SIGNIFICANCE:The Fitting of Orthokeratology in the United States (FOKUS) survey provides information about the US orthokeratology market. This independent survey is the first to attain detailed assessment of the orthokeratology market.PURPOSE: This study aimed to develop and administer a survey to eye care providers in the United States who are managing orthokeratology patients and those who are not, to determine a profile of prescribers, patients, and overall market.METHODS: The FOKUS survey was administered and distributed online. Outcome measures of the FOKUS survey involved general categories of (1) practice and practitioner profiles, (2) clinical prescribing patterns, (3) patient profile, (4) products and marketing, (5) fees, and (6) market size and growth.
RESULTS:The number of eye care providers who are actively fitting and managing orthokeratology patients in the United States is approximately 3000. A total of 545 responded to the survey; 283 reported that they were actively fitting orthokeratology. Furthermore, 68% of respondents prescribed orthokeratology with the intent of managing myopia, 53% monitor axial length, and 61% start orthokeratology patients at 13 years or younger. The mean number of years a patient wears orthokeratology is 7.8 years. A commonly reported complication with orthokeratology is corneal staining. Microbial keratitis is rarely or never seen by 86% of respondents. Of those currently fitting, 56% anticipate growth of orthokeratology fitting over the next 12 months. Of those not currently fitting orthokeratology, 46% plan to start within 2 years.CONCLUSIONS: Orthokeratology represents a small but growing segment of the US contact lens market. The number of practitioners actively prescribing and fitting orthokeratology in the United States is approximately 3000 with high potential for growth within the next 2 years. Results of the FOKUS survey are relevant to practitioners currently fitting or considering orthokeratology, manufacturers, educators, and researchers as baseline for future orthokeratology market assessment.