Clinical Scorecard: Orthokeratology Today: Predictable Ortho-k Outcomes

At a Glance

Key Highlights

• Eccentricity (e-value) of 0.50 or higher may predict better refractive changes.
• Visual iris diameter (VID) measurement is critical for determining lens sagittal height.
• Corneal elevation differences greater than 25 µm may necessitate toric peripheral curves.
• Understanding topographic data enhances first-fit success rates.
• Collaboration with design consultants can improve fitting outcomes.

Guideline-Based Recommendations

Diagnosis

• Assess corneal shape, size, and elevation metrics during initial evaluation.

Management

• Utilize e-value and VID measurements to guide lens selection and fitting.

Monitoring & Follow-up

• Regularly evaluate lens centration and patient satisfaction post-fitting.

Risks

• Undersized sagittal height can lead to inferior decentration.

Patient & Prescribing Data

Individuals seeking myopia control through orthokeratology.

Successful outcomes depend on precise measurements and understanding of corneal characteristics.

Clinical Best Practices

• Measure VID on the oblique meridian to avoid overestimation.
• Choose lens designs that match 90%-97% of corneal diameter.
• Familiarize with topographic maps for better fitting decisions.

References

• Mountford J. An analysis of the changes in corneal shape and refractive error induced by accelerated orthokeratology.
• Mountford J, Ruston D. Orthokeratology: Principles and Practice.
• Carney LG, Mainstone JC, Henderson BA. Corneal topography and morphology of the normal human cornea.
• Chen Z, et al. Prediction of orthokeratology lens decentration with corneal elevation.