You should explain the benefits and discuss the risks with the patient, or their parents if appropriate, so the patient can make an informed decision whether to be fitted with orthokeratology contact lenses. You should explain the increase in risk of complications associated with overnight wear.

You should explain to patients that infectious keratitis is a sight threatening complication of overnight wear and tell them about: 

1. the importance of contact lens hygiene
2. signs and symptoms to look out for
3. the need for prompt medical care
4. the importance of attending for regular aftercare
5. an out-of-hours contact number for emergencies, as well as  the number of the local eye casualty department.

You should carry out an overnight trial fitting to confirm the patient’s physiological response before beginning the treatment.