Use of Orthokeratology Lenses associated with Surface Complications, finds study

A recent study published in the journal of the Contact Lens & Anterior Eye showed that adolescents using orthokeratology (ortho-K) lenses for myopia control show increased tear film instability and significant Meibomian gland loss. These findings highlight potential risks to ocular surface health, highlighting the need for regular follow-up and close monitoring in such patients.

This cross-sectional case-control study examined 60 adolescents, half of whom had worn OK lenses for more than 5 years, while the other half used traditional spectacles. The two groups were carefully matched to ensure comparable demographics. This comprehensive assessment of ocular surface health, including tear stability, corneal staining, tear meniscus height, lipid layer quality, and the condition of the Meibomian glands.

The adolescents who had worn Ortho-K lenses long-term showed significantly reduced tear film stability, as indicated by a shorter non-invasive tear break-up time. They also expressed thinner tear film lipid layers, which is a factor in preventing tear evaporation. The OK lens group demonstrated a significantly higher rate of lower Meibomian gland loss (MGL), suggesting that prolonged lens wear may impair the function or structure of these glands.

The male participants were found to have a substantially higher rate of MGL when compared to females. In addition, adolescents with higher levels of myopia were more likely to experience gland loss. For every unit decrease in myopia (measured in diopters), the rate of gland loss declined, which indicated a protective effect associated with milder refractive error.

Despite these, the study did not report severe or immediate complications, and the visual acuity outcomes remained stable. However, the subtle but consistent changes in tear film quality and gland health suggest that the effects of long-term Ortho-K lens use may accumulate over time, potentially leading to dry eye symptoms or other ocular surface disorders.

These findings emphasize that orthokeratology remains a valuable tool in myopia management, especially given its non-surgical nature and effectiveness in slowing eye elongation in children. However, the study illuminates the importance of close monitoring. 

The parents and patients are also advised to remain cautious for symptoms such as the dryness, irritation, or fluctuating vision. Overall, early detection of ocular surface changes can help guide timely interventions, such as adjusting lens wear schedules or incorporating supportive treatments.

Source:

Yang, X. D., He, X. Y., Lyu, Y., Wang, W. Q., & Wan, G. M. (2026). Effects of wearing orthokeratology lenses for more than 5 years on the ocular surface of adolescents. Contact lens & anterior eye : the journal of the British Contact Lens Association, 49(1), 102494. https://doi.org/10.1016/j.clae.2025.102494