Orthokeratology Improves Accommodative Measurements in Children

Closeup of contact lens on finger
Contact lens close-up. Very Shallow DOF. Developed from RAW; retouched with special care and attention; Small
The use of 0.01% atropine solution did not significantly affect vergence measurements.

Orthokeratology (OK) treatment increases positive relative accommodation (PRA) and binocular accommodative facility (BAF) while decreasing accommodative lag in children after 3 months of wear, according to a study published in Contact Lens and Anterior Eye. Findings also revealed that the use of 0.01% atropine solution did not significantly affect vergence measurements. 

Researchers enrolled 62 children (age range 8-12 years, 33 girls) in the prospective, randomized controlled trial and randomized them into 1 of 4 groups: treatment with OK and 0.01% atropine (group 1, n=16), OK with placebo drops (group 2, n=15), treatment with 0.01% atropine and spectacles (group 3, n=16) and treatment with spectacles and a placebo solution (controls, n=15). They administered comprehensive eye examinations to all participants and obtained measurements of distance and near horizontal phoria, fusional vergence, accommodative lag, accommodative convergence/accommodation (AC/A) ratio, and accommodative amplitude (AA). The team repeated baseline measurements at a 3-week follow-up. 

During the follow-up visit, the investigators noted that accommodative lag decreased significantly in group 2 (P =.002), while remaining the same in all other groups. However, BAF and PRA increased significantly in groups 1 (P =.008 and P =.049, respectively) and 2 (P =.004 and P =.003, respectively), while remaining unchanged in group 3 or the control arm. Overall, there were no significant changes in horizontal phoria, horizontal fusional vergence and AC/A ratio.

“Accommodative measurements improved similarly in terms of PRA, BAF and accommodative lag in the combination and OK groups,” according to the researchers. “The positive effect of the OK lens on accommodative function may be related to its role in decreasing myopia progression.”

The study was limited by a small sample size and a short duration. 


Jiang J, Long W, Hu Y, et al. Accommodation and vergence function in children using atropine combined with orthokeratology. Cont Lens Anterior Eye. Published online May 5, 2022. doi:10.1016/j.clae.2022.101704