Compliance assessment in orthokeratology lens wearers

Background. Orthokeratology has been widely used in Russia since 2002 as a method of correcting refractive errors and effectively controlling myopia progression. However, similar to other contact lens modalities, orthokeratology lenses (OK lenses) may lead to microbial keratitis if proper lens care and handling protocols are not followed. Purpose: to assess the level of patient compliance with medical recommendations, identify key causes of non-compliance, and develop measures to improve adherence. Materials and methods. A questionnaire-based survey was conducted among OK lens wearers and their parents. The study included 101 patients aged 7 to 18 years and 24 parents responsible for lens care and handling. The survey was administered at the end of the first year of OK lens wear. Results. Full compliance with recommendations (adherence to follow-up schedules, wearing, and lens care instructions) was observed in 17.6% of OK lens wearers. Full compliance with lens care routines was reported in 28% of patients, of whom 80.9% had their lens care supervised daily by a parent, while 19.1% were not supervised. The most frequent noncompliance issues included irregular mechanical cleaning of lenses, wearing lenses during episodes of acute respiratory infections, rinsing storage cases with tap water, and washing hands without soap. The rate of full adherence to follow-up visit schedules was 46.4%. Follow-up schedule violations were recorded within the first 1–9 months of lens wear, primarily due to absence of symptoms and lack of time. Conclusions. The findings indicate that OK lens wearers do not always follow recommended care and handling instructions. This underscores the importance of regular parental supervision over lens wear and care in children and adolescents. To reduce the risk of complications and maintain high compliance levels, patients should attend regular follow-up visits. Enhancing compliance requires repeated patient education on lens care practices, organization of online educational webinars for patients and parents, implementation of telemedicine consultations, use of mobile applications for reminders about follow-up visits and hygiene protocols, and demonstration of possible complications via digital devices.

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