With Ortho-K (orthokeratology), many appropriately fitted patients see clearly all day without glasses or daytime contact lenses, because the vision correction happens while they sleep. Specially designed rigid gas-permeable lenses worn overnight temporarily reshape the front surface of the cornea, and they are taken out in the morning.
In children, Ortho-K can also be used as a myopia-management strategy to help slow the progression of nearsightedness. It does not permanently eliminate myopia, and no myopia-management method can guarantee that progression will stop.
How Does Ortho-K Work?
Ortho-K lenses are designed so the tear layer and lens geometry create a controlled change in the shape of the corneal epithelium — the outermost layer of the cornea. That change alters how light focuses in the eye.
The effect is temporary and reversible. If regular lens wear stops, the cornea gradually returns toward its previous shape and the original nearsighted prescription returns.
Who Can Use Ortho-K?
Ortho-K can be considered for selected children and adults with myopia. Suitability depends on factors such as:
- the amount and type of refractive error;
- corneal shape and eye health;
- tear-film and eyelid health;
- ability to insert, remove, and care for lenses safely;
- family and patient expectations; and
- willingness to attend scheduled follow-up visits.
It is not the right lens for every prescription or every eye.
Why Is Ortho-K Used for Childhood Myopia?
Ordinary glasses and contact lenses correct blurry distance vision but are not necessarily designed to slow myopia progression. Myopia management has a second goal: reducing how quickly the child's nearsightedness increases.
Clinical evidence supports Ortho-K as one option that can slow myopia progression in many children. Other options include Stellest glasses, NaturalVue daily contact lenses, and low-dose atropine.
The choice is individualized. We consider the child's prescription, how quickly it has been changing, age, eye health, lifestyle, comfort with contact lenses, and family preferences.
See also How Overnight Contact Lenses Work to Control Myopia.
What Does an Ortho-K Fitting Involve?
A recent comprehensive eye exam is the starting point. The fitting also requires detailed information about the cornea.
Park Slope Eye uses a Scout corneal topographer to map corneal curvature. Those measurements, along with the prescription and eye-health findings, help guide the initial lens design.
The process may include:
- corneal topography and other measurements;
- diagnostic or initial lenses;
- instruction on insertion, removal, cleaning, and disinfection;
- morning or other scheduled follow-up after beginning wear;
- repeat topography and vision measurements; and
- lens-design changes when needed.
Ortho-K is a treatment process rather than a one-visit purchase.
Is Ortho-K Safe?
Ortho-K is used successfully by many patients, but it is not risk-free. Because the lenses are worn during sleep, careful hygiene and follow-up are especially important. Overnight contact lens wear is associated with a higher risk of serious corneal infection than not wearing lenses overnight.
Risk reduction includes washing and drying hands before handling lenses, using the prescribed cleaning and disinfection system, keeping lenses away from tap water, replacing lens-care supplies as directed, and not wearing a lens when the eye is painful, unusually red, light-sensitive, or producing discharge.
Sudden pain, marked redness, light sensitivity, or reduced vision during Ortho-K wear requires prompt eye-care evaluation.
Something urgent? Don’t wait for an online appointment: see our urgent and emergency guidance.
Will I Be Free of Glasses All Day?
Many patients obtain useful daytime vision without glasses, especially after the treatment effect stabilizes. Results vary by prescription, corneal response, lens wear, and fitting quality. Some patients may still use glasses for particular tasks or during the early fitting period.
Because the effect is temporary, skipping lenses for enough nights allows myopia to return.
Is Ortho-K the Same as LASIK?
No. LASIK permanently changes corneal tissue with surgery. Ortho-K changes corneal shape temporarily with a removable contact lens and is reversible when wear stops.
Ortho-K at Park Slope Eye
Park Slope Eye offers Ortho-K both as a specialty contact lens option and as part of myopia-management care. We also offer Stellest glasses, NaturalVue daily contact lenses, and low-dose atropine for selected children.
If you or your child are interested in Ortho-K, book an appointment to discuss candidacy, expected benefits, limitations, fitting, and follow-up.
Originally published . Substantially updated .