SIGNIFICANCE: Although the myopia control efficacy of orthokeratology lenses has been established with clinical trials, reports of axial length change in non–study‐based patient care are scarce. This study investigates the use of orthokeratology lenses for myopia control in a clinical population and compares axial elongation against those published in recent clinical investigations. PURPOSE: This study aimed to investigate factors affecting axial elongation during use of orthokeratology lenses for myopia control in an academic clinical setting. METHODS: This study was a retrospective consecutive case series from the Myopia Control Clinic at the Herbert Wertheim School of Optometry at the University of California, Berkeley (Berkeley, CA). Patients ranging from 5 to 18 years old using orthokeratology for at least 1 year were included in the study. Data from 102 patients' eyes were analyzed at baseline (before the initiation of treatment) and after 1 year of wear (12 ± 3 months). Multivariate analysis was undertaken to identify factors significantly associated with axial elongation over this period. RESULTS: Mean (±standard deviation) spherical equivalent refraction and axial length at baseline were −2.54 (±1.21) D and 24.53 (±0.82) mm, respectively. By the 1‐year follow‐up, eyes had shown significant axial elongation (0.18 ± 0.24 mm; P <. 001), which was found to be inversely correlated with age ( P <. 001). Race, sex, baseline axial length, and baseline refraction were not significantly associated with axial elongation. CONCLUSIONS: Factors influencing axial length and the magnitude of axial elongation in our orthokeratology patient population are consistent with orthokeratology treatment groups from published randomized clinical trials and support the use of these lenses for myopia control in a clinical practice setting.

Purpose: To investigate the short-term impact of scleral lens wear on intraocular pressure (IOP) and retinal nerve fiber layer thickness (RNFL). Methods: This prospective study included 31 healthy participants aged 26 ± 3 years who were randomly fitted with a 16.5 mm scleral lens over one eye and a soft contact lens on the other eye. IOP and RNFL thickness were examined at baseline in the morning and following 8 hours of scleral and soft contact lens wear in the evening. Two tonometers (a transpalpebral Diaton and a non-contact tonometer) were used to measure IOP. Measurements of IOP and RNFL were taken under four different conditions: pre- and post-lens application, and pre- and post-lens removal. Results: Eyes fitted with a scleral lens exhibited a significant increase in IOP (pre-application: 11± 3 mmHg vs. post-application: 16 ± 4 mmHg, P < 0.001) immediately after scleral lens application, and the increase in pressure was sustained throughout the 8 hours of lens wear (pre-removal IOP: 16 ± 4 mmHg). IOP returned to baseline after scleral lens removal (11 ± 3 mmHg). Eyes fitted with soft contact lenses did not show significant IOP changes under any condition (P >0.05). Eyes with a scleral lens also showed a small but significant thinning of peripapillary RNFL (pre-application: 110 ± 11 µm vs. post-application: 107 ± 11 µm, P < 0.001) after 8 hours of lens wear, which was not significant with soft contact lens wear (P > 0.05). IOP data obtained from Diaton showed poor within-participant variation and poor agreement compared to IOP data from the non-contact tonometer. Conclusion: This study suggests that short-term scleral lens wear may significantly raise IOP and cause transient peripapillary RNFL thinning, which returns to baseline immediately following lens removal. Monitoring IOP and RNFL is recommended for scleral lens wearers, with future research needed to assess the long-term effects.