Ortho-K lenses are specially designed contact lenses that gently reshape the cornea overnight, providing clear vision during the day without glasses or daytime contacts. This non-surgical approach is particularly valuable for children and adolescents with myopia, offering both vision correction and a way to slow the progression of nearsightedness.
Myopia, or nearsightedness, is a common condition where the eye grows too long or the cornea curves too much. This causes distant objects to appear blurry while close objects remain clear. Myopia is becoming more common in young people worldwide.
With Ortho-K, rigid gas permeable lenses are worn during sleep to temporarily reshape the cornea. The lenses apply gentle pressure that flattens the central cornea slightly. This reduces the refractive error that causes nearsightedness. When the lenses are removed in the morning, the reshaped cornea allows light to focus properly on the retina.
Ortho-K does more than correct vision for the day. Studies suggest it may slow the progression of myopia by reducing axial elongation, which is the lengthening of the eye that makes nearsightedness worse over time. This can help protect your child's long-term eye health by reducing the risks associated with high myopia. Children also enjoy freedom from glasses during sports, swimming, and other activities.
The corneal reshaping effect is temporary. If lenses are discontinued, the cornea gradually returns to its original shape within one to four weeks. This reversibility means the treatment carries minimal long-term risks and provides flexibility for families.
Designing Ortho-K lenses starts with understanding the unique structure of your child's eye. Our eye doctors use a corneal topographer to create a detailed map of the front surface of the eye. This painless procedure captures critical measurements including apical curvature, horizontal visible iris diameter, sagittal height, pupil size, and astigmatism.
Based on these measurements and your child's prescription, a customized lens is designed using specialized software. The software simulates how the lens will reshape the cornea and predicts the outcome. This approach reduces the need for lengthy in-office trial fittings.
Our eye doctors adjust several parameters to create the ideal lens for your child:
Each lens is made from a rigid gas permeable material that allows oxygen to reach the cornea during overnight wear. Only FDA-cleared lens materials designed for overnight use are used. The lenses are typically replaced every one to two years to maintain performance.
Often called the white-to-white measurement, this determines the overall size of the lens needed. It ensures the lens covers the necessary area of the cornea for effective reshaping.
This refers to the curvature at the center of the cornea, where the curve is steepest. Steeper apical curvature generally means there is greater potential for corneal flattening, which is key to effective myopia correction.
The sagittal height, or sag height, is critical for matching the lens to the corneal shape. If the lens does not align well with the peripheral cornea, it may not stay centered, reducing treatment effectiveness.
The level of astigmatism influences whether a spherical or toric lens design is needed. Higher astigmatism may require a toric design to maintain an even fit around the cornea.
Measuring pupil size in both bright and dim lighting is important. Larger pupils can sometimes create visual effects such as glare and halos, especially in low light conditions.
The process begins with a comprehensive eye exam that includes a refraction test, tear film evaluation, and assessment of the front of the eye. The corneal topographer captures the detailed map needed for lens design.
Key measurements including horizontal visible iris diameter, apical curvature, astigmatism, sagittal height, and pupil size are recorded. These measurements help determine if your child is a good candidate for Ortho-K and guide the lens design.
Using the gathered data, our eye doctors work with specialized software to design a lens that will create the desired change in corneal curvature. In many cases, more than one pair of lenses may be developed during the fitting process to achieve effective results.
Once the lenses are produced, your child begins wearing them during sleep. In the morning, the lenses are removed and vision is evaluated. Our eye doctors inspect the lens fit and examine the corneal reshaping pattern to ensure proper treatment.
Regular check-ups help ensure the lens design continues to perform as expected and that your child's corneal shape remains healthy. Adjustments to the lens design may be made based on these findings. Many patients experience noticeable improvements as early as the next morning, though results typically stabilize within a week or two.
All contact lenses carry some risk of infection. Studies have shown that the rate of infection with Ortho-K lenses is lower compared to extended wear of soft contact lenses. Strict hygiene is essential to minimize risks. Never rinse lenses or lens cases with tap water. Before fitting lenses, thorough instructions on proper cleaning and handling are provided to both children and parents.
A well-fitted lens should have minimal movement, ideally less than 1 mm, and stay centered on the cornea. Careful fitting prevents complications such as lens decentration, which can cause discomfort and reduced visual clarity.
Remove lenses immediately and contact our office if you notice any of these signs in your child:
Frequent office visits help spot any early signs of complications, such as corneal staining. Monitoring the fit and overall health of the cornea ensures any issues are addressed quickly. Continued education about proper lens care is provided at each visit.
Ortho-K can be particularly beneficial for children with mild to moderate myopia or those with astigmatism. For many patients, achieving 20/20 vision is possible with proper lens design and consistent wear. Children who are active in sports or who do not want to wear glasses during the day often do well with this treatment.
The degree of myopia and the presence of astigmatism are key factors in determining the ideal lens design. Our eye doctors evaluate each child individually to determine if Ortho-K is the right choice for their vision needs.
Initially, consistent nightly wear is required to achieve and maintain the corneal reshaping. Once the desired vision is achieved, some patients may only need to wear the lenses a few times per week for vision correction purposes, though any change to the wearing schedule should be directed by our eye doctors, as reducing the number of nights may reduce the myopia control effect. Success depends on following the prescribed wearing schedule and maintaining proper lens hygiene.
Our eye doctors have training in myopia management and orthokeratology. Dr. Thanh Mai, OD, FSLS, FIAOMC serves as VP of Clinical Innovation for Treehouse Eyes and sits on the EssilorLuxottica advisory board for Stellest. Dr. Nathan Schramm, OD, FSLS, FBCLA served as principal investigator in the Euclid Phoenix ortho-k trial. Dr. Ariel Chen, OD served as co-investigator in the same trial and manages ortho-k and atropine protocols.
We use the Zeiss AXL WAVE Optical Biometer for precise axial length tracking and Pentacam corneal tomography for detailed corneal mapping. These tools help us design lenses accurately and monitor your child's progress over time.
Our team guides families through every stage, from the initial fitting and early adjustments to long-term vision maintenance. We serve patients across Orange County and welcome families visiting from other areas who are seeking myopia management options for their children.
Many children notice clearer vision as early as the first morning after wearing the lenses. However, optimal results typically stabilize within one to two weeks of consistent nightly wear. For higher prescriptions, it may take up to four weeks for the full effect.
Yes. One of the main benefits of Ortho-K is that children have clear vision during the day without wearing glasses or daytime contacts. This makes it easier to participate in sports, swimming, and other physical activities safely.
Missing one night occasionally may cause slightly blurrier vision the next day. If lenses are not worn for several days, vision will gradually return toward the original prescription. Consistent wear is important, especially during the first few months of treatment.
Most children adapt to wearing the lenses within a few nights. The lenses are custom-fitted to your child's eyes, which helps with comfort. Some children feel awareness of the lenses at first, but this typically improves quickly.
Follow-up visits are more frequent at the start of treatment, often within the first week and then at regular intervals. Once vision is stable and the lenses are fitting well, visits typically occur every few months. Our eye doctors will create a schedule based on your child's individual needs.
Research suggests that Ortho-K may slow the progression of myopia, but it does not stop progression entirely in most cases. The goal is to reduce how quickly nearsightedness worsens, which can help protect long-term eye health. Results vary from child to child.
