Toric Lenses Preferred Over Spherical Lenses in Astigmatism, suggests study

A new clinical study published in the journal of Contact Lens and Anterior Eye showed that patients with astigmatism of at least –0.75 diopters achieve better visual acuity with toric lenses when compared to spherical lenses and also tend to prefer them. These findings suggest that clinicians should consider toric lenses as a primary option for correcting astigmatism to improve both vision quality and patient satisfaction.

This randomized, crossover clinical trial involved 53 habitual soft contact lens wearers between the ages of 20 and 40, and analyzed 84 eyes in total. Participants were grouped based on their level of astigmatism, which ranged from none (0.00 DC) to −1.50 diopters cylinder (DC), increasing in increments of 0.25 DC. Each eye was tested using three types of correction as spherical soft contact lenses, custom toric soft contact lenses, and full-correction spectacles.

The Pupil-Controlled Vision Testing System (PUCS) dynamically adjusted lighting conditions to simulate different pupil sizes—2.5 mm, 4.0 mm, 5.5 mm, as well as each participant’s natural minimum and maximum pupil diameters, which allowed the research to assess visual acuity in more realistic conditions than standard testing methods.

Visual acuity decreased as pupil size increased across all types of vision correction, confirming that larger pupils can reduce clarity. However, toric lenses consistently delivered better visual performance than spherical lenses once astigmatism reached −0.75 DC or higher. This improvement was statistically significant across all pupil sizes.

On average, toric lenses improved visual acuity by about 0.06 logMAR (roughly three letters on an eye chart) at −0.75 DC, and by 0.12 logMAR (about six letters) at −1.50 DC. Also, toric lenses performed on par with full-correction spectacles, long considered the gold standard for astigmatism correction.

The participants increasingly favored toric lenses as astigmatism levels rose. From −0.75 DC onward, toric lenses were the preferred choice, and at −1.25 DC or higher, no participants preferred spherical lenses at all. Toric lenses demonstrated excellent rotational stability in maintaining consistent visual clarity.

Overall, the study suggests that toric soft contact lenses should be routinely prescribed for individuals with astigmatism of −0.75 DC or greater. The benefits are not only measurable in clinical terms but also strongly felt by patients in everyday vision quality.

Source:

Read, M., Morgan, P., Maldonado-Codina, C., Orsborn, G., Vega, J., & Navascues-Cornago, M. (2025). Evaluating the visual benefits of toric soft contact lenses using a novel pupil-controlled vision testing system. Contact Lens & Anterior Eye: The Journal of the British Contact Lens Association, 49(2), 102604. https://doi.org/10.1016/j.clae.2025.102604