Understanding Myopia Management Options: MiSight and Orthokeratology

MiSight lenses showed a 59% reduction in refractive progression and a 52% reduction in average axial elongation over a 3-year period vs single vision contact lenses, according to a study, and ortho-k lenses flatten the central cornea to correct the patient’s refractive error while creating peripheral steepening that leads to myopic defocus.

By: Patricia Fulmer, OD, FAAO

Optometric Management December 8, 2025

Objective:

To evaluate MiSight soft contact lenses and orthokeratology (ortho-k) as options for myopia management in children.

Key Findings:

MiSight lenses utilize ActivControl technology to create myopic defocus, slowing axial lengthening.
MiSight lenses correct refractive errors from -0.50 to -7.00 with no toric option available.
Ortho-k lenses can correct between 5 D and 6 D of myopia and moderate astigmatism.

Interpretation:

Both MiSight and ortho-k lenses provide effective options for managing myopia in children, with distinct mechanisms and fitting considerations.

Limitations:

MiSight lenses currently do not offer a toric option for astigmatism.
The effects of ortho-k lenses are temporary and reversible.

Conclusion:

MiSight and ortho-k represent innovative approaches to myopia management, with specific benefits and considerations for practitioners and patients.

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