LEARNING METHOD AND MEDIUM
This educational activity consists of a written article and 20 study questions. The participant should, in order, read the Activity Description at the beginning of this activity, read the material, answer all questions in the post test, and then complete the Activity Evaluation/Credit Request form. To receive credit for this activity, please follow the instructions provided below in the section titled To Obtain CE Credit. This educational activity should take a maximum of 2 hours to complete.
CONTENT SOURCE
This continuing education (CE) activity captures key statistics and insights from contributing faculty.
ACTIVITY DESCRIPTION
This course reviews advances in soft contact lens materials, designs, and applications, from silicone hydrogel chemistry and water gradient technology to myopia management optics, prosthetic applications, and emerging technologies like drug delivery and biosensors.
TARGET AUDIENCE
This educational activity is intended for optometrists, contact lens specialists, and other eyecare professionals.
ACCREDITATION DESIGNATION STATEMENT
This course is COPE accredited for 2 hours of CE credit. COPE Course ID: 107374-CL
DISCLOSURES
Tiffany C. Lu, OD, has received travel funding from Valley Contax.
DISCLOSURE ATTESTATION
The contributing faculty member has attested to the following:
1. That the relationships/affiliations noted will not bias or otherwise influence her involvement in this activity;
2. That practice recommendations given relevant to the companies with whom she has relationships/affiliations will be supported by the best available evidence or, absent evidence, will be consistent with generally accepted medical practice;
3. That all reasonable clinical alternatives will be discussed when making practice recommendations.
TO OBTAIN CE CREDIT
To obtain COPE CE credit for this activity, read the material in its entirety and consult referenced sources as necessary. We offer instant certificate processing for COPE credit. Please complete the post test and evaluation online by using your OE tracker number and logging in to visioncarece.com.
Upon passing the test, you will immediately receive a printable PDF version of your course certificate for COPE credit. On the last day of the month, your course results will be forwarded to ARBO with your OE tracker number, and your records will be updated. You must score 70% or higher to receive credit for this activity. Please make sure that you complete the online post test and evaluation on a device that has printing capabilities.
NO-FEE CONTINUING EDUCATION
There are no fees for participating in and receiving credit for this CE activity.
Disclaimer
The views and opinions expressed in this educational activity are those of the faculty and do not necessarily represent the views of Contact Lens Spectrum. This activity is copyrighted to Conexiant ©2026. All rights reserved.
CE Questions? Contact accred@conexianteducation.com for help.
Release date: November 1, 2026
Expiration Date: September 30, 2029
WHY REVISIT SOFT CONTACT LENSES? They are probably familiar because they are commonly used for refractive error correction. But recent advances in materials science and optical design have improved oxygen permeability, comfort, and wear time. In addition to refractive error correction, their applications now include myopia management, ocular surface protection, prosthetic and cosmetic restoration of the ocular appearance, and even platforms for drug delivery and disease monitoring. This article reviews the soft contact lens wonderland, from the materials that make modern lenses possible to the ever-growing range of designs and clinical applications.
Materials
A Brief History Lesson: From innovations in durability to oxygen permeability and comfort, contact lens materials have advanced considerably in the last 8 decades. Glass and partially plastic scleral lenses emerged in the 1930s, followed by the introduction of polymethylmethacrylate (PMMA), a rigid, durable, and optically transparent polymer, in the 1940s.1 But PMMA lacked oxygen permeability, so lenses made using this material were limited to daily wear. Still, it remained the dominant contact lens material until GP materials were developed in the late 1970s.2
Hydroxyethyl methacrylate (HEMA)–based hydrogels allowed greater oxygen permeability, flexibility, and comfort. They reduced the risk of corneal hypoxia and microbial keratitis compared to PMMA, but were still not sufficiently safe for extended contact lens wear. Because oxygen permeability in HEMA-based hydrogels is directly correlated with water content and inversely correlated to thickness, lens manufacturers faced a persistent struggle between lens thinness and dimensional stability.
