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Can Contact Lenses Provide an Effective Correction for Astigmatism?

Astigmatism is a relatively common eye problem, historically corrected primarily by eyeglasses. However, contact lenses now exist which can correct nearly all types of astigmatism, and they may be a better option, depending on your needs and preferences.

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What is Astigmatism?

There are two types of astigmatism: corneal astigmatism and lenticular astigmatism.
A corneal astigmatism is when the cornea (a clear, round dome-shaped portion of your eye that covers both the iris and pupil) isn’t evenly curved, causing it to refract light incorrectly onto the retina at the back of the eye.
A lenticular astigmatism is when the lens of the eye, which sits just behind the cornea, is misshapen.
In both cases, the result is blurry vision (both with objects close and objects far from away.) More severe cases can also lead to eye strain, chronic headaches, squinting, and poor night vision.
Astigmatism is often inherited, and most people who suffer from it were born with it. However, it can also occur after an eye disease, injury, or surgery.

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How is Astigmatism Treated?

In most cases, astigmatism is easily treated with corrective lenses. Many people wear glasses for this, which feature special cylindrical prescription lenses that offset the problem. Most of these people just need a single vision lens, though people over the age of 40 are more likely to need bifocal or progressive lenses.
However, contact lenses are an increasingly popular method of treatment for many people who have moderate astigmatism. In fact, there is reason to believe that contact lenses are better at correcting astigmatism than glasses since contacts can provide clear vision with an unobstructed, wider range of view (as a result of them sitting directly on the eyes, while glasses sit in front of the eyes.)
However, it is not all that simple. Hard lenses generally performed better at correcting astigmatism compared with soft lenses, at least in cases where it is more pronounced. However, more recent developments with soft contacts have led to increased efficacy and comfort.
When looking into contact lens options for correcting astigmatism, you are likely to encounter two specific types of lenses: gas permeable lenses and toric lenses.

Toric Contact Lenses

Toric contact lenses are soft lenses specifically designed to correct astigmatism. They are either made out of a conventional material or a special, breathable silicone hydrogel, and are different from standard soft contacts in two major ways.
First, they have different powers in different meridians of the lens. This is to correct the different amounts of nearsightedness or farsightedness in the eyes which characterize astigmatism.
They also include a special feature that allows the lens to rotate to the proper orientation on the cornea so its various power meridians align correctly with the various meridians of the eye. This operates via a small weight on the edge of the lens that keeps it aligned, even as you blink (which can cause lenses to rotate). This also helps ensure that when you put them on, they start off aligned correctly.
Because no two cases of astigmatism are identical, it may require more than one pair of toric lenses to find the brand and design that is the best for you, in terms of function and comfort. Fitting these lenses is more complicated than fitting regular soft lenses, so they tend to cost more, and the same is true for replacement lenses. Getting an exact fit is extremely important, so there is no way around this.

Various Options

Various Options

These days, lenses (in particular soft lenses) for correcting astigmatism are readily available, from various brands and in numerous styles. This includes even daily disposable lenses.

There are toric lenses that are designed to be worn for up to 30 days, including overnight, and bifocal toric lenses that can also correct presbyopia (farsightedness due to age).

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Gas Permeable Lenses

Rigid gas permeable lenses (alternatively referred to as RGP of GP contact lenses), are a popular type of contact lenses specifically used for correcting astigmatism.
Being rigid lenses, they will maintain their spherical shape over the eye instead of conforming to the abnormal shape of an eye with astigmatism (which is an issue with soft lenses.)
The properly shaped, uniform front surface of gas permeable lenses effectively takes the place of the misshapen cornea, becoming the primary refracting surface of the eye without needing to control the rotation of the lens (as with toric lenses). For more severe or unusual cases, gas permeable lenses can also include a toric design, but in most cases that is unnecessary.
An additional option are large-diameter gas permeable lenses called scleral lenses. These provide effective astigmatism correction even when there are highly irregular corneal surfaces.
In many cases, people who go with gas permeable contact lenses have markedly sharper vision with them as opposed to with soft toric contact lenses. However, because they are thicker and more rigid, they typically take more time to adapt to, and some people cannot get used to them at all.
Gas permeable lenses also take more time and expertise to fit than soft lenses, and must be custom-made to the parameters prescribed by your eye care professional. So getting fitted with these lenses (and replacing them) costs more than soft lenses.
In some extreme cases, you can use hybrid lenses which have a gas permeable lens in the center for purposes of vision correction with a soft lens skirt surrounding it for comfort and stability.

Further Questions

For additional, or more detailed questions about contact lenses to correct astigmatism, consult with our eyecare optometrist, who specializes in fitting contact lenses for astigmatism. Our doctor will be able to provide a full exam and advise you on whether contact lenses for astigmatism are the best choice for you.

