Using orthokeratology (ortho-k) for the purposes of myopia control and correction has provided so much fulfillment in my practice. While most wearers are young patients with the intent of limiting the progression of their myopia, others are adults seeking nonsurgical freedom from contact lenses.

Regardless of age and indication, patients wearing ortho-k lenses long-term can fall into negative habits that can potentially compromise their successful wearing experience.

Early Days: Adaptation vs Adjustments

The initial comfort of an ortho-k lens is an important contributor to long-term success. According to the Stabilizing Myopia by Accelerating Reshaping Technique (SMART) study, the most common reason for patient drop was discomfort during lens wear, with just under 20% of patients dropping out by day 28.¹

Clinicians should be aware of 2 factors from this statement. First, comfort is important to our patients. It can be easy to become complacent with dispensing lenses when the fluorescein pattern of the central lens is appropriate, and it is only edge lift that needs to be adjusted. Second, drop out happens early—before 28 days—in this group. Make adjustments early to ensure the patient remains excited and committed to the process.

Maintaining a high standard of ‘dispense-worthy’ lenses can set up the provider and patient for long-term success.

Next Phase: Proper Care and Follow-Up

After the initial phase of adaptation, the second hurdle for long-term success is patients’ commitment to both proper lens care and adhering to the monitoring schedule recommended by the prescriber.² A common reason for improper lens handling is cumbersome or inconvenient cleaning protocols.³ Simple and effective methods can promote long-term compliance.

Another challenge for long-term success is adherence to follow-up schedules. Without receiving regular updated instructions, reminders on lens care, and patient education, ortho-k users can consider follow-up care appointments to be less important over time. Patients who have been experiencing success with their ortho-k lenses may perceive follow-up care as unnecessary and inconvenient.² One study found that informing parents during appointments of their child’s axial length changes increased compliance with follow-up schedules.⁴

Happy Patients and Providers

Finally, in a survey done to assess the satisfaction and compliance of ortho-k wearers, it was found that 88% of patients were satisfied with their vision, and 98% were willing to continue utilizing ortho-k for vision correction.⁵

Our patients want to continue using ortho-k lenses, so let’s make sure we give them all the tools they need to be successful.

References

1. Davis RL, Eiden SB, Bennett ES, Koffler B, Wohl L, Lipson M. Stabilizing myopia by accelerating reshaping technique (SMART)-study three-year outcomes and overview. Adv Ophthalmol Vis Syst. 2015;2(3):46. doi:10.15406/aovs.2015.02.00046
2. Jun J, Bian Z, Wang F, Lian L, Lu F. Level of compliance in orthokeratology. Eye Contact Lens. 2018;44(5):330-334. doi:10.1097/ICL.0000000000000516
3. Saw J. Beyond the basics: sustaining ortho-K success over the long term. Myopia Profile. Published June 25, 2026. Accessed August 22, 2026. https://www.myopiaprofile.com/articles/beyond-the-basics-sustaining-ortho-k-success
4. Chang LC, Sun CC, Liao LL. Compliance with orthokeratology care among parents of young children in Taiwan. Cont Lens Anterior Eye. 2021;44(5):101427. doi:10.1016/j.clae.2021.02.013
5. Wu SY, Wang JH, Chiu CJ. Assessment of satisfaction, compliance and side effects among long-term orthokeratology wearers. J Clin Med. 2022;11(14):4126. doi:10.3390/jcm11144126

Brooke M. Messer, OD, FSLS, FAAO, practices at Vance Thompson Vision in West Fargo, ND. She is also a fellow of the American Academy of Optometry. She has received remuneration from Bausch + Lomb SVP, Glaukos, Heidelberg, and Tarsus.

 The content supported by Bausch + Lomb