Silicone-based materials solved the oxygen issue, but introduced a wettability problem. Silicone’s inherent hydrophobicity led to poor wetting and discomfort. The copolymerization of a silicone monomer like fluoromethacrylate or siloxymethacrylate with a hydrophilic comonomer gave rise to silicone hydrogel (SiHy) materials in the 1990s.1 Subsequent incorporation of materials such as polyvinyl alcohol (PVA) and hyaluronic acid (HA), surface coatings like polyethylene glycol (PEG), and water gradient technologies that pair a SiHy core with a high-water-content hydrogel surface have improved SiHy wettability and comfort.3 These material advancements have allowed contact lens applications to expand beyond refractive correction to managing corneal disease, delivering drugs, and serving as prosthetic devices.
Oxygen Transmissibility: Dk/t describes the oxygen transmissibility of a lens, where D is diffusivity, k is solubility of a gas in the material, and t is the lens thickness. A greater Dk/t value reduces the risk of corneal hypoxia, edema, and infiltrative keratitis.2 The Holden-Mertz criteria of Dk/tavg=24x10-9 for daily wear (DW) and Dk/tavg=87x10-9 for extended wear (EW) remain important historical benchmarks for minimum average Dk/t to maintain normal corneal integrity.2 Although these values have been revised in recent years, Dk/t remains an important consideration for patients who have high-plus or high-cylinder powers that require thicker lenses and patients who have an EW schedule.
Water Content and Wettability: Contact lens–related dry eye occurs in part because of increased tear film osmolarity associated with reduced tear film thinning times due to evaporation or dewetting.4 Counterintuitively, lower-water-content HEMA materials tend to provide greater hydration and comfort compared to higher-water-content materials.5 This is likely due to increased evaporation and dewetting rather than dehydration of the lens itself.4
Lubricity, or the reduction of friction between the eyelid margin and the contact lens surface, is a significant contributor to contact lens comfort.5 Post-fabrication processes, including application of surface coatings, moisturizing agents, and water gradient technologies, have greatly increased SiHy wettability and comfort.3,6
Modulus: Modulus is the mechanical “stiffness” of a contact lens. Early, higher modulus materials were associated with mechanical complications, such as papillary conjunctivitis, mucin balls, and superior epithelial arcuate lesions.3 Generally, a thinner contact lens made from a low modulus material minimizes eyelid interaction.6 High modulus materials, however, have the benefit of masking some corneal astigmatism at the possible expense of comfort.
Replacement Schedule: Recommended soft lens replacement schedules have shortened considerably since the 1970s.3 Most soft contact lenses are now prescribed with a replacement schedule of 1 month or less. Daily replacement schedules reduce the rate of corneal infiltrative events and improve compliance.3 For those concerned about environmental sustainability, lens manufacturers have made efforts to reduce plastic packaging and minimize environmental impact.
Ultimately, the ideal contact lens material is not necessarily the one that has the highest Dk/t or the greatest wettability, but the one with combined properties that best match the patient’s ocular physiology, wearing habits, and handling needs.
Designs
Spherical and Toric Designs: Spherical and toric designs make up the bulk of everyday contact lens fittings in clinic. Commercially available parameters for these lenses, especially daily disposable SiHy lenses, have expanded significantly in recent years, enabling practitioners to improve quality of life for a greater range of patients.
Toric soft lens stabilization designs include prism ballast, periballast, and dynamic (thin-zone) stabilization. Prism ballast utilizes a thicker zone in the inferior portion of the lens to harness gravity and eyelid interaction to keep the lens from rotating. Periballast (ie, “double slab-off”) thins the superior and inferior peripheral zones to create an asymmetric thickness profile for optimal eyelid interaction. Similarly, dynamic stabilization utilizes thin zones at the superior and inferior lens margins to allow eyelid pressure to rotate the lens into the correct position with blink, allowing for faster rotational recovery. Understanding these mechanisms enables practitioners to troubleshoot unstable rotation and pivot to a different design when necessary.
