I have a colleague who recently introduced orthokeratology (ortho-k) into her practice. She asked me, “What should I do when parents are interested in ortho-k for their children but the children won’t participate in the application and removal class?” Parents concerned with their child’s progressively deteriorating eyesight are usually on board with fitting their kids with contact lenses, but their children often don’t share the same motivation. And if you think about it, it makes sense! What elementary schoolers are open to having their finger come anywhere close to their eyes? Children are frequently content to wear eyeglasses and are not interested in adding to their nightly routines, let alone something that involves applying rigid contact lenses onto their eyes.

The majority of our ortho-k patients start wearing lenses between the ages of 6 and 12 years old and are, at that age, indifferent to their myopia progression. When I began fitting children with contact lenses to control their myopia, parents would ask to cancel their program after the student had several ill-fated instructional lessons. However, I quickly learned that if I could overcome their child’s apprehension, my efforts would not be in vain, and the children would receive the desired help. So, I’ve developed the following system that has ensured children’s engagement and parents’ admiration.

My Formula for Success

Here are the steps that have consistently turned the application and removal “no” into a “yes” in our practice.

1. Education Using a large letter on our eye chart, we demonstrate to children how blurry their unaided vision is during the examination. This reaffirms why their parents brought them to us for a consultation.
2. Homework When parents enroll in our program, we teach the children how to instill lubricating eyedrops into their eyes and ask them to practice this daily prior to their lesson. We also email parents links to videos of the application and removal technique so that children can visually and mentally prepare for their class.
3. Pass or Fail No parent wants his or her kid to fail. So, we remind parents that children who practice with their eyedrops and watch the video beforehand are more likely to pass their class.
4. The Secret Sauce All of the previous steps are helpful, but they’re not good enough to ensure a child’s engagement. So we ask children to select a gift from Amazon worth up to $30 in anticipation of their success. We have the gift ordered and delivered in time for their class. We place the gift next to the tray that contains their lenses. All that they need to do to take the gift home is apply and remove their lenses three times.

The Smiles of Success

Since we instituted these four steps, parents have stopped requesting to discontinue their kids from the program. In the process, our success rate for first-class passage improved to more than 90%.

We’ve learned that to succeed with orthokeratology, you may need to think like a kid and to sometimes act like one too! Give these four simple steps a try; you’ll be rewarded for your efforts and will have fun along the way. The proof is in the smiles on our patients’ faces upon successfully completing their class (Figure 1)! CLS