Practicing in East Texas we have a large hispanic population, many of whom need high - astigmatism or "high cylinder" contact lenses. Our options for these patients have been woefully poor for my entire 15 year optometry career. Until a few months ago the ONLY disposable soft lens that came in anything over -2.25 cylinder was B&L's Soflens Toric, now a 25 year old product. I like it ok, except that it's plastic and 90+% of the rest of the world who are not wearing dailies (also not avail in high cyl) are wearing silicone. Any Rx over 3 diopters of astigmatism gets the dreaded CooperVision Frequency 55 Toric XR for $85/box, or the Coopervision Proclear Toric XR (XR stands for "entended range"), both also over 20 years old and both also made of plastic. We need a disposable silicone toric in high cylinder Rx's. This cannot be THAT difficult. Alcon, B&L & J&J have exactly ZERO products available in ANY material for high cyl patients, and Coopervision only has $85/box 20 year old designs. Now I understand the manufact's traditional comeback to this complaint: "there are not enough of these" (i.e. low demand). The reps will also tell us how we can "mask" a diopter of cyl, which I often do. But in the age of silicone dailies (DT1, the best lens on the market right now and the lens I choose for my own family), can we really feel good about "masking" that much cylinder or telling these folks they have to wear a lens design from 1994? I mean I have 2 of these patients a day, so it can't be that rare. I'm selling more high cyl torics than I am multifocal dailies, and multifocal dailies are made by multiple manufacts. Come on, contact lens industry. We need for you to step up now. It's past time. As the band INXS once said: "21st Century's YESTERDAY!" (from "Need You Tonight").


  1. as an aside: I'm sure I will get a comment about gas perms. patients don't want gas perms, plus bitorics are expensive. I want a "go to" silicone high cyl disposable that's the same cost or comparable cost to current silicone disposable torics.

  2. Sorry for being a little off topic, but I’d like to know your opinion.

    I’m a white male, and have high astigmatism. I used to see very well (assuming almost no astigmatism) until I was about 14. After that my vision started to worsen. Now at the age of 29, I’m nearsighted (-2 D) with high astigmatism (-3.5 D at least). My parents don’t have astigmatism.

    I’ve suffered from pollen allergy since I was about 12. I remember rubbing my eyes a lot during allergy seasons. Could this cause my astigmatism? What else could do it? Thank you very much.

    1. Nah it's still genetic, even if you used to see well, and even if your parents don't have astigmatism.


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