ORTHO-K SAFETY · CONCORD MYOPIA CLINIC
Are Ortho-K lenses safe?
A straight answer from a Sydney optometrist.
The short version — yes, when they're fitted properly and cared for correctly. But "safe" deserves a proper explanation, because the one thing that matters most is something we can teach you in five minutes.
ORTHO-K SAFETY- THE NUMBERS
The risk is real. It's also very small.
About 5 in every 10,000 years of ortho-K wear ends in a serious eye infection. That's roughly the same risk as your child wearing daily soft contact lenses to school, and it's been well understood after 25 years of data. Almost every case traces back to a single, preventable failure — tap water touching the lenses.
The myopia control effect is what makes Ortho-K different from just correcting vision. Because the lens changes how light focuses on the peripheral part of the retina, it signals the eye to slow down the elongation that drives myopia progression. That's the part we care about most — not just helping your child see today, but keeping their prescription from getting worse over the next 5 to 10 years
WHAT "UNSAFE" MEANS IN ORTHO-K
Ortho-K lenses don't cause long-term damage to the eye. They don't change vision permanently. They don't cause anything your child can't walk away from if it isn't working — if you stop, the eye reverts to its original shape within a week or two.
The one thing that can cause lasting harm is a rare type of eye infection of the cornea, which can happen with any contact lens. Ortho-K is no different in this respect — but there are three specific reasons ortho-K gets discussed more carefully than most contact lens modalities:
The only serious risk worth talking about is infection.
Why ortho-K warrants extra care
- Lenses are worn overnight, which slightly raises baseline infection risk compared to day-wear lenses
- They're worn by children, who need parental supervision to maintain perfect hygiene habits
- They must be rinsed and stored only in contact lens solution — never tap water, never anything else
Signs that mean stop wearing and call us the same day
A red eye, pain, sensitivity to light, or blurry vision that doesn't clear within a few hours of taking the lenses out. These are uncommon — but if they appear, they need to be seen promptly, not watched and waited on.
THE HYGIENE RULE
No tap water. Ever.
If we could pick just one rule for you to remember, this is it. In the studies tracking ortho-K infections across thousands of patients, the single most common cause is tap water getting on the lenses — rinsing them under the kitchen tap, storing them in water, washing the lens case in the sink. The microorganisms in clean-looking tap water can cause infections that are extremely difficult to treat. Stick to contact lens solution for everything, and the risk drops enormously.
Tap water contact
Rinsing lenses, storing them in water, or washing the case under the tap. Number one cause across every case series.
Wearing while swimming or showering
Pools, spas, and even showers introduce bacteria and parasites the lens traps against the cornea.
Old cases or expired solution
Lens cases grow biofilm after a month of use — an invisible layer bacteria live in. Solution bottles get contaminated once opened past their expiry window.
Wearing through discomfort
Pain, redness, or irritation that gets ignored. Almost every serious case has this pattern in retrospect.
Solution only — never water
For rinsing, storing, and cleaning the case. Bottled water doesn't count. Boiled water doesn't count. Contact lens solution only.
Fresh case every month with Soleko Platinum
The solution system we recommend includes a new case with every monthly bottle. Swap both together, same time every month — no separate reminder to remember.
Clean hands before every handle
Soap and water, dried on a lint-free towel, every time — before putting lenses in and before taking them out. This one is easy to skip and shouldn't be.
Stop at the first sign of trouble
Red eye, pain, blur — stop wearing immediately, call us that day. Never "wait and see" with eyes.
Ready to talk through whether ortho-K is right for your child?
HOW WE REDUCE THE RISK FURTHER
What we do that makes ortho-K even safer.
Fitting practices make a measurable difference to ortho-K safety. Good monitoring catches problems early, when they're still easy to treat. Here's what happens when you start ortho-K at Concord Eyecare.
1The Ortho-K Patient Guide
We walk you and your child through a dedicated patient guide at the fitting appointment — rules, red flags, what to do when. No paperwork to sign, just a proper conversation you both leave confident about.
2Soleko Platinum solution system
We use a solution system that includes a fresh lens case with every monthly bottle. New case every month, automatically — no remembering, no shortcuts, no old cases quietly growing biofilm.
3Your optometrist's direct mobile number
Ortho-K patients get the direct mobile number of their treating optometrist — not the practice reception. If something looks off on a Sunday night, you text or call us. We'd rather see a false alarm than a missed warning sign.
4Direct referral to Sydney Eye Hospital
If anything looks serious, you bypass the GP step entirely. We call ahead and you go straight to specialist care within hours — not after a referral chain.