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Common Questions

There are a few different ones so I'll hit off on the most commonly used. The flat tops are the most commonly used. They have a straight hard line that separates the distance from the reading portion. Flat top 28 - Bifocal width will be 28mm Flat top 35 - Bifocal width will be 35mm. There are also rounded bifocal - The bifocal is round instead of the traditional half circle. There is another style called blended bifocal which is less noticeable because it does not stand out as the lined bifocal by eliminating the hard line and introducing a softer, smoother and rounded edge to the reading section.Then we have executive style which is essentially a flat top but with altered measurements that make the reading portion the entirety of the Rx below the line and distance Rx above it. Lastly we have Double D - Theses lenses have a bifocal on top of the lens and on the bottom
First it’s important to treat the patient’s dry eyes, but yes there are contact lenses for dry eye sufferers. Daily disposable contact lenses, specifically with a silicone hydrogel material, are the best type of soft contact lenses for patients suffering with dry eyes. These lenses, depending on the brand, allow for more oxygen permeability and are more hygienic on the eyes. With daily disposable contact lenses these are single-use contacts that are discarded after one day’s use, so they are less prone to lens deposits accumulating. Also, daily disposable contacts are sometimes found to feel more comfortable due to the thinner nature of the lens. Depending on the severity of dry eyes, there are also specialty hard contact lenses to help patients with severe dry eyes; such as scleral lenses.
Hard contact lenses are custom designed to fit specifically on your eye, the fitting process is more precise than with soft lenses, so this results in a more personalized fit with the hard lenses. There are various benefits of hard contact lenses. One benefit is that hard lenses provide sharper vision. Since hard lenses are custom fitted to your eye and maintain their form better than soft lenses, this results in sharper clarity of vision. Another benefit is that hard contact lenses are better for patients who have a high level of astigmatism, irregular corneas, or keratoconus, because hard lenses retain their shape allowing for better vision whereas soft lenses would just take up the shape of the irregular cornea and not correct the vision as well. Other benefits of hard lenses is that this may be a better option for patients suffering with dry eyes because hard lenses are deposit resistant and do not dehydrate. Another benefit is that hard lenses are extremely durable.
Trivex lenses a certain material that lenses are made of. Lens material is usually broken into a few categories such as: CR-39, Polycarbonate, Trivex, and Hi-Index. Each one has it's perks and cons. Trivex is a highly rated impact resistant, lightweight and UV protected lens. It also has a higher abbe value compared to polycarbonate meaning the light moves through the lens a little cleaner making the vision more crisp and clear.
Yes. Over the years there have been many advancements in contact lens technology, so if you’re a patient who has astigmatism and also wears bifocals there are contact lens options available for you. These specific lenses are called “toric multifocal” contact lenses. As of right now these lenses only come in a monthly modality. Be sure to visit your eye doctor to get a proper contact lens evaluation and determine which lens provides the best vision and fit.
Yes, you can use progressive lenses with smaller frames. Generally speaking, as long as there's about 25-30mm of vertical lens space then a progressive design should work.
Are daily contact lenses (dailies) better for eye allergy sufferers than monthlies? Answer: First it’s important to treat your eye allergies, but yes daily contact lenses are better than monthly contact lenses for patients who suffer with eye allergies. Dailies are single use contact lenses so you place a fresh new set of lenses into your eyes everyday. However with monthlies the same lens is used for 30 days so there is more protein and lipid deposits accumulating on the lens, and then when you place this lens on your eye it can cause irritation and discomfort. Dailies usually are also made of a thinner material so they feel more comfortable on your eyes than monthlies. Be sure to have a contact lens evaluation with your eye doctor to determine which lens is best for you.
Progressive lenses are similar to bifocals in having more than one prescription in them. However, whereas bifocals have two distinct and clearly separated areas of vision, progressives have a little more to them. In a progressive lens there are no hard, or curved lines, that visibly separate zones of vision. The lens is constructed in a way to gradually shift between distance, intermediate and reading zones in a comfortable and almost invisible progression.
Progressive lenses are a touch tricky to explain but let's just review the basics. We can think if a progressive lens as a trifocal, a lens with three different prescriptions, without a line. It's composed of a distance zone, intermediate or computer/office zone, and a reading zone. In-between these three zones are a steady gradation of increasing or decreasing powers, relative to direction, which aid in viewing from distance to near. As the eye "progresses" up and down the lens these little quarter steps between focal points keeps everything clear and in order for us.
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Summary

Contact lenses are a great choice for correcting your astigmatism, and there are many options available to ensure both effectiveness and comfort. Contact us today if you have any questions, or wish to schedule an appointment for an eye exam.

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