Ortho-k lenses: what are they and when are they recommended?

19/08/2025

From the Contactology Department of the Barraquer Ophthalmology Centre, we recommend the use of Ortho-k lenses in patients with very specific conditions and circumstances. There is no such thing as a perfect lens, and all have pros and cons. The patient must be aware of these before starting to use any of the options available on the market.

What is orthokeratology and how do Ortho-k lenses work

Ortho-k lenses, also known as overnight orthokeratology or informally as “pajama lenses”, are used as a treatment to correct a patient’s prescription. These lenses are worn at night, while we sleep, and allow the patient not to need glasses or contact lenses during the day. This is their main benefit for those patients who do not tolerate other correction systems, whether soft or rigid gas-permeable daytime lenses.

They are customised for each patient and allow temporary correction of prescription through controlled reshaping of the corneal surface.

When the use of Ortho-k lenses is recommended

This type of lens has certain peculiarities compared with daily wear lenses, which is why it is very important to carry out regular check-ups to review treatment stability and good habits, in order to avoid tissue alterations or infections. Due to the variety of factors that affect their performance, specialists recommend their use in particular cases:

Most common cases where Ortho-k is indicated

• Due to intolerance to other designs of contact lenses.
• Due to frequent water sports, where other lenses could increase the risk of infection.
• When surgery is not possible and the patient needs to pass medical tests that exclude the use of daytime lenses.
• For myopia control, when considered the best option among the treatments available.

Factors influencing the effectiveness of Ortho-k lenses

The good performance of these lenses depends on several factors:

• Correct handling (insertion and removal).
• Sleeping between 6 and 8 hours per night.
• Eye movements during sleep.
• Good eyelid closure while sleeping.
• Proper cleaning and disinfection.
• Review of corneal reshaping after several months of use.

What to do if adverse effects appear with Ortho-k lenses

As important as knowing when to start treatment is knowing what to do if adverse effects occur. These may be more difficult to reverse if proper follow-up is not carried out or if the patient delays reporting discomfort to their contactologist.

Alternatives to treatment with Ortho-k

In some cases, the ideal is to interrupt their use, either partially or definitively. Periodic monitoring allows problems to be anticipated, to assess when the lens should be replaced and to correct possible complications.

If Ortho-k lenses do not provide the expected results, the following alternatives may be considered:

• Switching to daytime contact lenses (soft or rigid gas-permeable).
• Temporary or permanent suspension of contact lens use if necessary.

Eloi Rodríguez
Contactologist at the Barraquer Ophthalmology Centre