. To find out if your child is a suitable candidate for this treatment requires a comprehensive eye examination and a discussion of your child’s vision needs.

And if you’re still on the fence and looking to learn more about this innovative approach to myopia control, keep reading.

Is my child suitable for contact lenses?

Myopia Control Effectiveness of Ortho-K Lenses

What exactly is myopia, and what causes it to progress?

Myopia occurs when the eyeball is too long relative to the focusing power of the cornea and lens, causing light rays to focus at a point in front of the retina rather than directly on its surface. This results in blurred vision when looking at distant objects. The progression of myopia is influenced by a combination of genetic and environmental factors, including excessive close work (e.g. focussing on digital devices), and a lack of time spent outdoors.

This is where Ortho-K comes into the picture. Ortho-K lenses are specially designed contact lenses that you wear overnight. While you sleep, these lenses gently reshape the surface of your eye, correcting myopia so that you can see clearly the following day without the need for glasses or contact lenses.

It’s the same principle as wearing an orthodontic dental retainer on your teeth overnight. The lenses work by coaxing the cornea (the front surface of the eye) into the optimal refraction for sharp vision the next day.

But the real magic of Ortho-K lies in its ability to reduce the stimulus for eyeball elongation, which is a key factor in myopia. By controlling this elongation, Ortho-K lenses play a crucial role in myopia control, potentially slowing down or even stopping the progression of myopia in children.

Now, you might be asking, “Is Ortho-K evidence-based?” Absolutely. A wealth of scientific research supports the effectiveness of Ortho-K. Numerous studies have shown that Ortho-K can significantly slow down the progression of myopia in children, making it a powerful tool in our fight against this widespread vision issue.

Understanding the mechanics and science behind Ortho-K is crucial for any parent considering this treatment for their child. It’s not just about correcting vision temporarily; it’s about ensuring a healthier visual future for your child. That’s why it’s important to consult with an experienced optometrist who can evaluate your child’s eyes and determine if Ortho-K is the right choice for their specific needs.

Study Name (Year)

What it Found

Retardation of Myopia in Orthokeratology (ROMIO) Study (2012)

This study looked at kids aged 6 to 10 who were getting more nearsighted each year. They found that wearing Ortho-K lenses at night made their nearsightedness get worse much more slowly compared to kids who just wore regular glasses.

Corneal Reshaping and Myopia Progression (2009)

Researchers discovered that reshaping the cornea with Ortho-K lenses can help control how fast nearsightedness progresses in kids. This means their vision doesn’t get as bad as quickly as it might without these lenses.

Myopia Control with Orthokeratology Contact Lenses in Spain (2012)

This study showed that Ortho-K lenses were effective in slowing down the worsening of nearsightedness. The children wore the lenses overnight, and it helped control the increase in their myopia.

Source: Cho P, Cheung SW. – “Retardation of myopia in Orthokeratology (ROMIO) study: a 2-year randomized clinical trial.” Published in “Investigative Ophthalmology & Visual Science” in October 2012.

Source: Walline JJ, Jones LA, Sinnott LT. – “Corneal Reshaping and Myopia Progression.” Published in “British Journal of Ophthalmology” in September 2009.


Source: Santodomingo-Rubido J, Villa-Collar C, Gilmartin B, Gutiérrez-Ortega R. – “Myopia control with orthokeratology contact lenses in Spain: refractive and biometric changes.” Published in “Investigative Ophthalmology & Visual Science” in July 2012

Key Fitting Considerations for Ortho-K Candidates

So by now you might be thinking that Ortho-K lenses are the solution for your child’s myopia, but wondering if their age or specific vision needs might affect the treatment’s effectiveness.

Firstly, let’s talk about age. You might be surprised to learn that there isn’t a strict age limit for starting Ortho-K treatment. In fact, children as young as six or seven years old can be excellent candidates for Ortho-K lenses. The reason for this is quite simple: the earlier we can start controlling myopia, the better we can manage its progression over time. Younger children tend to show a more significant response to the treatment, because their eyes are still developing and the myopia progression can be more rapidly controlled.

Ortho-K lenses can correct myopia with or without moderate levels of astigmatism (a condition where the cornea has an irregular shape). Typically, Ortho-K can effectively correct up to -1.75 diopters of astigmatism. If your child’s astigmatism exceeds this level, the effectiveness of Ortho-K in fully correcting their vision might be diminished, though significant improvements can still be achieved. It’s a conversation worth having with your optometrist, who can assess the specific needs of your child’s eyes.

It’s also important to also understand the correction limits for high prescriptions. Ortho-K is remarkably effective for myopia up to approximately -6.00 diopters. Beyond this level, the effectiveness can vary, and the precision of correction might decrease. This doesn’t mean Ortho-K is off the table for higher prescriptions, but it does mean that expectations need to be managed, and additional treatments might be considered in conjunction with Ortho-K to achieve the best possible vision outcomes.