Presbyopic Designs: The parameters and optical designs of soft contact lenses for presbyopic patients continue to expand. Multifocal designs include concentric power zones, aspheric optics, and extended depth of focus (EDOF). Concentric (ie, annular) designs contain alternating discrete rings of distance, intermediate, and near power in the optic zone, allowing simultaneous images to be in focus. Aspheric designs utilize graduated variations in curvature across the lens to produce a gradual, progressive power change. EDOF designs manipulate higher-order spherical aberrations to extend the focal range. The US Food and Drug Administration (FDA) cleared the first daily disposable soft contact lens for presbyopia that uses EDOF optical design in January 2026.7 June 2025 saw the launch of the first daily disposable toric multifocal SiHy lens, thus expanding single-use convenience to this harder-to-fit population.8
Myopia Management and Control Designs: Contact lens designs for myopia management aim to slow axial elongation using elements similar to those used for presbyopic contact lens designs: spherical areas of positive power, dual-focus concentric rings, and EDOF-based optics.9 Dual-focus designs alternate concentric rings of central distance–correcting and peripheral myopic-defocus power. EDOF-based designs utilize a continuous add-power gradient to induce spherical aberration and peripheral defocus.
The first soft lens was approved by the FDA for myopia management in 2019. The first FDA-cleared daily disposable SiHy lens for myopia management launched in January 2026, shortly followed by a toric version in June 2026.10,11 The toric version is currently cleared for standard refractive correction rather than specifically for myopia management.
Tints: A light blue or green visibility tint aids in contact lens handling and application verification. A variety of soft contact lens tints serve purposes beyond visibility and handling. Cosmetic and prosthetic tints can enhance or restore iris appearance (Figure 1). Prosthetic tints for iris and pupil abnormalities are covered in further detail below.
A category of performance tints, such as light amber or yellow tints, seek to enhance visual performance (eg, contrast sensitivity) and/or comfort. One clinical trial is investigating the possibility that these lenses could reduce photophobia and migraine symptoms.12 Whether perceived performance tint benefits reflect genuine visual improvement or placebo effect requires further investigation.13
Applications
Optical Correction (Ametropia and Presbyopia): Soft lenses remain a first-line option for correction of myopia, hyperopia, astigmatism, and presbyopia across a wide range of patient populations. Recent expansions of available parameters have equipped practitioners with a larger tool kit for matching contact lens designs with patient visual demands and lifestyles. Poor visual quality and discomfort are the primary reasons for contact lens dropout in presbyopes.14
Custom soft lenses offer expanded parameter ranges, precision, and customizability of lens power, diameter, base curve, material, thickness, and multifocal zone size to maximize visual outcomes.15
Aphakia: High-plus soft contact lenses offer a viable and cost-effective option for restoring functional vision in aphakic patients.3 Attention to oxygen permeability and replacement schedule is important for maintaining corneal health in these patients.
Myopia Management: As discussed above, soft lenses that have a central distance zone and surrounding areas of defocus can significantly slow myopia progression.9 The availability of spherical and toric daily disposable soft lenses for myopia management minimizes risk of corneal infiltrative events and microbial keratitis due to improper lens hygiene or storage, expanding the pool of eligible candidates.16 Soft lenses remain a strong option for myopia management and improving patients’ vision-related quality of life.
Irregular Cornea: Soft lenses continue to play a meaningful role in irregular cornea conditions such as corneal ectasia and corneal transplants.17 Commercially available or custom soft toric designs can often provide adequate visual correction for mild to moderate cases of corneal ectasia. Piggyback systems, in which a corneal GP lens is placed on top of a soft lens, can offer increased stability and comfort for patients who have difficulty tolerating a GP lens alone.
Prosthetic and Cosmetic: Patients who have iris abnormalities, such as aniridia or traumatic mydriasis, often suffer from photophobia and diplopia. Iris occlusion prosthetic contact lenses contain dark tinted backing on the back surface and iris pigment on the front surface.18 These can have a clear or black pupil and varying pupil and iris diameters, allowing reduction of glare and diplopia while also restoring a more natural cosmetic appearance. Patients who have corneal scarring or opacification can also benefit from tinted soft lenses for improved cosmesis, confidence, and quality of life (Figure 2).
Performance and Protection: Class I UV-blocking soft contact lenses have been shown to protect the cornea and internal ocular structures from excessive ultraviolet light, offering meaningful protection for patients who spend time outdoors.19 Although the evidence for claims remains mixed, yellow- and amber-tinted soft lenses are marketed to reduce digital eyestrain and improve contrast sensitivity.13 Daily disposable versions of these tinted lenses make it easy for athletes to wear them for sports and wear their non-tinted lenses for typical daily activities.
