How Ortho-K Corrects Astigmatism and Myopia: What Australians Need to Know

Orthokeratology, also known as Ortho-K, provides an alternative to glasses or daytime contact lenses for individuals with mild to moderate myopia (short-sightedness) and certain types of astigmatism. By using specially designed rigid lenses worn during sleep, Ortho-K gently reshapes the cornea, allowing users to enjoy clearer vision during the day without the need for surgery.

In Australia, this non-invasive treatment is growing in popularity among both adults and children, particularly for families managing childhood myopia. This guide explains how Ortho-K works, who it’s suitable for, the expected vision outcomes, safety considerations, and typical costs across the country.

Understanding Ortho-K: What It Is and How It Works

Ortho-K involves custom-made rigid gas permeable (RGP) lenses designed to temporarily alter the shape of the cornea overnight. These lenses apply gentle hydraulic pressure to the tear film, redistributing corneal cells in a controlled way. This process changes the way light enters the eye, improving how it's focused on the retina.

The effect is temporary. Vision typically improves for one to two days after lens wear, which means the lenses must be worn regularly each night to maintain results. When lens use is stopped, the cornea gradually returns to its original shape within 72 hours.

Unlike laser procedures, Ortho-K is fully reversible and doesn't permanently change the eye’s anatomy. It's also non-invasive, making it appealing for those who aren’t eligible or ready for surgical correction.

Suitability: Who Can Use Ortho-K for Astigmatism and Myopia?

Ortho-K is suitable for children, teenagers, and adults who meet certain prescription and ocular health criteria. It’s particularly valued by people who:

• Lead active lifestyles and prefer not to wear glasses or soft lenses during the day

• Experience dry eyes or discomfort with soft contact lenses

• Have early signs of progressive myopia

• Are not suitable candidates for refractive surgery due to age or corneal thickness

Prescription suitability includes:

• Myopia (short-sightedness): Up to approximately −5.00 dioptres

• Astigmatism: Up to −1.50 dioptres with standard designs, and up to −4.00 dioptres using toric Ortho-K lenses (specialised designs for irregular corneal shapes)

An optometrist experienced in Ortho-K fitting will assess eligibility by examining corneal topography, tear film quality, and pupil size. These measurements are crucial for ensuring lens stability, comfort, and consistent visual outcomes.

Vision Outcomes: What to Expect With Ortho-K

Most users achieve noticeable visual improvement within the first few nights, with full correction stabilising after one to two weeks of nightly lens wear. Children and adults alike typically report clear daytime vision lasting at least 16 hours of wakefulness without glasses or contacts.

A typical improvement timeline looks like this:

Day of Wear	Visual Clarity	Notes
Day 1	Mild improvement	Slight blurring may occur at night
Day 3–5	Moderate clarity	Most users experience usable daytime vision
Day 7–14	Optimal clarity	Full daytime correction is stabilised

Visual performance may fluctuate slightly in the first week but usually becomes consistent with regular use and proper lens care.

Myopia Control Benefits in Children

Ortho-K is not only used for vision correction—it’s also one of the few non-pharmaceutical methods available to help slow the progression of myopia in children. Several studies suggest that consistent Ortho-K wear may reduce the rate of myopic elongation by approximately 50%, offering long-term benefits for eye health.

This makes it a valuable management tool for children diagnosed with progressive myopia, especially if they’re developing higher prescriptions at a young age. Early intervention can help reduce the risks associated with high myopia in adulthood, including retinal detachment and glaucoma.

Optometrists may recommend Ortho-K alongside regular axial length monitoring to ensure the approach remains effective as the child grows.

Safety, Risks, and Proper Aftercare

When fitted by a qualified practitioner and used in conjunction with proper hygiene practices, Ortho-K has a strong safety record. The estimated risk of microbial keratitis is approximately 0.07% per year, which is low and comparable to the risk associated with soft contact lens wear in adolescents.

To reduce the risk of complications:

• Wash your hands thoroughly before handling lenses

• Use only the recommended solutions for cleaning and storing

• Replace lens cases regularly

• Avoid using tap water on lenses or cases

• Attend all scheduled reviews with your optometrist

Initial lens fitting includes detailed instructions on application, removal, and cleaning. Most providers offer a follow-up plan that includes regular corneal health assessments and lens performance reviews.

