Purpose To evaluate and compare the vision-related quality of life and efficacy between myopic children and adolescents wearing orthokeratology (OK) lens, defocus spectacle (DS) lens and single vision spectacle (SVS).Methods This ambispective cohort study involved 93 participants who had worn optical correction lenses (31 OK lens, 31 DS lens and 31 SVS) for 1 year. The Pediatric Refractive Error Profile questionnaire was used to compare the visual-related quality of life after 1 year of lens wear among the three groups. Changes in axial length (AL) and spherical equivalent (SE) at 6 months and 1 year of lens wear across the groups were assessed.Results No significant differences were observed in academics and symptoms among the three groups (p>0.05). The OK lens group scored significantly higher in overall vision, far vision, appearance, satisfaction, activities, peer perception and overall scores than the SVS and DS lens groups (p