Best Contact Lenses of 2022 for Dry Eye and Astigmatism

Dry eye and astigmatism are common ocular disorders, and these conditions often coexist for many people. One in three people has some amount of astigmatism,¹ and up to 49 million people suffer from dry eye in the United States alone.² In contact lens-wearing patients, the concomitancy of these issues can generally result in decreased contact lens comfort and reduced clarity of vision.

In this article, we will discuss a variety of suitable contact lenses for patients dealing with astigmatic refractive error and dry eye. We will focus on lenses that continue to be popular in 2022 and discuss newer lens designs that have shown promising results among this group of patients.

^{Image taken from: https://www.acuvue.com/contact-lenses/acuvue-oasys-1-day-for-astigmatism}

This lens has arguably become the most prescribed daily disposable lens for astigmatism on the market and is a go-to lens for many prescribers. Through its eyelid-stabilized lens design, undesirable lens rotation is mitigated by four stabilization zones within the lens. This helps maintain position and clarity while blinking and reduces the chance of lens fallout.

The Acuvue Oasys 1-Day for Astigmatism lens also retains moisture very well for longer periods of time due to its tear-infused Hydraluxe technology. As a bonus feature, this lens also provides the largest range of axes available in a soft contact lens, making it an option for a larger scope of patients.³

^{Image taken from: https://coopervision.com/practitioner/our-products/myday-family/myday-toric}

Another good option for a daily disposable toric lens is the MyDay Toric from CooperVision. It is usually lower in cost when compared to the Acuvue Oasys 1-Day for Astigmatism and thus may serve as a budget-friendly option for patients. The MyDay Toric’s design is based on Optimized Toric Lens Geometry, similar to the Biofinity Toric, which is its monthly counterpart (more on this lens later). This design allows for a uniform horizontal ISO thickness, a smooth continuous ballast, and a large toric optic zone, making enhanced comfort and optimized vision possible, even while blinking.⁴

Furthermore, the MyDay Toric is made with Smart Silicone chemistry, which uses a unique blend of hydrogel and silicone to enhance oxygen permeability. Currently, this lens contains only a 4.4% amount of silicone, making it one of the lowest percentages of silicone found in a silicone hydrogel daily disposable lens.⁵

^{Image taken from https://precision.myalcon.com/contact-lenses/daily/precision1-for-astigmatism/}

The Precision1 for Astigmatism has been a promising lens since it was released into the market in early 2020. This lens strives to tackle the three main challenges patients feel with contact lens dropout: poor vision, poor comfort, and lens handling difficulties.⁷

The lens has been said to use a similar water gradient technology to the Dailies Total1 but at a more mainstream price. Furthermore, the Dailies Total1 are not yet available for astigmatism, giving the Precision1 for Astigmatism an edge here.

^{Image taken from: https://www.acuvue.com/contact-lenses/acuvue-oasys-astigmatism}

The Acuvue Oasys for Astigmatism bi-weekly lens is an excellent option for patients who are expecting to wear lenses for an extended period of time. Similar to its daily version (Acuvue Oasys 1-Day for Astigmatism), they are the original lens to have been designed with Eyelid Stabilized and Hydraclear technology,⁸ and thus can offer a similar level of comfort and quality of vision as the daily disposable version.

^{Image taken from: https://coopervision.com/practitioner/brilliance-of-biofinity-toric}

The Biofinity Toric is the lens I offer to patients in need of a monthly astigmatism corrective lens. It has consistently shown to be a reliable, long-wearing lens due to its Aquaform technology, letting it have a high breathability and Dk value. As with the MyDay Toric lens, this lens also utilizes Optimized Toric Lens Geometry, allowing for decreased rotation via its ballast toric design.⁹

Its extended range version, the Biofinity XR Toric, further sets the Biofinity Toric lens family apart from other monthly torics. The impressive range of powers available enables a successful fitting in patients with spherical powers ranging anywhere from +10.00 to -10.00D and cylinder powers from -2.75 onwards to -5.75D.¹⁰

^{Image taken from: https://www.bausch.ca/en-ca/products/contact-lenses/contact-lenses-for-astigmatism/ultra-for-astigmatism/}

Bausch + Lomb ULTRA for Astigmatism contact lenses feature MoistureSeal Technology which maintains 95% of lens moisture for a full 16 hours.¹¹ It also incorporates an OpticAlign design along with aspheric optics, which in combination helps to reduce the total amount of visual aberrations.

Together, the MoistureSeal and OpticAlign designs facilitate consistent comfort and clear vision with minimal fluctuations throughout the day. This lens is available in spherical powers ranging from +6.00 to -9.00, in 0.25D steps (-0.50D steps above -6.00D), and cylindrical powers of -0.75,-1.25,-1.75,-2.25 and -2.75D.¹¹

In addition to the most commonly experienced symptoms in patients with dry eye disease (i.e., ocular discomfort, irritation, burning, foreign body sensation and visual blur), there are also several clinical signs to evaluate.¹² Dry eye patients tend to have higher amounts of meibomian gland dysfunction (MGD), quicker tear break up times (TBUT), lower tear production, and more corneal surface irregularities.¹² Depending on the severity of dry eye, these findings will vary.

Contact lens use can be of even greater concern in these patients, as these clinical indications of dry eye disease may worsen depending on the duration that contact lenses are being worn. It is therefore important to understand which lenses may be more optimal choices for patients with dry eye and astigmatism. Determining a lens type that offers great hydration, comfort, and clarity without compromising on the correction of refractive error is the main objective in this group of patients.