If you have a higher prescription or astigmatism, you may be wondering whether overnight contact lenses are still an option. Sometimes they are. OrthoK suitability depends on your prescription, corneal shape and eye health, together with the lens design and the result you need. An assessment helps establish what is realistic before you commit. 1
Toric OrthoK designs can help fit an astigmatic cornea. High myopia raises a different question: how much correction can be achieved? Selected patients may be considered for partial correction with daytime glasses for the remaining prescription. Neither approach guarantees freedom from glasses. 2 4
At Vision Camberwell Optometrists, we’ll talk through your options in plain language. For children, the discussion also covers myopia management: improving daytime vision and slowing progression are separate goals, and both need follow-up. 7
Contents
How does astigmatism affect OrthoK?
OrthoK uses specially fitted rigid lenses worn overnight to temporarily reshape the front surface of the eye. Corneal shape influences how the lens sits and where reshaping occurs. This is why a prescription alone cannot tell us which design will fit well. 2
What a toric lens changes
A toric OrthoK lens has different curves in different directions to better match an uneven corneal shape. Often the toric element is in the peripheral fitting zones, while the central optical zone remains spherical. Its role includes improving alignment and centration. High myopia alone does not automatically mean a toric lens is needed. 2
Why the cylinder number is only part of the picture
We compare the astigmatism in your prescription with your corneal maps. These describe different aspects of the eye, so we assess them together rather than choosing a lens from the cylinder number alone. We’ll explain any remaining correction you may need and what we want to confirm during fitting.
Can OrthoK work for high myopia?
A higher prescription needs an individual assessment. Read about the difference between high and low myopia. We’ll discuss the intended correction, the limits of the proposed lens and whether the likely daytime vision will meet your needs. We do not use a single advertised prescription limit as a substitute for examining your eyes.
When partial correction may be considered
Partial correction means using OrthoK for part of the prescription and glasses for the remaining daytime blur. A two-year randomised study by Charm and Cho investigated this approach in highly myopic children and found less axial elongation than with single-vision glasses alone. However, only 28 of the 52 enrolled children completed the study. It supports a possible option for selected children, not a guaranteed outcome or evidence that every high prescription can be fully corrected. 4
If we discuss partial correction, we’ll make the need for daytime glasses clear at the outset. The goal is useful vision with a workable treatment plan, rather than leaving a child undercorrected. The study’s remaining prescription was corrected with glasses. 4
What does the toric OrthoK research show?
A study by Hong and colleagues compared toric and spherical OrthoK lenses in 100 adolescents with moderate-to-high astigmatic myopia. It reported better uncorrected visual acuity in the toric group after 12 months, but no significant between-group difference in cylinder at that point. These findings support considering toric designs for suitable eyes; they do not show that every person will obtain the same result or that toric lenses eliminate astigmatism. 3
A broader review of lenses with toric peripheral curves also supports their use in selected patients with myopia and astigmatism. Lens designs and study populations vary, so the published results help inform fitting rather than predict an individual outcome. 2
What happens at your suitability assessment?
We start with your vision needs and previous eye-care history. Bring any earlier prescriptions or corneal scans so we can understand what has changed and what has already been tried.
Prescription, corneal mapping and eye health
Assessment includes measuring your prescription, mapping the cornea and examining the eye surface. These checks help us decide whether overnight lens wear and the proposed correction are appropriate. Eye-health assessment remains important even when your main question is whether you can manage without glasses. 1
Your routine and expectations
Tell us about night driving, sport, sleep patterns and any previous difficulty handling lenses. For a child, we also discuss who will supervise cleaning and insertion. We’ll explain the fitting process, expected reviews and fees before you decide whether to proceed.
Myopia control and ongoing eye health
Clearer vision after OrthoK does not, by itself, tell us whether a child’s myopia progression has slowed. Myopia correction addresses blur; myopia control aims to slow progression. 7
For children, follow-up considers axial length, prescription, vision and eye health. IMI guidance emphasises an individual treatment plan and ongoing monitoring. If progression continues, the plan needs reassessment rather than an assumption that clear daytime vision means treatment is working sufficiently. 1 5
Because OrthoK changes the cornea and the measured prescription, axial-length measurements are particularly useful for monitoring progression during treatment. 7
High myopia also needs ongoing retinal care. Reshaping the cornea does not remove the need for this monitoring. Adults considering OrthoK still need regular eye-health reviews, and younger adults may continue to experience myopia progression. 1 5
If OrthoK is not the right fit
We’ll explain why and discuss another approach. For children, options may include myopia-control glasses, suitable soft contact lenses or prescribed atropine, depending on the clinical assessment. For adults, we can discuss glasses and daytime contact lenses around your vision needs. The choice should account for suitability, comfort, care requirements and your preferences. 1
Before your appointment
Bring your current glasses, previous prescriptions and any existing contact lenses, cases and care products. Let us know if you already wear OrthoK or other rigid lenses, and ask for individual instructions about lens wear before your visit. Tell us what you hope to change, whether that is sport, daytime lens comfort or managing your child’s increasing prescription.
