Clinical Scorecard: Reclaim Clear Vision
At a Glance
| Category | Detail |
|---|---|
| Condition | Progressive myopia in children |
| Key Mechanisms | Orthokeratology uses overnight contact lenses to reshape the cornea, providing clear daytime vision and inducing peripheral myopic defocus to slow myopia progression |
| Target Population | Children typically aged 6 years and older with myopia ranging from -0.75 D to -5.00 D and up to -1.50 D corneal cylinder |
| Care Setting | Optometry or ophthalmology clinics with structured follow-up and monitoring |
Key Highlights
- Orthokeratology (OK) is a reversible therapy that slows myopia progression while providing clear vision during the day.
- OK efficacy includes a median 1-year axial length progression reduction of approximately 0.17 mm and 0.30 mm over 2 years.
- Patient selection should consider refractive error, lifestyle, hygiene, maturity, and ability to comply with lens care.
Guideline-Based Recommendations
Diagnosis
- Assess myopia degree and corneal cylinder to determine OK candidacy.
- Evaluate behavioral factors including hygiene practices, ability to follow instructions, sleep habits, parental involvement, and child maturity.
Management
- Fit orthokeratology lenses using computer-aided or trial-lens methods to optimize fit and efficacy.
- Instruct children to wear lenses 6 to 8 hours nightly, ideally 8 hours.
- Educate on proper lens hygiene: hand washing before handling, daily lens cleaning, daily solution replacement, avoiding tap water, and regular case replacement.
- Provide checklists for lens care to support compliance.
Monitoring & Follow-up
- Schedule regular follow-up visits to monitor corneal health, lens fit, and myopia progression.
- Train staff to triage symptoms of complications promptly.
- Re-educate families if lens wear time or hygiene practices decline.
Risks
- Potential complications include redness, pain, irritation, blurred vision, and discharge.
- Higher risk of lens binding and decentration in high myopes.
- Immediate cessation of lens wear and clinical evaluation if complications arise.
Patient & Prescribing Data
Children with progressive myopia, typically aged 6 years and older, with myopia between -0.75 D and -5.00 D and corneal cylinder up to -1.50 D
OK provides effective myopia control with lifestyle benefits for active children or those who prefer not to wear glasses or daytime contact lenses; success depends on compliance with wear time and hygiene.
Clinical Best Practices
- Use simple, clear explanations and visuals to educate parents and children about OK and myopia management.
- Set expectations that OK is a medical therapy requiring follow-up and compliance.
- Empower children with responsibility for lens care appropriate to their maturity.
- Support families with printed and online educational materials.
- Monitor and address behavioral factors impacting treatment success.
Related Resources & Content
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