Objective To improve compliance and standardization of orthokeratology (Ortho-K) lens wear among children and adolescents with myopia. Methods A total of 84 pediatric patients with myopia who were fitted with Ortho-K lenses between December 2024 and April 2025 were selected for the study. Participants were randomly assigned to either an experimental group or a control group (n=42 per group) using a random number table. The control group received standard nursing care, while the experimental group received early-stage micro-habit behavioral training based on the Fogg Behavior Model in addition to standard care. Ortho-K lens compliance and operational proficiency were assessed at baseline, 21 days into intervention, and at 3-month follow-up. Vision-related quality of life was evaluated at the 3-month follow-up. Results Significant main effects for group and time, as well as a significant interaction effect, were observed for Ortho-K lens compliance (all P<0.05). At the end of the intervention and the 3-month follow-up, the experimental group demonstrated significantly higher scores in compliance and operational skills compared to the control group (all P<0.05). Furthermore, at the 3-month follow-up, the vision-related quality of life scores in the experimental group were significantly higher than those in the control group (P<0.05). Conclusion Early-stage micro-habit behavior training for Ortho-Klens based on the Fogg Behavior Model effectively enhances compliance among children and adolescents with myopia. Furthermore, it improves their operational proficiency and vision-related quality of life.