Discuss your OrthoK options in Camberwell
Vision Camberwell Optometrists is at 784 Burke Road, Camberwell VIC 3124, in Melbourne’s inner east. We welcome adults and families from Camberwell, Hawthorn, Balwyn, Kew, Canterbury and across Melbourne. Consultations with Jue Wang are available in English and Mandarin.
If you would like to understand whether OrthoK is suitable for your prescription, call (03) 9882 5666 or contact our team to arrange an assessment. You can also explore our orthokeratology overview for an introduction to overnight lenses.
Questions about OrthoK for higher prescriptions
Does astigmatism automatically rule out OrthoK?
No. Toric designs may suit some astigmatic corneas, but your measurements and trial response determine suitability. We’ll assess your eyes before recommending a design. 2
Will I still need glasses?
Possibly. If we recommend partial correction, glasses address the remaining daytime prescription. We’ll discuss this before fitting so you can decide whether that arrangement meets your needs. 4
Can OrthoK permanently cure myopia?
No. Vision correction and myopia control are different from a cure. OrthoK’s corneal reshaping is temporary, and follow-up remains necessary. We’ll help plan alternative correction if you stop treatment. 2 7
Is overnight lens wear risk-free?
No. Contact lenses can cause infection and corneal injury. Follow your prescribed cleaning and disinfection instructions, use fresh solution and keep lenses away from water. Careful handling reduces avoidable risks but cannot make lens wear risk-free. 6
What if my eye becomes painful, red or suddenly blurry?
Remove the lens and seek urgent eye-care advice, particularly with light sensitivity, discharge or reduced vision. Do not reinsert it or wait for the next routine review. If our practice is unavailable, seek urgent assessment through another eye-care service or emergency department. Bring your lenses and case for assessment. 6
References
- Gifford KL, Richdale K, Kang P, et al. IMI – Clinical Management Guidelines Report. Investigative Ophthalmology & Visual Science. 2019;60(3):M184–M203. doi:10.1167/iovs.18-25977.
- Michaud L, Harthan J, Shahidi A, Rah M, Reindel W. Clinical Safety and Efficacy of Orthokeratology Contact Lenses With Toric Peripheral Curves: A Review of the Literature. Eye & Contact Lens. 2025;51(5):237–243. doi:10.1097/ICL.0000000000001174.
- Hong H, Long Y, Li L, Lu H, Lin E. Efficacy and factors influencing toric orthokeratology lenses in managing moderate to high astigmatic myopia. Optometry and Vision Science. 2025;102(6):387–393. doi:10.1097/OPX.0000000000002264.
- Charm J, Cho P. High myopia-partial reduction ortho-k: a 2-year randomized study. Optometry and Vision Science. 2013;90(6):530–539. doi:10.1097/OPX.0b013e318293657d.
- Tahhan N, Bullimore MA, He X, et al. IMI—2025 Digest. Investigative Ophthalmology & Visual Science. 2025;66(12):27. doi:10.1167/iovs.66.12.27.
- United States Food and Drug Administration. Contact Lens Risks. Patient guidance. Accessed 14 September 2026.
- International Myopia Institute. IMI Myopia Correction, Myopia Control and Myopia Management: Definitions and Recommended Usage. IMI clinical summary. Accessed 14 September 2026.
Reviewed by Dr Shonit Jagmohan, B.Optom (Hons), FIAOMC, IACMM, Ophthalmic Medicines Prescriber, Fellowship Chair for the International Academy of Orthokeratology and Myopia Control (Oceania). Last reviewed October 2026.
Visit us in Camberwell
T. (03) 9882 5666
E. vision@visioncamberwell.com.au
Find Us at:
784 Burke Rd, Camberwell
Victoria 3124, Australia
Opening Hours:
Monday, Tuesday and Friday. 9am – 6pm
Wednesday. 9am – 5pm
Thursday. 10.30am – 7.30pm
Saturday. CLOSED
Book your appointment with one of our friendly team members today
T: (03) 9882 5666
Serving Camberwell and the Surrounding South Eastern Suburbs
An independent practice in Camberwell since 1951, we are experts in OrthoK fitting for high myopia and astigmatism, in adults and children. We welcome patients from Hawthorn, Deepdene, Surrey Hills, Balwyn, Kew, Canterbury, Box Hill, Glen Iris, and across greater Melbourne.
