Orthokeratology

Vanshika Sharma, Ragni Kumari* and Monica Chaudhary

Background: Orthokeratology (Ortho-K) has evolved from a temporary refractive correction technique into a well-established, evidence-based intervention for myopia management. With the increasing global prevalence of myopia, particularly among children and adolescents, orthokeratology has gained prominence because of its ability to provide daytime spectacle-free vision while slowing axial elongation through peripheral myopic defocus. Advances in reverse-geometry lens design, high oxygen-permeable materials, corneal topography, and imaging technologies have further enhanced its safety, predictability, and clinical effectiveness.

Objective: This narrative review aims to provide a comprehensive overview of the current evidence on orthokeratology, including its historical development, mechanisms of action, lens design, patient selection, clinical fitting, efficacy in myopia control, safety profile, complications, and emerging technological advances.

Methods: A structured literature search was conducted using PubMed, Scopus, Web of Science, Google Scholar, and the Cochrane Library to identify relevant English-language publications from 2000 to 2025. Original research articles, randomised controlled trials, systematic reviews, meta-analyses, consensus statements, and clinical practice guidelines addressing orthokeratology and myopia management were reviewed and synthesised narratively.

Results: Current evidence demonstrates that orthokeratology effectively provides temporary correction of low-to-moderate myopia while reducing axial elongation by approximately 30–60% compared with conventional optical correction in children. The treatment works primarily through controlled corneal epithelial redistribution and induction of relative peripheral myopic defocus, which modifies retinal signalling involved in ocular growth regulation. Modern high-Dk rigid gas-permeable lens materials, customised reverse-geometry designs, and corneal topography-guided fitting have substantially improved treatment precision and safety. Although complications such as corneal staining, lens decentration, and microbial keratitis may occur, their incidence remains low when appropriate patient selection, meticulous lens hygiene, and regular follow-up protocols are maintained. Emerging evidence also supports enhanced myopia control with combination therapy using low-dose atropine and orthokeratology.

Conclusion: Orthokeratology is a safe, reversible, and effective modality for both refractive correction and myopia control when implemented using evidence-based clinical protocols. Continued advances in lens technology, artificial intelligence-assisted fitting, ocular imaging, and combination treatment strategies are expected to further improve clinical outcomes and strengthen the role of orthokeratology in contemporary pediatric myopia management.

Keywords:

Published on: Jul 16, 2026 Pages: 10-23

Full Text PDF Full Text HTML DOI: 10.17352/2455-1414.000113
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