Your First Visit: Consultation and Candidacy Evaluation

The consultation is a 60 to 90 minute evaluation with one job: determining whether your eyes will respond predictably to overnight corneal reshaping. You will sit for a refraction, a slit lamp examination, a tear film assessment, pupil measurement, corneal topography, and if you are a child or teen, a baseline axial length reading. None of it hurts and none of it requires dilation for the candidacy decision itself. You leave the same day with a direct answer, the reasoning behind it, a realistic description of the result your eyes can reach, and the complete investment in writing. If the answer is no, we say so and explain what else is worth considering.

On this page

What This Visit Is and Is Not

What happens at an Ortho-K consultation?

A 60 to 90 minute evaluation covering your vision history, a full refraction, a corneal health examination at the slit lamp, tear film and pupil measurement, corneal topography, and for children a baseline axial length reading. It ends with a direct candidacy answer and a written summary of what treatment would cost.

What this visit is not is a demonstration. You will not try on a lens and see a preview of the result, because there is nothing to preview: the correction develops overnight, over multiple nights. What you get instead is a set of measurements that predict, with reasonable accuracy, how far your cornea can be reshaped and how stable that reshaping will be.

It is also not a comprehensive annual eye exam, though it overlaps with one. A candidacy evaluation is focused on the anterior surface of the eye and on the specific parameters that govern an Ortho-K fit. If you are due for a dilated health exam, tell us and we will coordinate it.

The First Fifteen Minutes: History and Goals

We start with conversation, not equipment. The questions are specific because the answers change the recommendation.

How your vision behaves through the day. Blur that worsens by evening, eye strain during screen work, and difficulty driving at night each point at different things.
Your history with contact lenses. Someone who quit soft lenses for dryness at 3:00 PM is often an excellent Ortho-K candidate, because the lens is out of the eye during waking hours.
Sleep. How many hours you actually get, and how consistently. The reshaping effect develops during closed-eye wear, so six hours is a working floor and four is not enough.
Sports, work, and environment. Swimmers, wrestlers, cyclists, dusty job sites, and stage performers all have reasons glasses and daytime lenses fail them.
For children, the progression history. How much the prescription changed at each of the last several exams, when it started, and whether either parent is myopic.

That last point deserves emphasis. A child whose prescription moved 0.25 diopters in three years and a child who moved 1.00 diopters in one year are in genuinely different situations even if their current numbers match. The rate of change is what drives the urgency of intervention. See Progressive Nearsightedness for how we read those trends.

What We Measure and Why

This is the part of the visit that produces the actual decision. Each measurement below answers a distinct question, and a single bad result in any of them can change the recommendation.

Refraction: How Much Correction Is Needed

A full refraction establishes the amount of myopia and astigmatism in each eye. Ortho-K is most predictable up to roughly 5.00 diopters of myopia with up to about 1.50 diopters of corneal astigmatism, and specialized toric designs extend that range further. Above those figures the reshaping still works, but full correction becomes less likely and a residual prescription is a realistic outcome we would tell you about now rather than at month three.

We also check binocular function: how the two eyes work together, whether there is a focusing lag, and whether one eye is being suppressed. That matters because Ortho-K changes both eyes and an underlying binocular problem can surface once the blur is removed.

Corneal Health: Whether Overnight Wear Is Safe

At the slit lamp we examine the corneal epithelium, the clear surface layer that Ortho-K actually redistributes. A drop of fluorescein, a yellow dye, makes any surface disruption glow under blue light. Existing epithelial defects, scarring, neovascularization, or signs of previous contact lens stress all change the picture.

We also examine the eyelids and lid margins. Blepharitis and meibomian gland dysfunction are common, often silent, and they degrade the tear film that a gas-permeable lens depends on. These are usually treatable, and treating them first is frequently the right sequence rather than a reason to decline treatment.

Tear Film: Whether the Lens Will Be Tolerable

Tear film quality is assessed by measuring how long the tear layer stays intact between blinks and by looking at the volume of tears present. A gas-permeable lens sits on a tear layer. When that layer is thin or unstable, the lens binds to the cornea overnight, comes out with difficulty in the morning, and can cause surface staining.

Mild dryness is usually manageable with a treatment plan started before fitting. Severe untreated dry eye is a genuine contraindication, and in a dry climate like the Phoenix valley it is worth taking seriously rather than working around.