Cost of Ortho-K in Australia

Ortho-K is a custom medical device fitted by optometrists with advanced training. As such, costs reflect the complexity of the initial fitting process, follow-up care, and the design of the lenses.

Typical Costs (First Year):

• Initial fitting, lenses, and follow-up reviews: AUD $800–$1,600

• Annual lens replacement and maintenance: AUD $300–$500, depending on lens type and wear patterns

Fees vary by practitioner experience, geographic location, and whether toric (for astigmatism) or standard Ortho-K lenses are required.

While Ortho-K is not covered under Medicare, some private health insurance extras policies may offer partial rebates under optical benefits. Patients are advised to check with their fund for eligibility.

Why Costs Vary:

• Toric lens designs for astigmatism involve additional manufacturing steps

• More complex prescriptions require extended consultation time and corneal mapping

• Clinics with advanced topography or axial length measurement tools may charge higher fees

Although the upfront cost is higher than traditional contact lenses or spectacles, the long-term benefits — including the potential slowing of myopia progression — make it a valuable investment for many families.

Alternatives and Comparisons

Ortho-K is one of several options available for correcting myopia and astigmatism. Here's how it compares with other commonly used methods in Australia:

Method	Daytime Vision	Reversible	Myopia Control	Suitability for Children	Upfront Cost (AUD)
Ortho-K	Yes	Yes	Yes	Yes	$800–$1,600
Soft Contact Lenses	Yes	Yes	No	Limited	$200–$400/year
Spectacles	Yes	Yes	Minimal	Yes	$150–$400/pair
LASIK Surgery	Yes	No	No	No (under 18)	$2,500–$3,500/eye

Key Differences:

• Reversibility: Ortho-K and soft lenses are fully reversible. LASIK is permanent.

• Children’s Use: Ortho-K is suitable for children aged 7 and above, under supervision.

• Myopia Management: Ortho-K is among the few options clinically shown to reduce myopia progression.

Expert Insights and Clinical Research

Several peer-reviewed studies support the safety and efficacy of Ortho-K in children and adults. A prominent Australian clinical trial reported a reduction of up to 50% in axial elongation in children who used Ortho-K over 2 years.

Expert Quote (Example):
"Ortho-K is a powerful tool in the optometric toolkit for managing both vision and long-term eye health, particularly in children with fast-progressing myopia."
— Dr Jason Tan, Therapeutically Endorsed Optometrist, NSW

Professional bodies such as Optometry Australia encourage evidence-based approaches to myopia control, and Ortho-K is included as one of the endorsed options when prescribed by appropriately trained clinicians.

Clinics offering Ortho-K must comply with the Australian Health Practitioner Regulation Agency (AHPRA) advertising guidelines, which require claims about treatment outcomes to be accurate, measured, and evidence-based.

Is Ortho-K the Right Choice for You or Your Child?

Choosing Ortho-K depends on several factors, including:

• Prescription range and corneal shape.

• Lifestyle needs — especially for active individuals, swimmers, or those in dusty environments.

• Comfort with nightly lens wear and hygiene routines.

• Parental involvement in supporting younger children with lens care.

• Commitment to regular optometrist reviews.

Recommended if:

• You want to be free from daytime glasses or lenses.

• Your child has progressing myopia.

• You prefer a reversible, non-surgical option.

Less suitable for individuals with very high prescriptions, severe dry eye, or irregular corneal conditions not compatible with lens fit.

Final Considerations and Next Steps

Ortho-K offers more than just freedom from glasses — it provides a clinically supported, safe way to manage vision while potentially slowing the progression of short-sightedness in children. For adults, it delivers visual independence without permanent surgical changes.

What to Do Next:

• Book a comprehensive eye examination with an optometrist who provides Ortho-K, such as the team at Eye Concepts

• Ask about toric lens options if you have astigmatism

• Check eligibility for private health rebates under your extras policy

• Explore myopia management programmes if your child’s prescription is increasing