Brian Chou, OD, FAAO
1. Besides noting the rotation of the lens based on laser mark position, use a handheld Jackson Cross Cylinder (JCC) to straddle the contact lens axis and assess if rotational compensation is needed.
2. Don’t bother use an aspheric soft lens design to “mask” low astigmatism, even if manufacturer reps and other clinicians suggest this. It doesn’t work.2
3. If the patient has more than 2.50 D of astigmatism due to corneal toricity, start thinking about prescribing rigid optics (such as hybrid lenses, corneal RGPs, and scleral RGPs) rather than soft toric lenses.
Related: Using toricity with scleral lenses