AIM:To investigate the monocular and binocular accommodative difference between wearing orthokeratology lens and frame lens in low myopic anisometropia children.METHODS: Totally 47 children(94 eyes)with low degree myopic anisometropia(1.0D≤binocular equivalent spherical lens difference <2.5D)were involved between November 2019 and April 2020 in the retrospective clinical study. Twenty-seven cases(54 eyes)wore frame lens were used as group A and 20 cases(40 eyes)wore orthokeratology lens were used as group B. The corrected visual acuity and the accommodative parameters [the accommodative response(AR), the accommodative facility(AF), the accommodative amplitude(AMP)] at 1mo after treatment were recorded and compared. RESULTS:In two groups the results of AR were positive, and it meant accommodative lag(AL). AL of the higher myopic eyes was higher than the lower eyes in group A(0.63±0.21D vs 0.25±0.34D, P<0.001), but there was no significant difference of AL in group B(P=0.104). Between two eyes, the difference of the corrected visual acuity and the monocular AMP in two groups were no significant(P>0.05). The binocular AR difference in group A was significantly higher than group B(0.38±0.36D vs 0.10±0.26D, P=0.005), and the binocular AF was lower(8.22±1.15c/min vs 9.95±0.89c/min, P<0.001). There was no statistical difference in binocular AMP(P=0.280).CONCLUSION: Low myopic anisometropia children with orthokeratology lens can obtain higher binocular AF and lower binocular AR difference than that with frame lens, so as to maintain more coordinated binocular accommodation.