Ortho-K, soft contact lenses or glasses for a child: how to choose

Where you are right now

Your child's prescription has gone up again. The optometrist has said myopia control is worth considering and mentioned three routes: overnight Ortho-K lenses, daytime soft contact lenses, or glasses. The clinical side is one thing. What you are really weighing up is whether an eight-year-old will put a lens in their own eye, who is cleaning what at 9 pm, and what happens at swimming on Thursdays.

This guide compares the three on those everyday terms. It does not repeat the product-by-product comparison on our Ortho-K versus myopia control glasses page, or the explanation of why ordinary glasses do not slow myopia in myopia control versus glasses for children. Read those for the products; read this for the daily reality.

What each option asks of your child every day

The three options differ most in when the work happens and who does it.

• Ortho-K. A custom rigid lens goes in before bed and comes out in the morning. The American Academy of Ophthalmology describes the lens as temporarily reshaping the front of the eye overnight so the child sees clearly through the day without glasses or lenses. The routine is nightly, at home, with a parent able to supervise. Lenses are reused, so they need cleaning and disinfecting every day.
• Soft daily disposable lenses. A fresh lens goes in each morning and is thrown away at night. There is no cleaning, but the child has to insert and remove a soft lens at school age, and wear it through the school day. Myopia control soft lenses are worn in place of glasses; the practice lists MiSight and ACUVUE Abiliti.
• Glasses. Nothing to touch the eye and nothing to clean beyond the lenses. The catch is that a myopia control lens such as MiyoSmart only works while the glasses are on, so the Academy notes these designs need ongoing, full-time wear to get the full benefit. A child who takes them off for sport, screens or vanity loses the benefit for those hours.

Sport, swimming and school

For an active child, Ortho-K's main attraction is that nothing is worn during the day. There are no glasses to fog, slip or break during rugby, and no lens in the eye at the pool. That matters because the CDC advises removing contact lenses before swimming or showering to avoid exposing them to germs in water, which rules a soft lens out of the pool unless goggles are worn and the lens is replaced afterwards.

Soft daily lenses suit sport well on dry land. Glasses are fine for most school sport with a sports-safe frame, and prescription swimming goggles solve the pool. If your child plays a lot of contact sport or swims most days, that alone can decide the question.

At school, glasses are visible and lenses are not. Some children mind that; many do not. Ask your child rather than guessing.

Age, maturity and hygiene

Age matters less than maturity. The American Academy of Ophthalmology's guidance for eye doctors says there is no reason to rule out contact lenses because of a child's age alone, that daily disposables are useful when sticking to lens care is a concern, and that the child should take part in putting the lenses in and caring for them, with a parent involved. The Academy's consumer page gives Ortho-K from age six and MiSight from age eight as the usual starting points, and our optometrists fit Ortho-K from age six.

Hygiene is the honest trade-off. The Academy says Ortho-K is associated with an increased risk of microbial keratitis, a serious infection of the cornea, and that children and adolescents may be less able than adults to keep up good hand and lens hygiene. Its 2025 review of childhood myopia treatments says overnight wear carries a higher risk of infectious keratitis than daytime wear, that reused lenses need thorough cleaning, and that daily disposables remove most of the care steps. Glasses carry no infection risk at all.

The CDC's rules are the same for any lens: wash and dry hands before handling, never let lenses touch water, use fresh solution every time, replace the case at least every three months, and take the lenses out and call the optometrist if the eye is uncomfortable. If you cannot see your family keeping to that routine every night, say so at the assessment. Our post on whether Ortho-K is safe for children covers how the practice manages the risk.

What each does for myopia control

This is where the three are not equal. The Cochrane living review of myopia control in children, updated in 2025 from 104 studies, found that Ortho-K appears to be the most effective optical treatment for slowing growth of the eye over the short term, while also noting it was often poorly tolerated, with more than half the children in some studies not completing treatment. It said soft multifocal contact lenses and myopia control spectacle lenses may reduce progression but that it remains uncertain about their benefit, and that most studies ran two years or less.

Ordinary single-vision glasses and ordinary soft lenses correct the blur and do nothing for progression, which the American Academy of Ophthalmology states plainly. So the real comparison is Ortho-K against a myopia control soft lens against a myopia control spectacle lens, and in each case against doing nothing.

We publish the figures the practice stands behind on the Ortho-K and MiyoSmart pages rather than repeating them here, because they come from different trials and are not directly comparable. Whatever you choose, Ortho-K and the lens options are all reversible: stop, and the correction fades and the myopia carries on from where it is. For the glasses and drops side of the decision, read MiyoSmart vs Stellest vs atropine.

What drives the cost

We do not print figures here. The consultation fees page lists the Ortho-K evaluation, the fitting and lens package, replacement lenses and follow-ups, and the soft lens fitting package for under-16s. What makes each option cost what it does:

Ortho-K is a custom-designed lens with a series of fitting visits, described on the fitting process page, and the lenses are replaced periodically. Daily disposables have a lower start-up cost but an ongoing supply every month for as long as they are worn. Glasses cost the frame plus the lens, and a myopia control lens is priced differently from a standard one.

Some health insurance plans, including Southern Cross, may provide partial cover for treatments such as Ortho-K; see insurance and funding. The Enable New Zealand children's spectacle subsidy lists eye examinations, frames, lenses and repairs for eligible children with a Community Services Card or High Use Health Card; its page does not list contact lenses, so ask before assuming it applies.

When this practice is the wrong place

A child in any contact lens who develops a red, painful eye, light sensitivity, blurred vision or discharge should have the lens taken out straight away and be seen the same day. Healthify NZ says a contact lens wearer with a painful red eye needs to be seen urgently. If we cannot see your child that day, go to an after-hours clinic or the hospital emergency department rather than waiting.

Call 111 or go to the emergency department for a chemical splash (flush with clean running water for at least 15 minutes first), anything that has pierced the eye, a sudden loss of vision, a shadow or curtain across the vision, or flashes with a sudden shower of floaters. None of these is an optometry appointment. Healthline on 0800 611 116 can help you decide where to go.