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

At a Glance

CategoryDetail
ConditionOrthokeratology (Ortho-k)
Key MechanismsMyopia management through lens fitting and reshaping corneal topography.
Target PopulationChildren with myopia.
Care SettingOptometric practice.

Key Highlights

  • Nearly 3,000 active prescribers of ortho-k in the US.
  • 80.5% success rate with the first lens fit according to the SMART study.
  • Concerns about the complexity of ortho-k fitting persist among clinicians.
  • Focus on troubleshooting in continuing education may deter new practitioners.
  • Clear vision and performance in activities are key indicators of success.

Guideline-Based Recommendations

Diagnosis

  • Assess myopia severity and suitability for ortho-k.

Management

  • Utilize streamlined fitting techniques to enhance patient outcomes.

Monitoring & Follow-up

  • Evaluate vision clarity and patient satisfaction regularly.

Risks

  • Potential for induced aberrations affecting axial elongation.

Patient & Prescribing Data

Children experiencing myopia.

First-fit success is high; consider alternatives if initial lenses do not provide clear vision.

Clinical Best Practices

  • Accept a fit that is healthy and effective rather than perfect.
  • Prioritize clear vision and patient performance over ideal topography.

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