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Contact Lens Spectrum

Article

GP Insights:
Tailoring Astigmatism Correction in Ortho-k

Orthokeratology lens technology has improved a great deal since the early days of reverse-geometry lenses.

By: John Mark Jackson, OD, MS, FAAO
Contact Lens Spectrum May 1, 2026 Vol 41, Issue May-June 2026 Page(s): 10

Clinical Scorecard: GP Insights: Tailoring Astigmatism Correction in Ortho-k

At a Glance

CategoryDetail
ConditionAstigmatism correction in orthokeratology
Key MechanismsUse of toric reverse and alignment curves to correct corneal astigmatism
Target PopulationPatients with astigmatism requiring ortho-k lenses
Care SettingOptometry practices specializing in contact lenses

Key Highlights

  • Toric ortho-k lenses recommended for corneal elevation differences >30 µm at 8 mm chord
  • Residual astigmatism often occurs if corneal and refractive astigmatism are mismatched
  • Under-correcting corneal cylinder can lead to better visual outcomes
  • Spherical reverse curves can be used to manage astigmatism effectively
  • Collaboration with GP labs can optimize lens selection

Guideline-Based Recommendations

Diagnosis

  • Assess corneal and refractive astigmatism to determine lens type

Management

  • Use toric designs for significant corneal astigmatism
  • Consider under-correction strategies for optimal outcomes

Monitoring & Follow-up

  • Evaluate post-treatment topography and visual acuity

Risks

  • Potential for residual astigmatism if lens design is not tailored appropriately

Patient & Prescribing Data

Individuals with astigmatism requiring orthokeratology

Tailor lens design based on corneal topography and astigmatism type

Clinical Best Practices

  • Utilize toric alignment zones for improved lens centration
  • Consult with GP labs for lens customization options
  • Aim for under-correction of corneal cylinder to minimize residual astigmatism

References