5Structured review schedule
Appointments at 1 day, 1 week, 1 month, then every 3–6 months. We're checking the cornea itself, not just the vision.
6Slit lamp examination at every review
At each review visit we examine the cornea under magnification with fluorescein dye. It's the test that actually catches early signs of infection or irritation — the kind of thing a vision check alone would miss.
WHEN IT'S NOT THE RIGHT FIT
When we'd suggest a different treatment.
Ortho-K isn't the right fit for every child. Some families get a better outcome with atropine eye drops, specialty contact lenses like MiSight, or defocus glasses like MiyoSmart. Here's when we'd steer you somewhere else.
Households using tank or bore water without proper filtration.
Children under 6–7 years, or those who can't articulate symptoms reliably.
Families who travel constantly or can't commit to the review schedule.
Children who show compliance problems at the first review — we'd rather change treatments than accept risky habits.
Prescriptions that can't be predictably corrected (very high myopia, irregular corneas, significant astigmatism).
Families where bathroom supervision of hygiene steps isn't realistic.
If ortho-K doesn't suit your child's situation, that's not a dead end — it's a redirection. We'll walk you through the alternatives at your consultation.
ORTHO-K SAFETY FAQ
Ortho-K safety questions, answered
Can my child swim while wearing ortho-K lenses?
No. Lenses come out before swimming, showering, or any water activity — even if the water looks clean. This rule isn't flexible. Your child wears the lenses only during sleep, in their bedroom.
What should I do if my child gets a red eye on holiday?
Stop wearing the lenses immediately and call or text your optometrist's direct mobile — ortho-K patients have that number for exactly this reason. If you can't reach them and it's urgent, go to the nearest eye hospital emergency department. Don't wait it out. Bring the lenses and case with you.
How often does the lens case need to be replaced?
Every month, without exception. We recommend the Soleko Platinum solution system because it includes a fresh case with every monthly bottle — the case and solution stay in sync, and there's nothing extra to remember. Lens cases grow bacterial biofilm inside that no cleaning can fully remove.
Is ortho-K safer than regular soft contact lenses?
In children, the infection rates are similar — around 5 per 10,000 patient years for ortho-K versus around 20 per 10,000 for daily soft lenses. The profile is different but the absolute risk is comparable or lower.
What happens if my child sleeps in the lenses an extra night?
Nothing serious in most cases, but it's not ideal. The lenses are designed for a single 6–8 hour sleep. An occasional longer wear won't cause lasting harm, but making it a habit raises the infection risk meaningfully.
Can the lenses permanently damage my child's eyes?
The lenses themselves cause no lasting change — stop wearing them and the cornea returns to its original shape within two weeks. The only way ortho-K can cause lasting harm is through an untreated infection, which is why we monitor so carefully.
What's the earliest sign of a problem I should watch for?
Any eye redness that persists after the lenses are removed. Eye pain of any kind. Light sensitivity that's new. Blurry vision that doesn't clear once the lenses come out. Any of these — stop wearing, call us that day.
What if I'm not sure my child is mature enough for ortho-K?
That's a common concern and a fair one. Maturity matters more than exact age — we assess this at your consultation and at the first review. If it isn't right yet, atropine drops or MiyoSmart glasses are excellent alternatives.
CLINICAL REFERENCES
- Bullimore MA, Mirsayafov DS, Khurai AR, et al. Pediatric Microbial Keratitis With Overnight Orthokeratology in Russia. Eye Contact Lens. 2021;47(7):420-425.
- Bullimore MA, Sinnott LT, Jones-Jordan LA. The risk of microbial keratitis with overnight corneal reshaping lenses. Optometry and Vision Science. 2013;90(9):937-944.
- Stapleton F, Keay L, Edwards K, et al. The incidence of contact lens-related microbial keratitis in Australia. Ophthalmology. 2008;115(10):1655-1662.
- Liu YM, Xie P. The Safety of Orthokeratology — A Systematic Review. Eye Contact Lens. 2016;42(1):35-42.
- Gispets J, Yébana P, Lupón N, et al. Efficacy, predictability and safety of long-term orthokeratology: An 18-year follow-up study. Contact Lens and Anterior Eye. 2022;45(1):101530.
Advanced Paediatric Eye Care (UNSW) · Last clinically reviewed April 2026
BOOK YOUR ORTHO-K CONSULTATION
Ortho-K done properly is one of the safest myopia treatments available.
Ortho-K fitting has been a core part of our myopia clinic for years. Our protocols are built around the evidence, not around convenience. If you're considering ortho-K for your child, the consultation is where we show you exactly what that looks like — for your specific child.