OVERVIEW: Mile Brujic, OD, FAAO, and Kriti Bhagat, OD, FAAO, discuss how precise astigmatic correction, modern toric lens design, and clear patient education can improve contact lens fit, visual performance, satisfaction, and compliance.

KEY POINTS: Toric contact lenses contain different powers in different meridians and must remain aligned with the patient’s astigmatic axis. Patients with 0.75 D of astigmatism may experience meaningful visual benefits from toric rather than spherical-equivalent correction. Lens rotation can shift the cylinder axis and cause blur or fluctuating vision, making stabilization, material properties, hydration, and wettability important to performance.

EVIDENCE DISCUSSED: A randomized crossover trial in patients with 0.75 to 1.50 D of astigmatism found that toric daily disposable lenses improved near visual acuity, digital reading performance, and subjective visual quality compared with spherical-equivalent lenses. A separate trial reported that participants read smaller text on digital devices with toric correction and that 85% preferred toric lenses. In a prospective trial of a multifocal toric daily disposable lens, more than 96% of participants were successfully fit with two or fewer pairs, more than 94% of eyes remained within 10 degrees of intended orientation, and participants achieved functional distance, intermediate, and near vision.

CONCLUSION: Broader parameters and improved toric and multifocal toric designs allow clinicians to correct the patient’s actual prescription more precisely. Daily disposable options can simplify lens care and support compliance, while stable orientation is necessary for consistent visual performance.