Orthokeratology May Improve Quality of Life in Children With Myopia

Treatment with orthokeratology may improve quality of life in children with myopia.

Treatment with orthokeratology (ortho-K) lenses is associated with greater improvements in vision-related quality of life (QOL) compared with spectacle wear among children with myopia, according to a patient-reported questionnaire published in Contact Lens and Anterior Eye.

Researchers recruited 70 children with a spherical equivalent refractive error between -0.75 and -4 diopters (D), astigmatism of 1.5 D or less in both eyes, and best-corrected visual acuity (BCVA) of 0.0 logMAR in each eye and assigned them to treatment with ortho-K (n=45; mean age, 8.38 years; 24 girls) or single-vision spectacles (SVS; n=25; mean age, 8.38 years; 10 girls) based on patient and caregiver preference. Visual outcomes and vision-related quality of life were evaluated during the 1-year study duration.

At 12 months, patients treated with ortho-K reported greater QOL improvements evidenced by higher Pediatric Refractive Error Profile (PREP) scores. Participants in the ortho-K group reported significantly higher QOL scores for 10 of the 11 survey items compared with control group participants. Patients treated with ortho-K reported higher PREP scores for overall, near and far vision compared with individuals treated with SVS (92.78 vs 78.33; P =.02; 89.17 vs 74; P =0.00; 86.39 vs 75; P =.03, respectively. ) They also reported greater satisfaction with their appearance (89.07 vs 58.33; P =0.00), ability to participate in activities (89.44 vs 51.55; P =0.00), and ease in handling ( 77.92 vs 68.75; P =.01).

A subanalysis of individuals treated with ortho-K revealed that the lenses were well-tolerated. A total of 2 patients agreed or strongly agreed that their eyes experienced itching, burning, or dryness while wearing the lenses and 1 reported difficulty in falling asleep. 

Orthokeratology should be considered by more optometrists when managing myopic children.

“This study demonstrated that myopic Chinese schoolchildren wearing ortho-K reported higher vision-related quality of life score[s] than those wearing SVS,” according to the study authors. “Orthokeratology should be considered by more optometrists when managing myopic children.”

Study limitations include the online administration of the PREP and the use of summary scoring for data analysis.


Mohd-Ali B, Low YC, Shahimin MM, et al. Comparison of vision-related quality of life between wearing orthokeratology lenses and spectacles in myopic children living in Kuala Lumpur. Cont Lens Anterior Eye. Published online October 29,2022. doi:10.1016/j.clae.2022.101774