How well does ortho-k slow myopia?

The evidence is strong. The ROMIO randomised controlled trial showed ortho-k substantially slowed eye elongation versus glasses, and a meta-analysis found it reduced axial elongation by around 0.27 mm over two years, with a greater effect in moderate-to-high myopia. For many children it roughly halves the rate the eye lengthens. It controls progression but does not cure existing myopia.

What are the best eye drops for dry eyes?

There is no single “best” eye drop for dry eye, as treatment depends on the underlying cause. According to the TFOS DEWS III framework, dry eye is a multifactorial disease involving tear film instability, inflammation, and ocular surface damage. For many patients, preservative-free lubricating eye drops are recommended as first-line therapy, particularly for frequent or long-term use. An optometrist can help select drops based on tear quality, evaporation rate, and ocular surface findings.

How often should I use eye drops for dry eyes?

The frequency of eye drop use depends on symptom severity and the type of drop used. Preservative-free drops may be used multiple times per day, whereas preserved drops should be used less frequently to avoid ocular surface irritation. If drops are needed more than 4–6 times daily, clinical guidance generally recommends preservative-free formulations and a dry eye assessment.

Can you use eye drops too often?

Yes. Overuse of preserved eye drops can worsen dry eye symptoms by disrupting the tear film and irritating the ocular surface. DEWS III emphasises minimising preservative exposure and addressing underlying causes—such as meibomian gland dysfunction or inflammation—rather than relying solely on frequent lubrication.

What is the difference between Polytears, Systane, and Hylo eye drops?

Polytears, Systane, and Hylo are lubricating eye drops, but they differ in formulation, viscosity, and preservative status. Some are better suited for mild, intermittent dryness, while others are designed for more persistent symptoms or contact lens wear. Brand name alone does not determine suitability; clinical evaluation does.

Are preservative-free eye drops better for dry eyes?

For many patients, yes. Preservative-free eye drops are commonly recommended for moderate to severe dry eye, frequent use, contact lens wear, and sensitive eyes. DEWS III highlights that long-term preservative exposure can contribute to ocular surface irritation in some people.

Can contact lens wear make dry eye worse?

Contact lenses can exacerbate dry eye symptoms by disrupting tear film stability and increasing evaporation. However, with appropriate lens materials, care systems, and compatible eye drops, many contact lens wearers can remain comfortable. Drops labelled as safe for use with contact lenses are typically preferred during lens wear.

How do I know which eye drops are right for me?

Dry eye is not a single condition. Effective management requires identifying whether symptoms are driven by evaporation, aqueous deficiency, inflammation, or eyelid disease. A dry eye assessment—including tear stability, ocular surface staining, and meibomian gland evaluation—helps guide targeted treatment rather than trial-and-error.

Are thicker eye drops better than watery ones?

Not always. Thicker drops may provide longer relief but can blur vision and may not be ideal for daytime use. Thinner drops may be better tolerated but may require more frequent application. DEWS III supports matching drop viscosity to symptom pattern and lifestyle needs.

Can dry eye be treated without eye drops?

Yes. While lubricating drops are commonly used, DEWS III emphasises a stepwise approach that may include eyelid hygiene, heat therapy, management of meibomian gland dysfunction, environmental modification, and lifestyle changes such as reducing prolonged screen use. Eye drops often remain part of treatment when symptoms affect comfort or visual quality.

When should I see an optometrist for dry eyes?

Seek professional assessment if symptoms are persistent, worsening, or affecting activities such as reading, screen use, or driving. Ongoing reliance on eye drops without improvement suggests an underlying issue that may require targeted treatment.

Orthokeratology for Myopia Control: What Parents Need to Know

Q: What is orthokeratology (ortho-k)?

Ortho-k uses custom rigid contact lenses worn overnight that gently and reversibly reshape the front surface of the eye while a child sleeps. In the morning the lenses come out and most children see clearly all day without glasses or daytime contacts. The reshaping is temporary.

Author: Jagrut Lallu, BOptom (Hons), MSc Specialty Lenses (Hons), FIAOMC. Therapeutic Optometrist & Contact Lens Specialist. Founder, New Zealand Eye Research Centre; Partner, Rose Optometry; WCO Asia-Pacific Myopia Ambassador; International Myopia Institute New Zealand Ambassador; Clinical Senior Lecturer, Deakin School of Optometry; Honorary Teaching Fellow, University of Auckland.

Published by the New Zealand Eye Research Centre. General information only — not a substitute for a personalised assessment.

Childhood myopia (short-sightedness) is rising worldwide, and it is more than an inconvenience: longer eyes carry a higher lifetime risk of retinal problems. As a myopia-management specialist and ambassador for the World Council of Optometry and the International Myopia Institute, this is the question I am asked most by parents: can we slow it down? Orthokeratology — ortho-k — is one of the best-evidenced ways to try.

What is orthokeratology?

Ortho-k uses custom rigid contact lenses worn overnight. They gently and reversibly reshape the front surface of the eye while your child sleeps. In the morning the lenses come out and most children see clearly all day without glasses or daytime contacts. The reshaping is temporary — stop wearing the lenses and the eye returns to its original shape.

How well does it slow myopia?

The evidence is genuinely good. The landmark Retardation of Myopia in Orthokeratology (ROMIO) randomised controlled trial showed ortho-k substantially slowed the elongation of the eye compared with normal glasses. A widely cited meta-analysis pooling multiple trials found ortho-k reduced axial elongation by around 0.27 mm over two years versus controls — with a greater effect in children with moderate-to-high myopia. Put simply: for many children ortho-k roughly halves the rate at which the eye lengthens.

Two important honest points

Ortho-k controls progression — it does not cure or reverse existing myopia. The goal is to end up less short-sighted as an adult than your child otherwise would have been.
Results vary between children, and the effect is strongest while lenses are worn consistently. Some children benefit more from other options (such as atropine drops or myopia-control spectacles/soft lenses), and combined approaches can help — which is why an individual assessment matters.

Is it safe?

Ortho-k has a strong safety record when fitted and monitored by an experienced practitioner. The main risk — as with any contact lens — is infection, which is minimised by correct hygiene, proper lens care and regular reviews. Good lens care matters: we recommend a daily ortho-k lens care routine using a multipurpose solution such as MeniCare Plus, periodic deep-cleans with Menicon Progent, and a handling tool like the DMV Classic remover to keep overnight lenses healthy.

Is my child a candidate?

Most children with progressing myopia are potential candidates, and there is no strict minimum age — suitability depends on the child, the prescription and the family's ability to manage the routine. The best time to start is early, because the goal is to prevent elongation that has not happened yet.

Talk to us

At Rose Optometry we fit and monitor ortho-k as part of a full myopia-management programme, backed by the research focus of the New Zealand Eye Research Centre. If your child's prescription is increasing, book a myopia assessment — the earlier we act, the more sight we can protect.

References

Cho P, Cheung SW. Retardation of Myopia in Orthokeratology (ROMIO) study: a 2-year randomized clinical trial. Invest Ophthalmol Vis Sci. 2012;53(11):7077–7085. PMID: 22969068.
Li SM, Kang MT, Wu SS, et al. Efficacy, safety and acceptability of orthokeratology on slowing axial elongation in myopic children by meta-analysis. Curr Eye Res. 2016;41(5):600–608. PMID: 26237276.
Kinoshita N, Konno Y, Hamada N, et al. Efficacy of combined orthokeratology and 0.01% atropine solution for slowing axial elongation in children with myopia: a 2-year randomised trial. Sci Rep. 2020;10:12750. doi:10.1038/s41598-020-69710-8.

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