To investigate the effect of using monocular orthokeratology lenses on the axial length and progress of anisometropia in children. We studied 30 children aged 8-12 years with myopic anisometropia who underwent monocular orthokeratology treatment. We divided them into an orthokeratology-using group (using group) and a group that did not use it (non-using group). We compared the changes in uncorrected visual acuity (UCVA), axial length, refractive error, and other parameters of both eyes before and after one year of using IP: 203 8 10920 On: Sun 18 Jun 2023 10:22:34 the orthokeratology lenses. After one year of usng monocular orthokatology lenses, the UCVA in the Copyright: American Scientific Publishers using group (LogMAR) improved from 0.58 & PLUSMN; 0.06 before treatment to -0.05 & PLUSMN; 0.08 after treatment. The Delivered by Ingenta difference in the refractive error before and after treatment in the using group was 0.06 D & PLUSMN; 0.11 D, and it was -0.51 D & PLUSMN; 0.29 D in the non-using group. The difference in the refractive error between both eyes decreased from -2.33 D & PLUSMN;0.59 D before using the orthokeratology lenses to -1.88 D & PLUSMN;0.77 D after treatment. The difference in the axial length between both eyes decreased from 0.73 mm & PLUSMN; 0.21 mm before using the orthokeratology lenses to 0.48 mm & PLUSMN;0.19 mm after treatment. The results of this study revealed that using monocular orthokeratology lenses was effective in controlling the increase in axial length and the worsening of myopia, and could effectively correct anisometropia.