Therapeutic: Therapeutic soft contact lenses include hydrogel bandage lenses used to protect the ocular surface, reduce discomfort, and promote healing following corneal injury or surgery.2 These barrier properties also support management of ocular diseases, including persistent epithelial defects,20 recurrent corneal erosions, and Thygeson superficial punctate keratitis.
Oh, My!
Soft lens technology is expanding rapidly beyond visual correction, and several emerging applications hint at developments to come.
Drug Delivery: Contact lenses are being explored as sustained-release platforms for drug delivery. Therapeutic drugs can be loaded into contact lenses via methods such as nanoparticle- or polymeric encapsulation, solution soaking, and molecular imprinting.1 Compared to topical dosing, these platforms offer enhanced bioavailability and more gradual release.
Biosensors: Soft lenses have also been used as biosensors for theranostic purposes. Contact lenses embedded with wireless sensors can continuously monitor physiologic parameters such as intraocular pressure and tear glucose concentration, and research into additional biomarkers is ongoing.21,22
Human-Machine Interaction, AI, and Personalized Lens Design: In an ever-evolving digital landscape, contact lenses may someday enable human-machine interaction via eye movements and blinks. Continued advances in artificial intelligence, computational modeling, and 3D printing point toward more personalized smart lens design in the years ahead.23,24
Wavefront-Guided Correction: For patients with significant higher-order aberrations, such as those who have corneal ectasia, soft lenses that utilize personalized wavefront-guided correction could reduce visual disturbances like shadowing, glare, and halos, further expanding the role of soft lenses in the management of patients who have irregular cornea.17
Conclusion
Soft lenses have evolved far beyond refractive correction. Advances in optics, materials science, and surface chemistry have expanded the use of soft lenses into myopia management, prosthetic visual rehabilitation, and therapeutic ocular surface treatment. Understanding materials, designs, and applications can inform contact lens selection for each patient. Continued innovation with focus on ocular surface disease and personalized diagnostics promises an exciting future ahead.
References
1. Musgrave CSA, Fang F. Contact lens materials: a materials science perspective. Materials (Basel). 2019;12(2):261. doi:10.3390/ma12020261
2. McMahon TT, Zadnik K. Twenty-five years of contact lenses: the impact on the cornea and ophthalmic practice. Cornea. 2000;19(5):730-740. doi:10.1097/00003226-200009000-00018
3. Efron N, Morgan PB, Nichols JJ, et al. All soft contact lenses are not created equal. Cont Lens Anterior Eye. 2022;45(2):101515. doi:10.1016/j.clae.2021.101515
4. Nichols JJ, Sinnott LT. Tear film, contact lens, and patient-related factors associated with contact lens–related dry eye. Invest Ophthalmol Vis Sci. 2006;47(4):1319-1328. doi:10.1167/iovs.05-1392
5. Vidal-Rohr M, Wolffsohn JS, Davies LN, Cerviño A. Effect of contact lens surface properties on comfort, tear stability and ocular physiology. Cont Lens Anterior Eye. 2018;41(1):117-121. doi:10.1016/j.clae.2017.09.009
6. Jones LW, Brennan NA, González-Méijome JM, et al. The TFOS International Workshop on Contact Lens Discomfort: report of the Contact Lens Materials, Design, and Care Subcommittee. Invest Ophthalmol Vis Sci. 2013;54(11):TFOS37-TFOS70. doi:10.1167/iovs.13-13215
7. Contact Lens Spectrum Staff. FDA clears first EDOF contact lens for presbyopia. Contact Lens Spectrum. Published January 2, 2026. Accessed July 31, 2026. clspectrum.com/news/2026/fda-clears-first-edof-contact-lens-for-presbyopia
