The goal of this work was to objectively characterize the external morphology, topography, and optics of the cornea after orthokeratology (ortho-k). A number of 24 patients between the ages of 17 and 30 years () were fitted with Corneal Refractive Therapy® contact lenses to correct myopia between and diopters (D) (). A classification algorithm was applied to conduct an automatic segmentation based on the mean local curvature. As a result, three zones (optical zone, transition zone, and peripheral zone) were delimited. Topographical analysis was provided through global and zonal fit to a general ellipsoid. Ray trace on partially customized eye models provided wave aberrations and retinal image quality. Monozone topographic description of the ortho-k cornea loses accuracy when compared with zonal description. Primary () and secondary () spherical aberration (SA) coefficients for a 5-mm pupil increased 3.68 and 19 times, respectively, after the treatments. The OZ area showed a strong correlation with (, ) and a very strong correlation with (, ). The OZ, as well as the TZ, areas did not correlate with baseline refraction. The increase in the eye’s positive SA after ortho-k is the major factor responsible for the decreased retinal optical quality of the unaccommodated eye.