Pupil Size and Corneal Topography

Pupil size is measured in dim light, because that is the condition under which night vision complaints occur. A large scotopic pupil sitting outside the treated optical zone is the main cause of halos and glare after dark. Knowing that number in advance lets us design a wider treatment zone or tell you honestly that some night glare is likely.

Corneal topography takes about twenty minutes and is covered in depth on Corneal Topography. It produces the three-dimensional map that a custom lens is calculated from, and it is also the test most likely to reveal a disqualifying corneal irregularity such as keratoconus.

Baseline Axial Length for Children and Teens

For every child and teen evaluated for myopia control, we measure axial length: the physical distance from the front of the eye to the retina, in millimeters. This is a light-based measurement that takes under a minute per eye and involves no contact.

Prescription is a lagging, noisy indicator of myopia progression. Axial length is the thing that is actually changing, and it is the number that tells you six months from now whether control is working. Without a baseline taken today, that comparison is impossible later. See Axial Length Monitoring.

Who Is a Good Candidate

The strongest candidates share a fairly narrow profile, and most people who ask about Ortho-K fall inside it.

Low to moderate myopia, roughly 1.00 to 5.00 diopters, with limited corneal astigmatism.
Healthy corneas with a regular, symmetrical shape on topography and no active surface disease.
Adequate tear film, or dryness that responds to treatment.
Consistent sleep of six to eight hours in a normal overnight block.
Willingness to run a nightly routine, including two minutes of lens cleaning every morning.
Children with progressing myopia, where the myopia control benefit is added to the daytime freedom. See Children and Pediatric Ortho-K.

Age is less of a factor than most people assume. We fit motivated seven and eight-year-olds with parental handling, and we fit adults in their fifties. What matters is the corneal picture and the reliability of the routine, not the birthdate. Adults and Teens cover those cases specifically.

Who Is Not a Candidate

We decline patients at this visit, and the reasons are concrete rather than judgment calls. If any of the following apply, you will hear it on the day.

Keratoconus or other corneal ectasia. An irregular, progressively thinning cornea is not a surface to reshape. Topography usually reveals this even when vision has not yet suffered.
Prescriptions beyond the predictable range. Very high myopia can be partially corrected, but if the realistic outcome still leaves you dependent on glasses, that should be your decision made with the number in front of you.
Significant irregular or lenticular astigmatism. Astigmatism originating behind the cornea cannot be corrected by reshaping the cornea.
Severe untreated dry eye or active ocular surface disease. Overnight lens wear on a compromised surface is the wrong risk to take.
Active corneal infection, recurrent erosion, or significant scarring in the visual axis.
Certain systemic conditions and medications that impair corneal healing or dramatically reduce tear production.
A situation where nightly hygiene will not realistically happen. This is a real and legitimate reason to decline, and it is about circumstances rather than character.

What You Leave With

The last twenty-five minutes of the appointment is a review, sitting down, with your maps and measurements on the screen. Four things are covered.

A direct candidacy answer. Yes, no, or conditional on something being addressed first, with the reason stated plainly.
A realistic result description. Not a promise of 20/20. What we expect your unaided vision to be, whether a residual prescription is likely, and whether night glare is a risk given your pupil size.
The full schedule. When lenses would be ordered, when they would arrive, and the dates of the follow-up visits.
The complete investment in writing. A program starts at $1,800 and this consultation starts at $250 credited toward it, but your exact figure depends on your prescription and corneal complexity, and you receive that figure in writing before you commit.

You are not asked to decide in the room. Take the written summary home. Pricing structure is explained further on Transparent Pricing and Package Pricing.

How to Prepare

Stop soft contact lens wear before the visit. Soft lenses temporarily change corneal shape. Two weeks out of soft lenses gives the most reliable topography, though we can work with less if you tell us. Rigid lens wearers need longer, and we will advise individually.
Come with your eyes in their normal state. Skip the eye makeup if convenient, and avoid rewetting drops in the hour before the appointment so the tear film assessment reflects reality.
Bring a parent or partner if a decision will be shared. Most of the information is delivered once, in the review, and a second listener helps.
Allow ninety minutes. Do not book anything tight afterward. Rushing the review is the one part of this visit that has no value when it is hurried.

