The Effects of Spectacles or Orthokeratology on the Tear Film in Children and Adolescents

Abstract Introduction Myopia prevalence among adolescents is increasing annually. While orthokeratology (OK) is effective for controlling myopia progression, it may also be detrimental. We investigated tear film parameters [including tear mucin 5AC (MUC5AC) concentration] in children and adolescents with myopia treated with spectacles or OK compared with those with emmetropia. Methods This prospective case–control study enrolled children (aged 8–12 years; 29 and 39 with myopia treated with OK and spectacles, respectively, and 25 with emmetropia) and adolescents (aged 13–18 years; 38 and 30 with myopia treated with OK and spectacles, respectively, and 18 with emmetropia). We recorded the ocular surface disease index (OSDI), visual analog scale (VAS) score, tear meniscus height (TMH), noninvasive tear breakup time (NIBUT), meibomian gland score (meiboscore), ocular redness score, and tear MUC5AC concentration in the emmetropia, spectacle (after 12 months of spectacle wearing), and OK (baseline, and after 1-, 3-, 6-, and 12-month use) groups. We observed changes from baseline to 12 months in the OK group and compared parameters among the spectacle, 12-month OK, and emmetropia groups. Results The 12-month OK group differed significantly from the spectacle and emmetropia groups in most indicators among children and adolescents (P