Orthokeratology

Orthokeratology—often shortened to Ortho-K—is a nonsurgical way to sharpen eyesight by wearing specially shaped, oxygen-breathing contact lenses only while you sleep. The lenses gently flatten the front of the eye (cornea), so when you wake up and remove them, light focuses clearly on the retina. The effect lasts most of the day, giving many people 20/20 vision without glasses or daytime contacts. Ortho-K is FDA-cleared for children and adults with mild to moderate nearsightedness and small amounts of astigmatism.[1] It is also one of the best-studied methods to slow eye growth in children, helping to reduce the long-term risks tied to progressive myopia.[2]

An Ortho-K fitting starts with corneal topography to map every hill and valley on the front of your eye. Using this data, the eye-care provider designs a rigid gas-permeable lens with four or five curves: a steep central “reverse” curve that moves tears and epithelial cells outward, alignment curves that hug the mid-cornea, and a peripheral curve for comfort. You wear the lenses nightly; during sleep, gentle hydraulic forces reshape the corneal surface by about 10–20 µm—thinner than a human hair. Modern materials (Dk ≥ 100) let plenty of oxygen reach the cornea, reducing hypoxia. Lens designs include single-vision myopia control, toric Ortho-K for astigmatism, and dual-focus optics that target peripheral defocus.[1] The FDA’s guidance permits overnight wear up to –6.00 D of myopia and 1.75 D of astigmatism, though “off-label” higher prescriptions may be attempted in expert hands.[3]

Good candidates are children or adults with stable corneas, healthy tear film, and a prescription typically between –0.50 D and –6.00 D (with ≤ 1.75 D astigmatism). Ortho-K is especially helpful for kids 6–18 whose nearsightedness is still getting worse, athletes who dislike glasses, or people who want daytime freedom but are not ready for LASIK. Caution is advised if you have very dry eyes, corneal scars, severe allergies, or cannot keep lenses scrupulously clean. Your provider will review topography, ocular surface health, and lifestyle needs before deciding.[1][4]

Because Ortho-K is considered elective, most insurance plans do not cover it. In the United States, complete treatment—exam, custom lenses, and one year of follow-up—usually runs $1,000 – $4,000 for both eyes. Annual lens replacement and care solutions add roughly $300–$500 per year.[1] A recent pricing survey from NVISION Eye Centers puts the national average at $1,120 – $4,158, noting that urban areas and highly experienced fitters sit at the upper end of the range.[5]

Benefits: daytime lens-free vision, reversible treatment, no tissue removal, and strong evidence of slowing axial eye growth by about 40–60 % in children. A 2023 meta-analysis of randomized trials confirmed significant reductions in yearly myopia progression compared with spectacles.[6] Limitations & risks: mild glare or halos during the first weeks, temporary blur if you skip a night, and an estimated microbial keratitis rate of 1–2 per 10,000 wear-years—similar to other overnight lenses.[1]

Most people notice clearer vision after the first night, with full correction reached in 7–14 days. During that period you may wear low-power soft lenses as a bridge. Follow-ups are scheduled at day 1, week 1, month 1, and every 6–12 months thereafter to check topography, lens fit, and corneal health. Because the effect is temporary, you must continue nightly (or every-other-night) wear to maintain clarity. Strict hygiene—using preservative-free saline, daily cleaning, and monthly peroxide disinfection—keeps infection risk very low.[1][7]

Research now explores pairing Ortho-K with low-dose atropine or red-light therapy to further slow axial elongation. A two-year randomized Chinese trial published in JAMA Ophthalmology compared 0.04 % atropine, 0.01 % atropine, and Ortho-K, showing comparable myopia-control power among the strongest regimens.[8] Meanwhile, a 2023 single-blind study of a high-oxygen “Breath-O-Correct” lens reported excellent vision, stable corneas, and no serious adverse events over 24 months.[9]

If you or your child struggle with worsening nearsightedness or want freedom from glasses during the day, book a comprehensive eye exam. A cornea or refractive specialist can map your eyes, discuss expectations, and design custom Ortho-K lenses. You can connect with the right specialist on Kerbside for a medical-education consult—no physician-patient relationship will be created.[1][5]