Just like every other aspect of a successful specialty lens program—from fitting and follow-up to troubleshooting and billing—the way you dispense orthokeratology (ortho-k) lenses plays a critical role in long-term patient success. It's not just about the lenses themselves; the care kit and supporting supplies you provide on day 1 can make all the difference.

Providing patients with information on the exact products you want them to use may increase the likelihood that they’ll stick to your guidance over time. However, clarity is key. If your explanations or instructions leave too much room for interpretation, then patients will often turn to alternative sources such as friends, relatives, or “Dr. Google” for answers.

We’ve seen it all: patients hoarding bottles of contact lens solution and lens cases instead of using them, kids skipping handwashing (even after COVID), and suction cups blackened from years of improper storage. To avoid these pitfalls, you should give clear written instructions and verbally reinforce them. Here are our tried-and-true recommendations:

• Employ good hand hygiene. Always wash hands thoroughly before handling ortho-k lenses.
• Opt for a clean environment when caring for your lenses. Avoid the bathroom for lens application, removal, and cleaning. A clean desk or table is best.
• Remember lens safety. Rigid lenses can bounce unpredictably. Lay a clean terrycloth towel (loop-side up) on the work surface to soften any accidental drops. Additionally, use a frameless mirror, as a dropped lens can crack against a framed edge.
• Use visual targeting. To help with proper alignment during lens application, mark a target on the mirror to steady the nonworking eye.
• Never rinse lenses with tap water. Always use a recommended lens solution.
• Avoid rubbing lenses with fingers. This increases the risk of warping or cracking. We recommend a hands-free hydrogen peroxide system.
• Utilize cushioning drops. Use at least 2 drops of a preferred-viscosity solution in the bowl of the lens retainer before application.
• Practice safe removal. Improper lens removal can damage the corneal epithelium. A drop of artificial tears and gentle pressure from the lower eyelid against the lens edge helps break the seal prior to lens removal.
• Reserve suction cups for parental use in emergencies. Although suction cups can be helpful, they’re easily misplaced. We encourage digital removal for daily use.
• Never use a suction cup blindly. Aways ensure the lens is visible and discard the storage tube immediately.

By setting expectations early and equipping patients with the right tools and guidance, you can help prevent complications and make the ortho-k journey more successful for patients and their families.

ROBERT GEROWITZ, OD, is an optometrist-orthokeratologist and owner of Mission: Myopia Control in Zion, Illinois. He has no financial disclosures to report.

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