Correction of astigmatism with toric contact lenses allows for minimal image distortion and improved peripheral vision. Simply put, they offer better quality of vision to your patients. However, toric soft contact lenses are not used as heavily as one might expect. A whopping 45% of potential contact lens wearers have astigmatism of 0.75 diopters or more.1 Yet, the percentage of toric contact lens fittings is significantly lower. Data from the Contact Lens Council found that, in 2004, only 13% of the contact lenses fit in the United States were toric soft contact lenses.2

We have a tremendous opportunity here to expand our toric contact lens use—and, it appears that attendees of the “Controversies in Care” event are seizing this opportunity, while the more broad ECP population reflected in the literature is not. For example, when polled during the event, 56% of the “Controversies in Care” audience said that over 20% of their practices consists of toric lens patients. Another poll question asked about the initial amount of astigmatism present before the practitioner would recommend a toric contact lens. Here again, my thinking was the practitioners would perhaps reach for a spherical equivalent lens in low astigmatic correction. But, the respondents again showed amazing acumen: 90% of the “Controversies in Care” attendees choose a toric lens in as low as 0.75D astigmatism.

So, what is the biggest reason more patients are not fit in toric contact lenses? Cost. Most of the “Controversies in Care” audience agreed that it was important for the practitioner to charge for the additional visit time and the increased level of service required to fit these lenses. Several practitioners said they like to give the patient the benefit of seeing what better optics can do for them, and then allow the patient to make an educated decision.

While many doctors use a tiered fee structure, others believe it makes better business sense to inform the patient of the costs up front to eliminate problems afterward.

Overall, there was no shortage of debate in this inaugural “Controversies in Care” event. Stay tuned next month for a lively discussion about kids and contact lenses.

We also welcome you to join the discussion live. You can register for upcoming online events at  

1. For whom to fit toric contact lenses? About Vision. Available at: (accessed February 2012).
2. Contact Lens Council. Statistics on Contact Lens Wear in the U.S. 2004 Nov. Available at: (accessed February 2012).