Contact LensCalc

Soft Multifocal or Corneal Reshaping: Comparing Lens Parameters

Two design families carry a myopic defocus treatment and they differ in what you order: a soft lens takes a converted distance power, a reshaping lens takes curves from keratometry and no converted power at all.

This is a parameter-set comparison for practitioners, not a recommendation between the two. Which design suits a given patient is a clinical decision; what each design asks you to specify is a documentation problem, and that is what this page answers. The category overview is on Myopia Control Contact Lenses: Optics and Ordered Parameters.

Clinical takeaway

A converted spectacle power is the starting point for a soft myopia control design and is not the starting point for an ortho-k design at all. Everything else in the comparison follows from that one difference.

Not a Rx

Not a prescription / on-eye next step

This page compares parameter sets. It does not select a design, and neither family is presented as preferable. A licensed practitioner makes that decision and verifies the result on eye.

Stop wear

Urgent symptoms: take the lens out and get seen

Pain, redness that will not settle, light that has become hard to tolerate, discharge, or a drop in vision belong to neither parameter set. The lens comes out, it stays out, and a licensed eye care practitioner is contacted the same day — or an emergency eye service if you cannot reach one. On an overnight reshaping lens, that means the lens is not worn again until it has been checked. The wearer is usually a child, who may not report it, so ask.

Reviewed by Optom. Deepak Ghimire, B. Optometry, PGDOVS — Consultant Optometrist, Myopia & Contact Lens Specialist.

What differs in the ordered parameter set?

Almost everything. The two families share a purpose and share no parameter names except diameter.

Ordered parameters compared between soft centre-distance and orthokeratology myopia control designs
What you specifySoft centre-distance designOrthokeratology design
Primary inputThe refractionThe topography — central radii, eccentricity and HVID
Distance powerOrdered, as a vertex-compensated sphere at the corneal planeNot ordered as a power; expressed as the target flattening built into the back optic zone radius
Treatment opticA stated add, selected from what the design offersThe reshaped corneal profile itself; no add is ordered
Back surfaceOne base curve, usually from a short list per designFour or five curves: back optic zone, reverse, alignment, peripheral
What sets the vaultBase curve and diameter togetherReverse curve depth and alignment zone radius or angle
DiameterUsually fixed per designOrdered, and sized against HVID
VerificationOver-refraction and centration at the slit lampPost-wear topography difference map, read before the refraction
When it is wornDaytimeOvernight; nothing is worn during the day

The row worth dwelling on is what sets the vault. On a soft lens, base curve and diameter act together as the pair described on Sagittal Depth of Contact Lenses. On a reverse-geometry lens the base curve has already been spent on producing central flattening, so, as Mountford and Noack (Contact Lens Spectrum, June 2002) set out, sagittal height is controlled instead by the reverse curve depth and the alignment zone. Two lenses, two entirely different levers for the same geometric quantity.

When is a converted spectacle power the starting point, and when is it not?

On the soft side it always is. On the reshaping side it never is.

A soft centre-distance design still needs a distance zone that gives clear vision, and that zone carries the same vertex-compensated sphere any soft lens would — calculate it on the Contact Lens Conversion Calculator and read vertex-compensated contact lens power for why the spectacle and corneal planes diverge above about ±4.00 D. The treatment optic sits around that number; it does not substitute for it.

An ortho-k lens has no power zone in the ordinary sense. The amount of myopia to be reduced enters the design as flattening applied to the back optic zone radius relative to flat K — the Jessen and compression factor arithmetic on RGP Contact Lens Parameters and Starting Power. Converting a spectacle sphere and ordering it as a power would be a category error: there is nothing on the lens for it to be ordered into.

The verification step inherits that split. A soft fit is verified with over-refraction through the trial lens. A reshaping fit is verified with a post-wear topography difference map, and Mountford and Noack are explicit that the map is taken before the refraction, because a refraction measured over a decentred treatment zone carries no usable information. Details of that reading are on Ortho-K Lens Design and Post-Wear Topography.

What are the toric limits in each family?

Both families run out of astigmatic range, and they run out for different reasons — one optical, one mechanical.

Most soft myopia control designs carry spherical distance powers only. Melanie Frogozo, OD (Review of Cornea & Contact Lenses, February 2026) describes the practical consequence: where a significant cylinder does not correct acceptably in the chosen design, consider a design that offers astigmatic correction, and where none is available, spectacles worn over the lenses for the residual error are an option. The limit here is that the cylinder cannot be ordered, not that the eye cannot be corrected.

In a reshaping design the limit is that the lens must land 360° on the mid-periphery. Astigmatism is handled with a toric landing zone rather than a cylinder power. Myopia Profile gives around 1.50 D of corneal toricity, or a sagittal height difference of around 30 µm over an 8 mm chord, as generally agreed thresholds — noting that the chord and difference vary between manufacturers.

Neither of those is soft toric rotation, which is a third problem again. Starting sphere, cylinder and axis, the stability assessment and the LARS compensation live on the Toric Contact Lens Calculator.

Which page covers what?

This page is the parameter comparison. The optics and the geometry each have their own page, and the calculators stay where they are.

This site publishes no brand parameter grids and no comparison of one manufacturer's design against another's. What it can compare is what each design family asks you to write down, which is the comparison above. Which family a patient should be in, at what age, and on what schedule are clinical decisions this site does not make.

Read Starting Contact Lens Parameters Are Not a Prescription for the bound that applies across this site.

How we calculateMedical disclaimer

Sources

Clinical claims on this page are attributed to the publications below.

  • Melanie Frogozo, OD, Succeed with Soft Multifocals (Review of Cornea & Contact Lenses, February 2026) — myopia control soft designs carrying spherical distance powers; considering a design offering astigmatic correction where cylinder does not correct acceptably, and over-spectacles for residual error where none is available; lathe-cut designs allowing specified base curves, diameters and zone sizes.
  • John Mountford and Don Noack, Corneal Topography and Orthokeratology: Post-fit Assessment (Contact Lens Spectrum, June 2002) — reverse-geometry sagittal height controlled by the reverse curve depth and the alignment zone radius or angle rather than by base curve and optic zone diameter; the post-wear map taken before the refraction.
  • Myopia Profile, What topography data do I need to fit orthokeratology lenses?— sagittal height from central radii and eccentricity over a stated chord; lens diameter sized against HVID; around 1.50 D of corneal toricity, or around 30 µm of sagittal height difference over an 8 mm chord, as generally agreed toric-design thresholds that vary between manufacturers.

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