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HomemiequipmentComfortable, Stable Vision New Contact Lenses for Astigmatism

Comfortable, Stable Vision New Contact Lenses for Astigmatism

Now in its 75th year, Alcon has released two contact lenses for patients with astigmatism – Total1 for Astigmatism and Precision1 for Astigmatism. These new contact lenses are expected to present growth opportunities for optometrists due to the low number of astigmatic patients currently wearing toric contact lenses, combined with the lack of choice of toric lenses compared to spherical lenses.

Astigmatism is a common vision problem, caused by an irregularly shaped cornea, which can cause images to blur or stretch out. Alcon estimates that toric lenses, which correct astigmatism, represent 23% of the almost AU$15 billion global contact lens market.1 As a result, there is a significant opportunity for the new Total1 for Astigmatism and Precision1 for Astigmatism contact lenses to attract new wearers and reduce lens dropouts. For example, studies show that 41% of patients are astigmatic,2 but only 10% wear toric contact lenses.3 Furthermore, about 65% of contact lens dropouts have astigmatism.

Optometrists in Australia and New Zealand who have trialled Alcon’s two new contact lenses for astigmatism have quickly embraced the technology


Total1 for Astigmatism 

Total1 for Astigmatism is the premium, daily disposable contact lens that Alcon has developed for this market. Described as “the first and only Water Gradient contact lens for patients with astigmatism”, this lens material features a gradual increase in water content approaching 100% water at the surface, so all that touches the eye is a “cushion of moisture”.4,5 Additionally, it boasts two other proprietary technologies from Alcon:

  • Precision Balance 8|4 lens design – the stabilisation technology used in both the Precision1 and Air Optix plus HydraGlyde for Astigmatism contact lenses. Total1 for Astigmatism is designed to settle in an average of 37 seconds,6 with primary gaze lens orientation within 2Åã of ideal orientation within two minutes on average.
  • SmarTears Technology, which facilitates the release of an ingredient found naturally in tears to help stabilise the lipid layer of the tear film.

Precision1 for Astigmatism 

This daily disposable, silicone hydrogel (SiHy) contact lens is also born from Water Gradient technology and it features SmartSurface technology, a permanent micro-thin, high-performance layer of moisture that steps up from 51% water at the core to greater than 80% water at the outer surface7 to support a stable tear film and deliver lasting performance.Additionally, Precision1 for Astigmatism incorporates proven Precision Balance 8|4 for a stable lens-wearing experience.8-10 Clinical studies show the toric lens settles in less than 60 seconds and 3. of ideal orientation for a 99% first fit success rate.9*

Additionally, Alcon has included a single six o’clock scribe mark to make fitting “exceptionally easy”.


Optometrists in Australia and New Zealand who have trialled Alcon’s two new contact lenses for astigmatism have quickly embraced the technology, noting that they are easy to fit and provide their patients with comfortable, stable vision.

For Adele Jefferies, optometrist and National Clinical Manager at Matthews Eyecare Eyewear in Auckland, New Zealand, the new contact lenses are a welcome evolution in technology.

“There’s no doubt the technology available to improve both the wearing comfort and visual stability for our astigmatic patients has been getting better and better over the last five to ten years. The R&D teams have been creating some great products that fit well and quickly, in a range of modalities. “The key benefits for my patients and I, with the release of Total1 and Precision1 for Astigmatism, are the unique benefits we’ve come to know and love from the spherical lenses and Total1 Multifocal. Having Water Gradient and SmarTears Technology improves wearing comfort in all patients, but particularly those with drier eyes. It’s also a great option for those wanting, or who appreciate cutting-edge premium products.”

Josh Clark, from EyeQ Optometrists St Ives in Sydney, said Total1 for Astigmatism has quickly become his “lens of choice for astigmats”, who make up around 50% of his patient base. This is due to the lens’ Water Gradient technology which assures comfort, something traditional contact lenses for astigmats have not provided.

“Any patient with -0.75 cylinder of astigmatism should be prescribed an astigmatic lens,” he said. “I have Total1 for Astigmatism on any astigmatic patient who has symptoms that could include dry, irritated, sore or blurry eyes. I also prescribe this lens for many patients who are wearing Total1 spherical lenses”.

Mr Clark described Precision1 as “a great value” lens.

“The material provides great vision and comfort at a lower price point, which is attractive for patients with no dry eye symptoms or who are more price conscious. This is great for occasional wear.”

