The aim of this study is to review the current literature on ortho-K lenses use in myopia with a particular focus on the efficacy and safety of orthokeratology in myopia, and its effects in the case of high myopia, as well as the impact of COVID-19 pandemic on myopia and orthokeratology. COVID-19 pandemic influenced the incident of myopia as well as progression of myopia. Ortho-K lenses have been shown to be safe and effective in reducing the axial elongation and decreasing myopia progression in low to moderate myopia and with some limitations in high myopia patients. During the COVID-19 pandemic, ortho-K treatment was not affected, and the pandemic had no effect on the axial elongation in myopia children undergoing treatment with ortho-K lenses. Myopia is becoming a major health problem worldwide that is increasing to an alarming rate. The progression of myopia can lead to serious irreversible complications. There is sufficient evidence proving that orthokeratology lenses are effective and safe in myopia. More studies need to be done in high myopia. Long term success of the use of ortho-k lenses increases with the proper lens fitting.