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Is This the New Norm?:
Is Overcomplicating Ortho-k the New Normal?

After more than 20 years in practice, it can be surprising to see what products have gone out of favor.

By: Mile Brujic, OD, FAAO, DAVID L. KADING, OD, FAAO
Contact Lens Spectrum September 1, 2026 Vol 41, Issue September-October 2026 Page(s): 30

Clinical Report: Is Overcomplicating Ortho-k the New Normal?

Overview

The article discusses the current state of orthokeratology (ortho-k) in the U.S., highlighting the low number of active prescribers despite its effectiveness in myopia management.

Background

Orthokeratology is a non-surgical method used to correct myopia, particularly in children, by reshaping the cornea overnight with specially designed contact lenses. The adoption of ortho-k remains limited among practitioners.

Data Highlights

No numerical data available in the source material.

Key Findings

  • Approximately 3,000 active prescribers of ortho-k exist in the U.S.
  • Ortho-k is primarily driven by myopia management.
  • The SMART study reported an 80.5% success rate with the first lens fit.
  • 95.5% of fits in the SMART study required only one lens change.
  • Perceptions of ortho-k fitting complexity may stem from continuing education courses focusing on troubleshooting.
  • Success in ortho-k fitting can be achieved even without perfect topography if vision is clear.

Clinical Implications

Clinicians should reconsider the perceived complexity of ortho-k fitting and focus on achieving clear vision for patients. Emphasizing successful outcomes over perfect fits may enhance the adoption of ortho-k in myopia management.

Conclusion

The article advocates for a reevaluation of the fitting process for ortho-k lenses, suggesting that high success rates can be achieved with a more streamlined approach.

Related Resources & Content

  1. Lipson MJ, Curcio LR, Optom Vis Sci, 2022 -- Fitting of orthokeratology in the United States: A survey of the current state of orthokeratology (FOKUS)
  2. Davis RL et al., Adv Ophthalmol Vis Syst, 2015 -- Stabilizing myopia by accelerating reshaping technique (SMART) study: three year outcomes and overview
  3. Hiraoka T et al., Ophthalmology, 2015 -- Influence of ocular wavefront aberrations on axial length elongation in myopic children treated with overnight orthokeratology
  4. Lau JK et al., Invest Ophthalmol Vis Sci, 2020 -- Higher-order aberrations and axial elongation in myopic children treated with orthokeratology
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