Ms Jefferies said the new technologies are enabling her to expand her contact lens patient base.

“For Precision1 for Astigmatism with SmartSurface Technology, I typically look at this as an option for two types of patients. Firstly, younger patients to set them up for longer-term success in terms of comfort and ocular surface health, while also giving them the high-performance vision and comfort they expect for their busy lifestyles. Secondly, as a more advanced product, at a price point that may be less of a barrier for patients I’m fitting who have previously been using older technology, particularly when they’ve been buying really cheaply online.”


Traditionally, astigmatic patients have had little joy with contact lenses.

“Personally, I have always tried to correct the astigmatism with an astigmatic contact lens, which is thicker than a regular lens. If the patient was not happy with comfort, then I would change them into a spherical lens and ‘mask’ the astigmatism.

“I find that patients are generally happy with this prescribing philosophy. Patients with traditional astigmatic contact lenses may have some issues with comfort, which can be aided by lubricating eyedrops. Patients who choose not to correct the astigmatism may have low grade symptoms, such as eyestrain on the computer or difficulty with night driving… There is a strong viewpoint that having 90% vision with a comfortable lens is a better outcome than 100% vision with a less comfortable lens.”

Mr Clark says quite a few patients drop out due to discomfort, and those who do, can be reluctant to try a new lens technology.

When trialling Alcon’s new lenses Mr Clark said, “It was almost as though these patients expected the new lens technology to be heavy or to not fi t correctly. It was interesting to observe this negative mindset. But I am pleased that most patients have been very happy with the comfort and their vision with Precision1 for Astigmatism and Total1 for Astigmatism. Clinically, I have not had a patient where the lens does not fit.”

With traditional astigmatic contact lenses often frustrating to fi t, the fitting process for both these new lenses is a bonus in the clinic.

“Fitting these contact lenses relies on the lens rotating into the right position. You can tell this due to a marking on the contact lens. I am very pleased that all Precision1 or Total1 astigmatic lenses have fitted correctly. This is amazing,” Mr Clark said. Ms Jefferies agreed. “So far, I have been lucky to have no fitting challenges for both these lenses. Both have so far centred and moved well, with minimal rotation. When rotation has occurred, it has been stable in all directions of gaze. I have been fortunate to have trial lens sets in practice which make it easier to get lenses on the eye sooner and reduces chair time.

“I have reached out to many patients to see if they’re interested in trying the lenses, and the interest from patients has been strong. The biggest limiting factor in getting more patients in these lenses has been on me having enough appointment times free to get the patients in.”


Ms Jefferies said feedback from those who have trialled the lenses has been resoundingly positive.

“One young patient with mild perennial ocular allergies, who was alternating between reusable and daily disposables, told me, ‘I really liked the new dailies, they were super comfortable, way better vision than the last dailies and more comfortable than the two weeklies’.

“Another patient in her late 30s said, ‘Contact lenses are great, comfortable, and it’s amazing to be able to see properly again!’.

“I am really pleased to finally have access to both Total1 for Astigmatism and Precision1 for Astigmatism. Firstly, this has allowed me to problem solve for many patients still having contact lens discomfort – I know they will be comfortable in these lenses from insertion to removal. Secondly, as well as providing consistently clear vision for my patients, I like the confi dence that I am setting my patients up with lenses that support good ocular surface health now and into the future.”


*Based on lens movement, centration and rotation at initial fitting. 

  1. Alcon Estimates and independent market research. 
  2. Luensmann, D., Contact Lens and Anterior Eye (2018). 
  3. Multi-Sponsor Surveys 2014 Gallup target market report. 
  4. Angelini TE, Nixon RM, Dunn AC, et al. Viscoelasticicty and mesh-size at the surface of hydrogels, characterized with microrheology. Invest Ophthalmol Vis Sci. 2013; 54:E-Abstract 500. 
  5. Pitt WG, Jack DR, Zhao Y, Nelson JL, Pruitt JD. Loading and release of a phospholipid from contact lenses. Optom Vis Sci. 2011; 88(4); 502-506. 
  6. In a study where n=47 subjects, Alcon data on fi le, 2020. 
  7. Alcon data on fi le, 2019. 
  8. Alcon data on File, 2019. 
  9. Alcon data on File, 2020 (n=78 eyes). 
  10. In a randomized, subject-masked, multi-site study with over 150 patients; signifi cance demonstrated at the 0.05 level; Alcon data on fi le, 2005.