There are certain other eye conditions which could make orthokeratology a challenging strategy for your child, including:

  • Severe Dry Eye Syndrome: Ortho-K lenses require a certain level of tear production to maintain eye health and lens comfort. Children with severe dry eye syndrome may find Ortho-K lenses uncomfortable or may experience exacerbated eye dryness and irritation.

  • Corneal Disorders: Conditions affecting the cornea, such as keratoconus (where the cornea thins and bulges forward), corneal dystrophies, or severe corneal scars, can affect the fitting and effectiveness of Ortho-K lenses. These conditions can alter the cornea’s shape in a way that makes Ortho-K treatment challenging or less effective.

  • Active Eye Infections or Inflammations: Children with active eye infections, such as conjunctivitis, or inflammatory conditions like uveitis, are generally advised to avoid contact lens wear, including Ortho-K lenses, until these conditions are fully resolved.

  • Severe Allergies: Kids with severe eye allergies that cause significant itching, redness, and discomfort may struggle with Ortho-K lens wear due to increased irritation and risk of rubbing their eyes, which can dislodge the lenses or introduce allergens.

  • Poor Hygiene or Inability to Handle Lenses: Ortho-K requires strict adherence to lens care and hygiene routines. Children who cannot commit to this routine, either because they are too young or lack the discipline to manage it properly, may not be suitable candidates due to the increased risk of eye infections.

It’s important to consult with an experienced optometrist who can conduct a thorough examination of your child’s eyes and evaluate their overall health, lifestyle, and specific needs to determine if Ortho-K lenses are a suitable option. This evaluation should include a discussion of any existing eye conditions and a comprehensive assessment to ensure the best possible outcome for vision correction and eye health.

It’s completely reasonable to ask questions about the safety of any kind of eye treatment for you child, so if you have concerns, I suggest watching the following video by Dr. Miglani where she addresses many of the common questions.

The Ortho K Fitting Process

So what goes into the process of fitting Ortho-K lenses? It’s not just picking eyewear off the shelf. It’s a detailed, technical process that ensures the lenses are perfectly tailored to your or your child’s eyes.

The procedure begins with a comprehensive eye examination, focusing on the spherical component of refraction. This step is crucial as it helps us understand the degree of myopia or nearsightedness that needs correction. Ortho-K lenses are designed to temporarily reshape the cornea, and determining the right amount of correction is essential for achieving clear vision without glasses or contact lenses during the day.

Next, we examine corneal topography, a fascinating and vital part of the Ortho-K fitting process. Corneal topography involves mapping the surface of the cornea, revealing its shape and contours with incredible precision. This map is critical for designing Ortho-K lenses because it allows us to customize the lens to the unique curvature of your cornea, ensuring the best possible fit.

Among the topography parameters vital for Ortho-K success, corneal eccentricity and apical corneal power stand out. Corneal eccentricity gives us insight into the shape of the cornea, indicating how quickly it flattens from the center to the periphery. This information is crucial for designing a lens that can effectively reshape the cornea. Apical corneal power, on the other hand, measures the curvature at the cornea’s highest point, helping us to determine the lens’s power needed to correct your myopia.

Once we’ve fitted you with new lenses, we conduct personalized training sessions, meticulously taking each patient (or their parents) through the processes of inserting, removing, cleaning, and storing Ortho-K lenses, ensuring they are equipped with the knowledge and skills for safe and effective lens management.

During follow-up appointments, our optometrists closely monitor the success of Ortho-K lenses, assessing vision improvement and corneal health, and making necessary adjustments to address any unexpected issues or discomfort.

Understanding these technical aspects of fitting Ortho-K lenses highlights the precision and customization involved in this process. It’s not a one-size-fits-all solution; it’s a carefully tailored approach to vision correction that requires expertise and attention to detail.


Have we sparked your interest in the transformative potential of Ortho-K lenses for yourself or your child?

It’s a journey we’re passionate about guiding our patients through, ensuring you’re equipped with all the necessary information to make an informed decision.

In this article, we’ve talked about myopia, the innovative approach of Ortho-K in managing and controlling this condition, and the meticulous process involved in fitting these specialized lenses. We’ve also touched on the lifestyle and responsibility considerations crucial for success with Ortho-K lenses.

If you’re considering Ortho-K lenses, or simply wish to explore more about how they can benefit you or your child, we warmly invite you to book a consultation with our optometry team. It’s an opportunity for us to discuss your condition in detail, address any concerns or questions you might have, and decide if orthokeratology is the right for you.

To make an appointment, give us a call at 02 9891 2020 or click the “Book Online” button on our website.

Dr Jotinder Khosla – Optometrist

B.Optom (UNSW), CertOcTher (UNSW) Therapeutically Endorsed Optometrist

Member of the Orthokeratology Society of Oceania