To book, call (480) 706-3937 or request an appointment. We are at 15215 S 48th St Ste 180 in Phoenix, near the I-10 and Loop 202 interchange, Monday to Friday, 9:00 AM to 5:00 PM. What comes after this visit is laid out on The Process.

What Happens at Your Consultation

The first visit is an evaluation, not a sales appointment. You leave with a clear answer about candidacy and a written summary of what treatment would involve.

History and Goals
About 15 minutes
We discuss your vision history, daily demands, sports and screen habits, and what you want treatment to achieve.
Comprehensive Measurement
About 30 minutes
Refraction, corneal health assessment, tear film evaluation, pupil measurement, and baseline axial length.
Corneal Topography
About 20 minutes
Detailed three-dimensional mapping of the corneal surface, which determines whether a predictable Ortho-K design is achievable.
Candidacy and Plan Review
About 25 minutes
A direct answer on candidacy, the realistic result to expect, the follow-up schedule, and the complete investment in writing.

What's Included in the Consultation

A complete candidacy evaluation. Investment starts at $250, and it is credited toward your program if you move forward.

Comprehensive refraction
Full prescription measurement including astigmatism and binocular vision assessment.
Corneal health examination
Surface integrity, tear film quality, and any condition that would make overnight wear inadvisable.
Corneal topography
Three-dimensional mapping to determine whether your corneal shape supports a predictable result.
Baseline axial length
Included for every child and teen being evaluated for myopia control.
Written candidacy answer
A direct yes, no, or conditional answer with the reasoning explained plainly.
Complete written investment summary
The full cost of your specific program, what it covers, and what it does not, before you decide.

Frequently Asked Questions

How long does the Ortho-K consultation take?

Plan for 60 to 90 minutes. History and goals take about 15 minutes, the measurement sequence about 30, corneal topography about 20, and the findings review about 25.

It runs longer for children, because we explain each step to the child as well as the parent and because rushing a nine-year-old through a topography capture produces a worse map.

Will my eyes be dilated?

Not routinely, and not for the candidacy decision itself. Every measurement that determines whether Ortho-K will work is taken with your pupils in their natural state, and pupil size is deliberately measured in dim light rather than after drops.

If your history or examination suggests a retinal health question that needs answering, we will discuss dilation and you can decide whether to do it that day or schedule it. If we do dilate, arrange a ride or plan on blurry near vision for a few hours.

Do I need to stop wearing my contact lenses before the appointment?

Yes, for the most accurate result. Soft lenses temporarily flatten or warp the corneal surface, and topography taken over a warped cornea produces a lens design built on the wrong shape. Two weeks out of soft lenses is the usual request.

Rigid gas-permeable lens wearers need a longer break, sometimes several weeks, because the corneal molding from rigid lenses is deeper. Call us before you stop so we can give you a specific number for your situation.

What does the consultation cost, and is it credited?

The consultation and candidacy evaluation starts at $250, and it is credited toward your program if you go ahead with treatment. You receive your exact figure in writing before you commit to anything.

A complete Ortho-K program starts at $1,800 and covers the consultation, topography, custom lens design for each eye, the lenses, training, a starter care kit, and the first month of follow-up visits.

Do I find out the same day whether I am a candidate?

Yes, in the great majority of cases. The topography and the refraction together answer the question in the room, and we review the maps with you on screen.

Occasionally something needs resolving first, most often dry eye or lid disease that should be treated before a lens goes on the eye. In that case the answer is conditional and comes with a specific plan and a recheck date rather than a vague maybe.

Is my child too young for an Ortho-K consultation?

Probably not. We evaluate children as young as seven, and readiness matters far more than age. A motivated eight-year-old who follows a bedtime routine is often a better candidate than a careless fifteen-year-old.

For younger children the parent handles insertion and removal at first, so the honest question is whether the parent will commit to the routine. If your child is showing yearly increases in prescription, earlier evaluation is better than later, because there is more remaining progression to prevent.

Can I be evaluated if I have already had LASIK or PRK?

Sometimes, but it is a more complex fit and the evaluation is more involved. A previously treated cornea has an altered shape and a thinner central profile, and topography will show whether a predictable Ortho-K design is achievable over it.

Come in and be measured rather than assuming either way. The comparison between the two approaches is covered on Ortho-K vs LASIK and LASIK Alternative.

Last updated August 23, 2026. Clinically reviewed by Dr. Mark Page.