How to Fit Toric Daily Contact Lenses

Quick answer

Fitting toric daily contact lenses requires careful evaluation of the lens’s rotational stability, base curve, and cylinder power to ensure clear vision and all-day comfort.

Steps for fitting toric daily contact lenses

1. 1. Measure corneal curvature and diameter: Use a keratometer or topographer to get the flat and steep K readings. The base curve of the lens should match the flatter meridian to prevent excessive movement. Check that the lens diameter covers the entire cornea without impinging on the limbus. A mismatch in base curve can cause the lens to rotate or decenter, blurring vision.
2. 2. Verify cylinder power and axis: Your prescription includes cylinder (power for astigmatism) and axis (orientation). The toric lens must be ordered with the exact cylinder and axis. During the fitting, place the lens on the eye and wait 10–15 minutes for it to settle, then check the axis alignment with a slit lamp. If the axis is off by more than 5–10 degrees, the lens may need a different design or parameter.
3. 3. Assess rotational stability: After the lens settles, observe its position. A well-fitting toric lens should rotate no more than 5–10 degrees when blinking or moving the eye. Use the lens markings (e.g., hash marks or laser marks) to gauge rotation. If rotation exceeds this, consider a lens with a different stabilization design. Excessive rotation often means the lens is too loose or the lid interaction is weak.
4. 4. Evaluate comfort and movement: Ask the patient about comfort immediately and after 5 minutes. Check lens movement with a push-up test: gently nudge the lens upward and see if it returns to center. Ideal movement is 0.5–1.0 mm. Too little movement can cause dryness; too much can cause rotation. A lens that feels dry or moves too much may not be the right choice for the patient’s tear film.
5. 5. Perform over-refraction if needed: If vision is still blurry after lens settling, do a manifest refraction over the lens. Adjust the sphere power based on the over-refraction result. Toric lenses often require a sphere adjustment to fine-tune vision. Never change the cylinder or axis without re-evaluating the fit; it may mask a rotation problem.

Product facts

• DAILIES AquaComfort Plus Toric - 30 pack: Alcon will be discontinuing some parameters of this product starting October 1st, 2021; discontinued parameters are only available while supplies last. If you rely on a specific base curve or cylinder power, check availability with your eye care professional before ordering.

  

• MyDay 1-Day Toric - 90 Pack: MyDay 1-Day Toric uses Smart Silicone™, which means less silicone per lens for more moisture retention. This can improve comfort for wearers with dry eyes, but the lens still requires a proper fit to maintain rotational stability.