With the increasing use of orthokeratology (ortho-K) to halt myopia progression in minors, researchers in Chicago believe it’s necessary to investigate whether the modality’s benefits outweigh the risks. Their study explored whether ortho-K increases the frequency of Acanthamoeba keratitis (AK) compared with other lens modalities. They found that the proportion of ortho-K cases among AK minors (13%) in their case series exceeded the expected percentage of ortho-K cases.

The study analyzed 47 contact lens users younger than 18 and diagnosed with AK between 2003 to 2016. Six patients (13%) wore ortho-K, 39 (83%) wore soft contact lenses, none used non-orthokeratology rigid gas permeable lenses and two (4%) were unknown .

The researchers noted that the results from their case series suggest a potential increased risk of AK in ortho-K users compared with other lens modalities. 

“In the context of a myopia epidemic and concerns regarding halting myopia progression, caution should be exercised when selecting appropriate treatment options to minimize microbial risk in minors,” they stated.

One possible alternative lens option for myopia control that they suggest is a daily disposable soft multifocal lens with similar optical profiles as ortho-K. Nevertheless, they propose continuous evaluation of the relationship between AK and different contact lens modalities.

Scanzera AC, Tu EY, Joslin CE. Acanthamoeba keratitis in minors with orthokeratology (OK) lens use. Eye Contact Lens. July 7, 2020. [Epub ahead of print].