Central flattening
The treatment zone reduces the eye's effective myopia for the waking hours that follow overnight wear.
Myopia management · Specialty lenses
Ortho-K Overnight corneal reshaping for clear days.
Orthokeratology lenses are rigid gas permeable designs worn during sleep. They flatten the central cornea temporarily, so many patients see without correction the next day. For children, practices also use ortho-k as an off-label way to slow axial growth.
OvernightLenses come out in the morning
43%Slower axial elongation over 2 years in the ROMIO trial
TemporaryEffect fades when wear stops
TopographyNeeded to design and follow every fit
How it works
Reverse-geometry lenses reshape the epithelium
A flatter central zone and a steeper reverse curve redistribute the corneal epithelium while the patient sleeps. The result is a flatter optical center for daytime vision and a ring of midperipheral steepening that changes peripheral focus.
Peripheral defocus
The steeper midperipheral ring is the proposed reason ortho-k slows eye growth in children.
Labeled for refraction
US approvals cover temporary reduction of myopia with overnight wear. Myopia control in children is an off-label use.
Data-driven design
Most modern fits start from topography, refraction and corneal diameter fed into the lab's fitting software.
Reversible
Stop wearing the lenses and the cornea returns toward its baseline shape.
FDA-approved ortho-k lenses
Several overnight orthokeratology lenses hold FDA premarket approval. Labs and designs differ in fitting software, toric options and support.
- Approved for overnight wear
- Custom lab-made designs
- Fitting software support
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Paragon CRT
CooperVision's corneal refractive therapy lenses in tisilfocon A; PMA P050031 dates to 2006 for the Paragon Z CRT material.
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Euclid orthokeratology
Euclid Vision holds PMA P040029 (2004) for overnight orthokeratology lenses in oprifocon A and tisilfocon A.
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ACUVUE Abiliti Overnight
A 2021 private-label approval of Menicon Z Night (tisilfocon A) lenses marketed by Johnson & Johnson Vision, with an astigmatism design.
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Other designs
Additional ortho-k designs are made by specialty labs under their own approvals. Confirm material and approval with the lab.
In the practice
The ortho-k visit sequence
Ortho-k is a series of visits, not a dispense. Plan the schedule and the fee around that.
Map and measure
Topography, refraction, corneal diameter and axial length set the design and the baseline for follow-up.
Dispense and train
Teach insertion, removal, cleaning and case care, with a parent involved for every child.
Early checks
See the patient the morning after the first night and again in the first weeks to read the treatment map and check the cornea.
Fit at a glance
Ortho-k practice checklist
| Lens type | Reverse-geometry rigid gas permeable lens, overnight wear |
|---|---|
| Required equipment | Corneal topographer, slit lamp, fluorescein; biometer recommended |
| Key approvals | PMA P040029 (Euclid), P050031 (Paragon Z CRT), P990018/S006 (Abiliti Overnight private label) |
| Labeled use | Temporary reduction of myopia with overnight wear |
| Myopia control use | Off-label; document informed consent |
| Main safety risk | Microbial keratitis with poor hygiene or overnight-wear complications |
| Care products | GP disinfecting and cleaning systems; no tap water |
| Replacement | Set by the prescriber and lab, commonly yearly |
| Billing | Usually a self-pay program fee; see the coding guide |
Questions doctors ask about ortho-k
Is ortho-k approved for myopia control?
US approvals cover temporary reduction of myopia with overnight wear. Using it to slow progression in children is off-label, so document the consent.
How much does ortho-k slow eye growth?
In the ROMIO randomized trial, axial elongation over two years was 43% slower than in children wearing single vision glasses.
Which patients are a poor fit?
Children who cannot keep up with hygiene, families who will not return for follow-up, and eyes with active surface disease.
Do I need a topographer?
Yes. Topography drives the design and is the main tool for reading each follow-up.
Do lens sales earn the 15% participation credit?
No. Contact lenses and Rx are excluded. The credit applies to eligible OTC orders on VisionRescue.com through RescueLink, such as GP care solutions.
What do families buy between visits?
GP cleaning and disinfecting solutions, a fresh case and rewetting drops, which you can stock or send through RescueLink.
References
- Cho P, Cheung SW. Retardation of myopia in Orthokeratology (ROMIO) study: a 2-year randomized clinical trial. Invest Ophthalmol Vis Sci. 2012;53(11):7077-7085. PubMed
- US FDA. PMA P050031, Paragon Z CRT (tisilfocon A) lenses for corneal refractive therapy. FDA
- US FDA. PMA P040029, Euclid orthokeratology contact lenses for overnight wear. FDA
- US FDA. PMA P990018/S006, ACUVUE Abiliti Overnight trade names for Menicon Z Night lenses. FDA
Make ortho-k a scheduled service.
Pair a topographer, a lab you trust and a visit plan, then price it as a program.
Product names are trademarks of their respective owners. Review the lens labeling and the lab's fitting guide, including warnings and contraindications, before fitting. Contact lenses are excluded from the 15% participation credit. Individual results vary.