Over the past three decades in practice, there has been an extraordinary transformation in toric contact lens technology. What was once a limited and sometimes frustrating category has become much more precise, comfortable, and reliable for most patients with regular astigmatism.
Today’s toric lenses are characterized by improved stabilization, reproducible manufacturing, expanded parameters, and the healthiest modalities we’ve ever had available.1
The evolution of stability and consistency in toric lenses
In the early years of fitting toric lenses, reproducibility was a constant challenge. A lens could perform beautifully, the patient could be delighted, and then the next supply would arrive with noticeably different performance.
Those inconsistencies are now a thing of the past. Current manufacturing processes—whether for monthly, 2-week, or daily disposable designs—produce lenses that are consistent from box to box and eye to eye.2
Stabilization has also advanced dramatically. The thick prism ballast systems of earlier designs often produced rotation and variable vision. Modern stabilization techniques allow the lens to sit where it should, and when it does rotate slightly—typically within 2° or 3°—it can be easily managed with the LARS rule.
It’s rare now to see a lens sitting even 10° off-axis.2 That confidence allows practitioners to focus more on optimizing vision and comfort rather than troubleshooting rotation.
Comfort, materials, and surface science
Comfort is another area that has advanced exponentially. Modern silicone hydrogel lenses have improved wettability via internal wetting agents or a novel surface coating. These technologies maintain hydration, resist deposit buildup, and support a more stable tear film.1
Water-gradient innovations, improved edges, and surface coatings have made toric lenses more wearable—even when the actual center thickness hasn’t changed. Patients frequently remark that the new lenses feel thinner, even though, as shown by Tyler’s Quarterly data, the physical measurements are nearly identical to older models. The sensation of thinness comes from the material technology itself.
For patients who spend long hours on digital devices, the introduction of blue-light-filtering options adds another level of visual comfort and protection.3 Heavy digital device use will negatively affect the tear film quality, and thus, technologies that improve wettability will help those who are heavy digital device users.
The combination of optical reproducibility and surface innovation has made toric lenses not just an option for astigmatic patients, but often the preferred choice.
The daily disposable advantage
Daily disposable toric lenses represent the healthiest and most convenient option available today.4 Each morning brings a clean, debris-free surface that hasn’t been exposed to overnight disinfecting solutions or days of handling.
This eliminates the risk of non-compliance with lens care and provides a consistently comfortable and safe wearing experience. Patients see better and feel better because the lens surface remains pristine every single day.
When toric lenses first came to market, many patients with higher amounts of astigmatism or less common axes had to settle for custom quarterly lenses. Now, expanded parameters in daily disposable and 2-week modalities allow most patients to enjoy the benefits of frequent replacement.
For those whose prescriptions still fall outside the standard ranges, custom soft toric options can meet virtually any need—offering axis steps by 1° and cylinder powers exceeding 5 diopters.5 There is no longer any reason to tell a patient that a toric lens cannot be made for them.
To download a patient handout on contact lens care, check out: Contact Lens Care for Patients with Take-Home Instructions!
Patient communication: Setting expectations and inspiring trust
When discussing toric lenses with patients, the key is to be clear, concise, and confident. I offer this simple explanation: “Because of your astigmatism, a standard spherical contact lens cannot provide the same visual clarity as your spectacles. A toric lens corrects for your astigmatism, resulting in sharper vision.”
For patients transitioning from spherical lenses, the improvement is often immediately apparent once the toric lens is placed on the eye. That “wow” moment makes the conversation easy.
Moreover, for first-time wearers, it’s important to highlight the balance between vision and comfort, and to avoid making assumptions about affordability. Many patients are willing to invest in a toric design once they experience the difference.
The current role of hybrid designs
Hybrid lenses once served a unique role—particularly for keratoconus or highly irregular corneas—but for routine cases, they pose more challenges than benefits. If fit improperly, they can be tight and difficult for patients to remove.6
In addition, patients often try to extend the lens’ replacement interval and/or become lax in its care; both of which can lead to red eyes. When doctors reinforce the 6-month replacement schedule, patients complain about the high cost.
While hybrid technology filled an important gap before scleral lenses became widely available, today’s corneal or scleral GPs have largely replaced the need for hybrids for most patients.7
The future is multifocal
One of the most exciting developments has been the combination of toric and multifocal technologies. Multifocal toric designs today are far more stable, comfortable, and optically consistent than their early counterparts—and innovation continues. We now have a daily disposable soft toric multifocal with a blue-violet light filter.8
Additionally, a segmented soft multifocal, currently in development, aims to function like a lined bifocal GP lens. It is lifted by the eyelid during downgaze, allowing the patient to view near through the lower segment.
This approach may reduce the visual compromise associated with simultaneous designs, in which the brain must suppress blurred near or distance images. This design could offer a more natural, alternating GP-like performance with the comfort of a soft lens, which would be a welcome addition to the fitting toolbox.9
Pro tip: With multifocal toric lenses, the key is to go for it! These lenses work…and patients want them.
Closing perspective
Modern toric contact lenses have evolved into one of the most precise and comfortable vision correction options available. With enhanced stabilization, reproducible optics, and healthier materials, there has never been a better time to fit astigmatic patients in contact lenses.
These innovations have transformed what was once a specialty lens into a standard of care—one that delivers the visual quality and comfort patients expect and deserve.
