FACTs: A Mnemonic for Their First Orthokeratology Lenses

March 10, 2019

March 10, 2022
By Dr. Cindy Shan, Cornea and Contact Lens Resident (Northeastern State University in Oklahoma)

Orthokeratology is a technology that has increased in popularity over the past decade due to the various applications for use. As optometrists, there is a long list of instructions to provide the patient after dispensing their first set of lenses. Luckily there is a quick mnemonic to make sure you have hit all the boxes.


It is important to educate the patient on how these lenses will need to be managed in the future. For patients using this lens for myopia management, this may mean appointments every three to six months. Adults may only require a check every six to twelve months. Providing patients with this information at the beginning of their orthokeratology journey will help reinforce the importance of their follow-ups and prevent negative effects from lens use.

Application and Removal

This can often be the longest part of the appointment but is an excellent opportunity to work with the patient to ensure their success. Provide patients with the tools they need such as plungers, lens cases, and solutions. Educating them on how to use each of the tools and how to clean them can increase your patient’s confidence once they leave the office. Making sure that they can remove and apply the lenses themselves while in the office can also help to identify any bad habits or issues early.

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With the wide range of cleaning solutions available, practitioners often have their go-to solution options to give to their new wearers. Depending on the patient, one step cleaning systems such as ClearCare or Boston Simplus can be great options. Boston Advance and Conditioner may also be another option for patients who need a stronger cleaning system.

One of the most important reminders is to educate the patient on rubbing the lenses prior to soaking in a cleaning solution. This will help loosen up protein deposits and lengthen the lifespan of the lenses.


Instructing the patient on what to do if the lenses dislodge is an important part of the dispensing appointment. In the first few days of use, it is common to have issues with the lens application and removal process. The inability to remove the lens can be a scary moment but remind the patient that a drop of artificial tears prior to removal can prevent suction.

If the lens has moved and decentered to other regions of the bulbar conjunctiva, this can be best resolved by removal of the lens and reapplying. Another technique involves shifting the lens towards the pupil and moving the eyes towards the location of the lens.

There you have it! A quick and easy way for you to make sure you hit all the necessary points before a patient leaves your office with their first pair of orthokeratology lenses.

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