8. Johnson & Johnson. Johnson & Johnson launches first and only daily disposable multifocal toric contact lens - Acuvue Oasys Max 1-Day Multifocal for Astigmatism. Published June 23, 2025. Accessed July 31, 2026. jnj.com/media-center/press-releases/johnson-johnson-launches-first-and-only-daily-disposable-multifocal-toric-contact-lens1-acuvue-oasys-max-1-day-multifocal-for-astigmatism
9. Logan NS, Bullimore MA. Optical interventions for myopia control. Eye (Lond). 2024;38(3):455-463. doi:10.1038/s41433-023-02723-5
10. Euclid Vision Corporation. Euclid introduces Be Free® Day lens, a new silicone hydrogel daily disposable for myopia. Published January 8, 2026. Accessed July 31, 2026. euclidlenses.com/euclid-introduces-be-free-day-lens
11. Contact Lens Spectrum Staff. Euclid Vision Corporation announces FDA clearance of Be Free Day toric lenses. Contact Lens Spectrum. Published June 21, 2026. Accessed July 31, 2026. clspectrum.com/news/2026/euclid-vision-corporation-announces-fda-clearance-of-be-free-day-toric-lenses
12. Samples JS. Comparison between spectacles and contact lenses. ClinicalTrials.gov identifier: NCT06905912. Updated April 28, 2026. Accessed July 31, 2026. clinicaltrials.gov/study/NCT06905912
13. Nambiar P, Steinemann T. Sport-tinted performance lenses: new? improved? Eye Contact Lens. 2025;51(1):1-2. doi:10.1097/ICL.0000000000001156
14. Rueff EM, Varghese RJ, Brack TM, Downard DE, Bailey MD. A survey of presbyopic contact lens wearers in a university setting. Optom Vis Sci. 2016;93(8):848-854. doi:10.1097/OPX.0000000000000881
15. Davis RL, Schwartz M. Custom soft lenses: expand your fitting options. Contact Lens Spectrum. 2021;36(10):38-42. Published October 1, 2021. Accessed September 14, 2026 clspectrum.com/issues/2021/october/custom-soft-lenses-expand-your-fitting-options
16. Bullimore MA, Ritchey ER, Shah S, Leveziel N, Bourne RRA, Flitcroft DI. The risks and benefits of myopia control. Ophthalmology. 2021;128(11):1561-1579. doi:10.1016/j.ophtha.2021.04.032
17. Swartz G, Alam K, Gentle A, Downie LE. Impact of contact lens correction on wavefront aberrations and vision quality in keratoconus. Ophthalmic Physiol Opt. 2025;45(7):1811-1828. doi:10.1111/opo.70037
18. Lam D. Soft contact lenses for prosthetic fitting. Contact Lens Spectrum. 2015;3(1):33-39. Published March 1, 2015. Accessed August 1, 2026. clspectrum.com/issues/2015/march/soft-contact-lenses-for-prosthetic-fitting
19. Chandler HL, Reuter KS, Sinnott LT, Nichols JJ. Prevention of UV-induced damage to the anterior segment using Class I UV-absorbing hydrogel contact lenses. Invest Ophthalmol Vis Sci. 2010;51(1):172-178. doi:10.1167/iovs.09-3996
20. Lee YK, Lin YC, Tsai SH, Chen WL, Chen YM. Therapeutic outcomes of combined topical autologous serum eye drops with silicone-hydrogel soft contact lenses in the treatment of corneal persistent epithelial defects: a preliminary study. Cont Lens Anterior Eye. 2016;39(6):425-430. doi:10.1016/j.clae.2016.06.003
21. Kim J, Park J, Park YG, et al. A soft and transparent contact lens for the wireless quantitative monitoring of intraocular pressure. Nat Biomed Eng. 2021;5(7):772-782. doi:10.1038/s41551-021-00719-8
22. Kim J, Kim M, Lee MS, et al. Wearable smart sensor systems integrated on soft contact lenses for wireless ocular diagnostics. Nat Commun. 2017;8:14997. doi:10.1038/ncomms14997
23. Liu H, Li L, Shen G. Recent advances in wireless smart contact lenses for ophthalmic health management and eye-function enhancement. Adv Mater. 2026;38(18). doi:10.1002/adma.202516945
24. Darge HF. Engineering Vision. Contact Lens Spectrum. 2025;40(3):26. Published April 1, 2025. Access September 14, 2026. clspectrum.com/issues/2025/april/fast-forward-to-the-future
