Orthokeratology in Morocco: Nighttime Contact Lenses for Children With Progressive Myopia

For children experiencing rapidly progressing myopia, nighttime contact lenses are emerging as one of the options ophthalmologists can consider to manage the condition while providing clear vision during the day. Known as orthokeratology, or Ortho-K, the technique uses specially designed rigid lenses worn while sleeping to temporarily reshape the cornea.

Unlike conventional corrective lenses, Ortho-K lenses are removed after waking. The temporary change in the shape of the cornea can allow patients to see clearly during the day without wearing glasses or contact lenses.

According to ophthalmologist Mohamed Charif Khalifi, the technique is particularly considered for children under 16 whose myopia is progressing quickly. He says the number of children affected has increased significantly since the Covid-19 period, when many spent more time indoors and had greater exposure to screens.

A treatment aimed at controlling progressive myopia

Myopia does not progress at the same rate in every child. In some cases, vision can deteriorate significantly within a relatively short period, making regular ophthalmological monitoring particularly important.

Dr. Khalifi cites cases in which a child's prescription can move from around -1 diopter to -2, -3 or even -4 within six months to a year. Orthokeratology is among the approaches that can be considered in such situations.

The lenses work by applying controlled pressure to the cornea while the patient sleeps. This temporarily alters its curvature, making it flatter and reducing the optical effect responsible for myopic vision. The result is intended to provide clearer daytime vision after the lenses are removed.

The adjustment period can take several weeks. During the first week, clear vision without glasses may last only through part of the day. Improvement can progressively extend into the evening during the second week, while some patients may achieve daytime correction throughout the day by the third week.

The effect depends on regular use

Orthokeratology does not permanently reshape the eye. Its effect is temporary and depends on continued use of the lenses according to the prescribed schedule.

If treatment is stopped, the cornea gradually returns toward its original shape, meaning the patient's myopia can become visible again and glasses may once more be necessary.

For children, this makes regular medical monitoring an important part of the treatment process. A single eye examination followed by several years without assessment is not sufficient when myopia is evolving.

Parents are encouraged to seek an examination when they notice signs such as a child sitting unusually close to the television, moving objects closer to the face or frequently narrowing the eyes in an attempt to see more clearly.

Family history can also be relevant. Children whose parents have significant myopia may have a higher risk of developing the condition.

Orthokeratology can be considered in young children

According to Dr. Khalifi, Ortho-K may be considered from around the age of six or seven in selected cases. The child's ability to tolerate the lenses, handle them appropriately and follow the required routine must be taken into account.

For some children, avoiding thick glasses can also be an important consideration. However, the decision to use orthokeratology requires an individual assessment by an eye-care professional rather than relying solely on age or prescription.

The technique also has correction limits. The ophthalmologist indicates that it can generally address myopia up to approximately -6 diopters. When the prescription is higher, the correction may remain incomplete, leaving the patient with residual myopia.

Astigmatism is another factor. Dr. Khalifi places the approximate limit at -3 diopters, beyond which the visual result may not be sufficient to eliminate the need for glasses.

Not suitable for every patient

Orthokeratology is not appropriate for all forms of visual impairment or all corneal conditions. Certain corneal diseases, including keratoconus, can prevent the use of this technique.

For adults whose myopia has generally stabilized after the late teenage years or early adulthood, other forms of vision correction may be considered depending on their individual circumstances. These can include laser procedures, conventional contact lenses or, in selected cases, implantable lenses.

The appropriate option depends on the patient's eye health, prescription, corneal characteristics and medical assessment.

Hygiene is essential

Because Ortho-K lenses remain in contact with the eyes during sleep, careful hygiene is a central part of their use. The lenses are rigid and require appropriate cleaning, storage and handling.

Poor maintenance can increase the risk of bacterial contamination and eye infection. Users are advised not to shower, wash their face or eyes, or swim while wearing the lenses.

Symptoms such as burning, redness or excessive tearing should not be ignored. According to Dr. Khalifi, patients experiencing these signs should stop wearing the lenses and seek an ophthalmological assessment to determine whether inflammation or infection is present.

For children, parents have an especially important role in maintaining the routine. They must help ensure that the lenses are worn for the recommended period, cleaned properly and brought to follow-up appointments.

Outdoor activity remains part of myopia management

Orthokeratology is not the only element involved in managing childhood myopia. Daily habits can also play a role in an overall approach to eye health.

Dr. Khalifi recommends limiting excessive screen exposure, encouraging children to spend more time outdoors and increasing exposure to natural light. Regular physical activity is also encouraged.

For children using Ortho-K, parents must combine these lifestyle measures with careful lens maintenance and scheduled medical examinations to monitor whether the treatment is producing the expected effect.

Local manufacturing develops in Morocco

Another development highlighted by the ophthalmologist is the possibility of producing orthokeratology lenses locally in Morocco.

Because each lens is individually designed for the patient's eye, manufacturing is not an off-the-shelf process. Dr. Khalifi estimates that production can take approximately two to three weeks.

Local manufacturing could reduce some of the costs and logistical constraints associated with importing customized lenses from abroad. The final price varies depending on the case, although the specialist describes it as broadly comparable to the cost of glasses fitted with thick corrective lenses, with Ortho-K potentially costing somewhat more.

A reusable option requiring long-term care

Unlike some soft contact lenses designed for daily or monthly replacement, orthokeratology lenses can be used for a considerably longer period when properly maintained.

According to Dr. Khalifi, a well-maintained pair can potentially be used for up to a year. This depends on proper cleaning, protection against scratches and careful storage to prevent the accumulation of dirt or other contaminants.

For families considering the technique, the central issue is therefore not simply whether nighttime lenses can eliminate the need for daytime glasses. Their use involves a continuing commitment to hygiene, regular ophthalmological supervision and adherence to the prescribed treatment routine.

For children with rapidly progressing myopia, orthokeratology represents one of the approaches that may be evaluated by an eye specialist as part of a broader strategy for managing the condition.