Clinical Report: Navigating Orthokeratology Through Imaging

Overview

This report discusses the role of diagnostic imaging in fitting and evaluating orthokeratology (ortho-k) lenses, highlighting the efficacy of ortho-k in slowing myopia progression. It emphasizes the importance of slit lamp imaging and corneal topography in optimizing lens fit and patient outcomes.

Background

Myopia is increasingly prevalent, necessitating effective management strategies. Orthokeratology has emerged as a leading option for slowing axial length elongation in myopic patients. Understanding the fitting and evaluation of ortho-k lenses through advanced imaging techniques is crucial for optimizing treatment outcomes.

Data Highlights

Ortho-k has been shown to slow axial length progression by 36% to 46%. A back optic zone diameter of 5.0 mm improves myopia management efficacy by 31.38% over 12 months.

Key Findings

• Ortho-k lenses induce peripheral myopic defocus, which may inhibit axial length elongation.
• Slit lamp imaging can reveal a characteristic bull’s-eye pattern indicating an ideal lens fit.
• Corneal topography allows for empirical fitting of ortho-k lenses based on corneal curvature and eccentricity.
• A sagittal height difference of 25 µm to 30 µm suggests the need for a toric ortho-k lens.
• Smaller back optic zone diameters enhance myopia control efficacy while potentially increasing higher-order aberrations.

Clinical Implications

Utilizing slit lamp and topography imaging can streamline the fitting process for ortho-k lenses, improving patient outcomes. Clinicians should consider customizing lens parameters based on imaging data to enhance treatment efficacy.

Conclusion

Incorporating advanced imaging techniques in ortho-k lens fitting is essential for optimizing myopia management. These methods facilitate better lens customization and monitoring, ultimately improving patient care.

References

1. Matthew McGee, OD, Optometric Management, 2025 -- Navigating Orthokeratology Through Imaging
2. Randy Kojima, FAAO, FBCLA, FSLS, FIAO, Contact Lens Spectrum, 2024 -- ORTHOKERATOLOGY TOPOGRAPHY—CONSIDERATIONS FOR TREATMENT SUCCESS
3. Therapeutic efficacy of orthokeratology lenses with different back optic zone diameters in myopia control: A systematic review and meta-analysis, ScienceDirect, 2025
4. Contact Lens Spectrum — ORTHOKERATOLOGY TOPOGRAPHY—CONSIDERATIONS FOR TREATMENT SUCCESS
5. Contact Lens Spectrum — GP INSIGHTS
6. IMI-Instrumentation for Myopia Management - PubMed
7. Therapeutic efficacy of orthokeratology lenses with different back optic zone diameters in myopia control: A systematic review and meta-analysis - ScienceDirect