Myopia (nearsightedness) affects people of all ages—from adults who have worn glasses for years to children whose prescriptions seem to change every time they visit the eye doctor. Many are now looking for alternatives to daytime glasses and contact lenses, including specialty options such as orthokeratology (Ortho-K). For others, vision may remain blurry or distorted even after a prescription update, which can be a sign of something more complex, like keratoconus.
At Premier Vision Care Optometry, myopia management is about more than just changing the numbers in your prescription. It is about understanding what is happening to the front surface of the eye and choosing the safest, most effective treatment for that specific situation. That is why screening for keratoconus is such an important step before starting Ortho-K—whether the patient is an adult exploring new options or a child whose myopia is progressing.
Why Keratoconus Screening Matters in Myopia Management
Keratoconus can change the shape and strength of the cornea over time. Ortho-K gently reshapes the cornea overnight to correct myopia. When these two conditions overlap, the right diagnosis is critical. Proper screening helps determine who is a good candidate for Ortho-K as part of a myopia management plan and who may need a different approach to protect their long-term vision.
Orthokeratology (Ortho-K) is a special eye treatment that helps correct nearsightedness (myopia) by gently reshaping the front surface of the eye with hard contact lenses worn overnight. Ortho-K can be a great way to help kids see clearly during the day without glasses or daytime contacts. Review of Myopia Management
But before we start Ortho-K, we always check for another eye condition called keratoconus. Keratoconus is when the clear front part of the eye (the cornea) becomes thin and bulges into a cone shape. This can cause blurry or distorted vision that glasses and regular contacts can’t fully fix. AAO
Here are three big reasons we check for keratoconus before Ortho-K:
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Some Risk Factors Overlap Kids who are good candidates for Ortho-K are usually school age, around 6–8 years old. That’s also the age when nearsightedness often gets worse and when keratoconus can first show signs. Because both conditions can happen in the same age range, it’s important to make sure we know why their vision is changing. Review of Myopia Management
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Keratoconus Can Get Worse Over Time Keratoconus doesn’t stay the same — it tends to slowly get worse if it’s not treated. If we miss keratoconus and fit Ortho-K lenses anyway, the lenses might hide changes happening in the cornea. That could delay diagnosis and treatment, which makes long-term vision worse. Early treatment — especially with a procedure called corneal cross-linking — is much more effective when keratoconus is caught early. Review of Myopia Management+1
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Protecting the Cornea Comes First Your child’s cornea is delicate. In keratoconus, the cornea is already thin and more easily damaged. Ortho-K lenses reshape the cornea every night, which is safe for healthy eyes. But on an already weak cornea, it could increase the risk of corneal scarring or other problems. That’s why we make sure the cornea is healthy before starting Ortho-K. Review of Myopia Management
How We Screen for Keratoconus
We use special imaging tools that map the shape and thickness of the cornea. These help us spot early signs of keratoconus even before symptoms start. We may also check vision changes and look for things like high astigmatism or unusual reflexes when we shine light into the eye. Review of Myopia Management
If keratoconus is detected, treatment starts first to keep the cornea stable and protect vision. After that, we can talk about the best options for clear vision, which might include glasses, soft or specialty contact lenses, or even Ortho-K when safe. Review of Myopia Management
In short:
✔️ Ortho-K can help slow nearsightedness and improve daytime vision.
✔️ But we screen first to rule out keratoconus because it can look similar at first and needs very different care.
✔️ Early detection can protect your vision long term.
Taking the Next Step in Myopia Management
Whether you are an adult exploring myopia management options or a parent considering Ortho-K for a child, screening for keratoconus is a key part of protecting eye health. Understanding whether the cornea is simply nearsighted or structurally weakened by keratoconus will guide every decision that follows—from lens design to follow-up schedule and long-term treatment planning.
At Premier Vision Care Optometry in Lomita, the goal is to match each eye with the right solution, not just a one-size-fits-all lens. If the cornea is healthy and stable, Ortho-K may be an excellent option to correct myopia and, in children, help manage its progression. If keratoconus or another corneal condition is present, there are still effective ways to improve vision and protect the eye—but the strategy will look different.
If you or your child has myopia, frequent prescription changes, or vision that still seems distorted even with new glasses, it may be time for a more in-depth evaluation. To schedule a myopia management or Ortho-K consultation, contact Premier Vision Care Optometry at (310) 220-0053 or request an appointment online. A careful, personalized assessment can help you move forward with clarity and confidence.
Questions You May Have About Keratoconus and Ortho-K
If I already wear glasses for myopia, should I still be screened for keratoconus?
- Yes. Most people with myopia will never develop keratoconus, but some do, and early changes can be subtle. If your prescription is changing quickly, you notice unusual distortion or ghosting, or your vision does not feel “right” even with new glasses, a corneal screening can help rule out keratoconus or catch it early.
Is Ortho-K only for children, or can adults use it too?
- Ortho-K is often used as part of a myopia management plan for children and teens, but many adults can benefit from it as well. Adults with stable, healthy corneas and mild to moderate myopia may enjoy clear daytime vision without glasses or daytime contact lenses. A thorough exam is needed to confirm that the cornea is suitable and that there are no signs of keratoconus or other conditions that would make Ortho-K unsafe.
Is the reshaping effect of Ortho-K permanent?
- No, the effect of Ortho-K is temporary and completely reversible. The lenses gently reshape the cornea overnight, and the improved vision typically lasts through the day. If you stop wearing the lenses, your cornea gradually returns to its original shape and your previous prescription returns. This reversibility is one reason Ortho-K is considered a flexible option for many people with myopia.
Does insurance usually cover Ortho-K or keratoconus-related care?
- Coverage varies. Many vision plans consider Ortho-K a non-covered or elective service, especially when it is used primarily for convenience or myopia management. However, medical insurance may cover parts of the evaluation and treatment when there is a diagnosed corneal disease such as keratoconus. The best approach is to discuss your coverage with the practice team so they can help you understand any out-of-pocket costs before treatment begins.
This article is based on the original piece: 🔗 3 Reasons to Screen Your Orthokeratology Patients for Keratoconus — Review of Myopia Management
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