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Don’t miss out on revenue and an opportunity to recapture the toric dropout
By Sheetal Bhaga, OD
April 24, 2026
It can be easy to equate a lack of patient complaints with success. If a contact lens wearer isn’t voicing any concerns, we tend to assume that their vision and comfort must be acceptable. But silence doesn’t always signal satisfaction. I’ve found this to be especially true for wearers with astigmatism, whose visual needs can be a bit more complex. Some of these patients discontinue contact lens wear without ever saying a word—a phenomenon I’ve come to think of as “the silent toric dropout.” For practitioners, this is a missed opportunity to optimize vision, improve patient satisfaction and capture long-term contact lens revenue.
The Business Impact of Toric Dropout
From a business standpoint, silent toric dropouts represent a significant missed opportunity for long-term growth.
In my practice in 2025, toric lenses represented 35% of total contact lens fits—and without fitting torics, I would have missed out on a quarter of a million dollars in revenue. This highlights that while toric fits may be underutilized, they represent a substantial revenue opportunity when successfully prescribed and retained.
When patients disengage from contact lens wear, we lose their initial sale, long-term revenue, patient loyalty and potential referrals. This study indicates that many lens discontinuations—particularly among toric wearers—are both preventable and underrecognized, representing a key opportunity for both practice growth and patient satisfaction.
Why Toric Wearers Go Overlooked
There are a handful of reasons why the silent toric dropout persists in clinical practice, including the perception of increased chair time associated with fitting toric lenses, the assumption that no complaints mean no problems and cost considerations. However, these barriers are increasingly outdated.
Modern toric lenses feature advanced designs that have significantly improved stability, expanded parameters to meet the needs of more patients and simplified fitting processes. I fit all the toric brands with recommendations made depending on each patient and what base curve suits their corneas the best. For monthlies, I often turn to Biofinity toric, TOTAL 30® Astigmatism or ULTRA for Astigmatism. My go-to daily lenses include MyDay toric, PRECISION1® for Astigmatism and INFUSE® One-Day for Astigmatism. For patients with dry eyes, I like DAILIES TOTAL1 ® for Astigmatism and Acuvue Oasys with Hydraluxe 1-Day for Astigmatism.
This evolution in lens design is especially evident with the Biofinity toric and MyDay toric from CooperVision, which share the same design and fitting approach. This allows for greater consistency and predictability when transitioning between monthly and daily disposable modalities. The alignment streamlines the fitting process, reduces chair time and increases practitioner confidence.
Advancements in toric lens technology have minimized many past challenges with toric lenses, making it easier than ever to successfully fit patients with astigmatism in contact lenses—and retain them as wearers.
Why Patients Don’t Speak Up
Unlike discomfort, which patients are quicker to report, sub-optimal vision is widely under-communicated. Over time, patients can normalize blur, fluctuation of vision or reduced sharpness. When asked, they may report that their vision feels stable without even realizing how much clearer it could be.
Patients describing nighttime halos, inconsistent clarity or feeling the need to squint to see more clearly are voicing signs of uncorrected or under-corrected astigmatism that we need to look out for. Even just slight hesitation or vagueness in describing visual quality can be a sign that something isn’t quite right, even if the patient can’t articulate it.
In my practice, I emphasize that a patient’s vision in contact lenses should be just as clear as it is in glasses. That expectation alone can shift how patients perceive their contact lens experience and whether they report issues. I also explain distortion and fluctuation to give my patients some vocabulary to better describe what they may be seeing or experiencing.
Patients should also know that toric contact lens fits may require a bit more fine-tuning, but the end goal is sharp, stable vision. The initial fit should be just that—a starting point. Follow-ups are imperative to achieving success and preventing dropout, particularly in early stages of wear. Many discontinuations can occur during the trial phase, before patients have even had a chance to fully adapt.
When patients understand what “good” looks and feels like, they are more likely to recognize when something isn’t right.
Redefining Toric Success
As practitioners, we need to move beyond defining toric lens success as the absence of complaints. True success is delivering clear, stable vision that meets—or exceeds—patient expectations. That requires us to be more proactive about identifying at-risk patients, educating them effectively and committing to optimization rather than acceptance.
Silent toric dropout isn’t about lenses failing. It’s about us, as eye care professionals, having an opportunity to do better. And when we do, the impact extends far beyond vision—to patient satisfaction, practice growth and the overall standard of care we provide.
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Sheetal Bhaga, OD, is a full-scope optometrist at Clarkson Eyecare in Frisco, Texas. |
