Overnight orthokeratology is becoming more and more popular especially in the Asia-Pacific region where the treatment is primarily used for myopic control in young children. Risk of complications in contact lens wear increases during overnight wear and may further increase when the treatment is used on children. The aim of this paper is to provide a comprehensive guideline for practitioners to improve their orthokeratology practice and minimize unnecessary or preventable complications. The fundamental requirement for starting an orthokeratology practice is to have proper education in the area and to equip the practice appropriately. Overnight trial fitting is recommended to confirm the physiological response prior to commencement of the treatment. Practitioners should provide adequate information, both oral and written, to patients before and after the commencement of treatment to avoid any legal dilemmas and to improve patients' compliance. Costs for the treatment should be transparent and provision of an emergency contact number is a must. Patients should be regularly recalled for aftercare visits and all communication with patients should be properly documented. In this paper, patient selection and the clinical procedures were discussed and a standard of practice in orthokeratology proposed. We believe that the key to providing a safe orthokeratology practice is to continually update knowledge in the field, and to practice to the highest professional standards.
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