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The prospect of getting through the day without the inconvenience of spectacles or contact lenses would be a utopia for any myope. Concerns of fogged up spectacles or dried out contact lenses in the air-conditioned office would be a thing of the past. But at what price does this pseudo-emmetropic lifestyle come at? The incidence of myopia varies across the world although Asian countries appear to be experiencing an epidemic of the condition. A report from Japan and Taiwan showed a 50% overall incidence and an 84% incidence in people under the age of 16 years respectively whereas the incidence of myopia in Europe and America was 20%-30% and 10%-20% in Africa. Early education being an epidemiological parameter is only one of many predisposing factors that contribute to the development of myopia. Other factors include genetic predisposition, axial length of the eye and corneal curvature, to name a few . We currently live in an era that revolves around seeking comfort in all aspects of life from doing your banking in your lounge to having an all-in-one camera, radio, email and phone. Therefore, it is not surprising that there is so much effort invested in making the management of refractive errors more convenient and thus conventional spectacles and contact lenses will no longer do. In its vastness, modern technology has provided methods that can purge refractive error such as laser refractive surgery. Such methods are not available to everybody and also carry their own risks. Orthokeratology, which was a serendipitous discovery, is another procedure used to manage myopia. Orthokeratology reduces myopia and provides adequate unaided vision for an average of an eight-hour working day, by a process that is still not entirely understood. Essentially, specifically designed rigid gas permeable lenses are used to thin out the central cornea thereby decreasing the refractive error temporarily. This procedure is most effective in patients with low to moderate myopia with low astigmatism. Studies have reflected similar results with reductions in myopia averaging between 1.75 D 3.33 D with many patients achieving good unaided visual acuity. The efforts made to reduce or eliminate myopia date as far back as the 1950’s with the development of polymethyl methacrylate (PMMA) contact lenses. Clinicians noticed that PMMA corneal contact lenses that were fitted flat inadvertently altered corneal shape and refractive error and in some patients, the flat fitting lenses had stopped myopic progression for up to two years. This observation gave rise to the interest in the possibility of designing a contact lens that could flatten the cornea permanently and eradicate myopia. The idealistic goal lead to many clinical investigations starting in the 1960’s beginning with the Orthofocus technique , and continuing until current day orthokeratology. Using the basic concept of flattening the cornea to decrease myopia, George Jessen developed the Orthofocus technique. His technique included the use of a plano-powered PMMA contact lens and the degree

A look at important issues regarding safe orthokeratology