Orthokeratology for Kids: Myopia Control in Menorca

Ortho-K is a treatment using special contact lenses worn overnight that, besides correcting myopia without daytime glasses, has been shown to slow its progression in children and teenagers. If your child has just started wearing glasses, or their prescription keeps increasing every year, it's worth discussing this option with your optometrist.

In Menorca, where many families juggle school, sports and water activities, more and more parents ask us about alternatives to conventional glasses for their children. Ortho-K is one of the most established myopia control tools, backed by years of clinical follow-up.

What is Ortho-K and how does it work?

Orthokeratology (Ortho-K) uses custom-designed, rigid gas-permeable contact lenses worn at night. While the child sleeps, the lens gently reshapes the curvature of the cornea. Upon waking and removing it, the cornea keeps that new shape throughout the day, allowing clear vision without glasses or daytime contact lenses.

The effect is temporary and reversible: if lens wear stops, the cornea gradually returns to its original shape within a few days.

Why is it especially recommended for children and teenagers?

Beyond the benefit of seeing clearly without glasses during the day — very useful for sports, swimming or PE classes — the available scientific evidence suggests Ortho-K can slow down eye elongation (axial length growth), the mechanism behind year-on-year myopia progression. A meta-analysis published in PLOS ONE, pooling several controlled studies in school-aged children, found that axial elongation in eyes treated with Ortho-K was, on average, 45% slower than in untreated eyes.

Why does controlling myopia matter, not just correcting it?

Prescribing glasses that compensate for the refractive error fixes vision at that moment, but doesn't act on progression. Higher myopia in adulthood is associated with a greater risk of certain long-term eye conditions. That's why, in recent years, clinical optometry has shifted from simply "correcting" myopia to actively trying to "control" it from an early age.

At what age can a child start?

There's no single age: the decision depends on the prescription, how it has evolved at recent check-ups, the child's ability to cooperate, and an individual assessment by the optometrist. Many children start around 7-8 years old, though every case is evaluated individually in the consultation room.

What other myopia control options exist besides Ortho-K?

Ortho-K isn't the only alternative. There are also specific myopia-control spectacle lenses (with peripheral defocus designs), worn like regular glasses during the day. These are often recommended at younger ages, or when Ortho-K isn't the best fit for a particular child or family — for example, if the child isn't yet ready for the responsibility that contact lens wear requires.

There are also soft peripheral-defocus contact lenses, worn during the day instead of overnight, which can be a good alternative when Ortho-K doesn't suit the child's or family's needs.

Finally, there's low-concentration atropine, night-time eye drops that have also shown effectiveness in slowing myopia progression. Atropine is prescribed by an ophthalmologist, and in some cases it's combined with Ortho-K or other options, since some studies have found that combined treatment can achieve greater slowing of progression than either option alone. The decision to combine treatments should always be assessed individually between optometrist and ophthalmologist.

In the consultation, we assess together which of these options — or which combination — best suits each case.

Is Ortho-K safe for a child?

It's a treatment with a long track record of use and follow-up in paediatric optometry, but like any contact lens, it requires proper hygiene, a personalised fitting based on corneal topography, and regular check-ups to confirm the cornea is responding well. That's why fitting and follow-up should always be done in a specialised consultation, never with a one-size-fits-all approach. In fact, the International Myopia Institute (IMI), the leading international reference in the clinical management of myopia, recommends in its guidelines that Ortho-K lenses be worn consistently, at least 8 hours per night, with continued professional follow-up.

What does follow-up involve?

After the initial fitting, periodic check-ups using corneal topography confirm the moulding is correct and that the eye tolerates the lenses well. It's a gradual process, not a one-time adjustment.

When should you start looking into it with your child?

A children's eye exam is the first step: it shows whether myopia is present, how much it has progressed since last year, and whether Ortho-K or another control option is right for that moment. As part of this exam, ocular biometry is considered the gold-standard tool in myopia control, as it precisely measures the eye's axial length — the most reliable indicator of whether myopia is truly progressing, even before a meaningful change in prescription becomes noticeable. September, with the start of the school year, is usually a good time to check how your child's eyesight has evolved over the summer.

If you notice your child squinting to see distant objects, sitting very close to the board or to screens, or their prescription has increased over the past year, at Óptica Carreras, Costa de sa Plaça, 16, 07702 Maó, we can assess their case and calmly walk you through all the available myopia control options. Call us on 971 363 560 or book an appointment here.

Frequently asked questions

Does it hurt to put in Ortho-K lenses?

No. After a short adaptation period, most children wear them comfortably overnight.

Can Ortho-K be combined with swimming or diving?

Yes — in fact, that's one of its advantages: since no glasses or lenses are needed during the day, it makes sports, including water sports, much easier without visual limitations.

What happens if my child stops wearing them for a while?

The effect is reversible and the cornea returns to its original shape within a few days, although it's best to check with your optometrist before pausing treatment.

Does Ortho-K replace regular eye check-ups?

No. It requires periodic reviews to confirm the fit remains correct and the eye is progressing well.

Is Ortho-K the only way to slow childhood myopia?

No. Besides Ortho-K, there are also specific myopia-control spectacle lenses, soft peripheral-defocus contact lenses, and low-concentration atropine, prescribed by an ophthalmologist. Your optometrist will help you choose the most suitable option, or combination of options, for your child's case.

Written by Mª Gracia Carreras, optometrist.
Collegiate number: 5.232