Believe it or not, daily disposable lenses have been on the market for over 25 years. Throughout this time, they have continued to evolve and improve, leading to a rise in popularity with patients and prescribers alike. Daily options can boast better compliance,1,2,3 fewer complications,4,5,6 and enhanced overall comfort.7
In addition, daily disposable lenses offer freedom from regular cleaning and storage, which is one of the greatest motivating factors. Furthermore, these lenses minimize potential interactions between the eye and disinfecting agents, reduce the potential for non-compliance when cleaning and/or storing, and are less likely to accumulate surface deposits.8
Contact lens dropout is a major problem for eyecare practitioners (ECPs) and their patients. The primary reasons for dropout are understood to be discomfort, unsatisfactory vision, and inconvenience (regarding contact lens care).9
Reduced severity of ocular infections coupled with greater reported comfort leads to greater compliance in daily disposable lens wearers.9,10,11 Though many still fear cost as a barrier for their patients, that too is being addressed by the eyecare industry to ensure greater accessibility.12
The combination of these factors makes daily disposable contact lenses the preferred choice for a vast range of patients. This article offers an overview of lens material, emerging technologies, and patient selection as well as recent additions to the daily disposable line-up.
A brief overview of contact lens materials
Due to the original materials used in contact lenses, severe hypoxic complications that limited wear times were not uncommon. However, advancements in contact lens material technology have drastically increased the safety profile and all but eliminated this issue.13
Daily disposable lenses fall into two primary material categories: hydrogel and silicone hydrogel. Hydrogel materials are composed of hydrophilic HEMA (2-hydroxyl-ethyl methacrylate) polymers, where oxygen is transported through the lens via water.14,15
Silicone hydrogel lenses have five times more oxygen permeability than traditional hydrogel.13,16 However, due to its hydrophobic nature, silicone hydrogel has reduced wettability and is prone to more deposits.13
In daily disposable contact lenses, both materials have proven safe and effective for compliant patients, and silicone hydrogel has become an increasingly common material for daily disposables.13,14
3 considerations for daily disposable contact lenses
There are three primary considerations to take into account when prescribing daily disposable contact lenses, including cost, parameter availability, and advanced technologies.17
Cost
For many patients, cost is a key factor and merits an upfront discussion to assess exactly how much an individual is willing to spend. Patient education on safety, decreased risk of infection, rebates, insurance, and lens recycling may help them make a more informed decision.12,17
Daily disposable lenses don’t require buying contact lens solution, which can save $150-200 per year for many patients. Also, soft contact lenses are now available at different price points, from entry-level to premium, with most manufacturers offering at least two options.
Patients could be encouraged to try lenses on both ends of the spectrum to weigh vision and comfort with cost. Johnson & Johnson, for example, offers a more cost-effective option with 1-Day Acuvue Moist, while also making available Acuvue Oasys 1-Day and Acuvue Oasys 1-Day MAX.17
Parameter availability
Of course, parameter availability should also be a prime consideration. Daily disposables provide parameters to accommodate patients in the “normal” ranges with astigmatism, myopia, and hyperopia.
For ametropic prescriptions outside of the mild to moderate range, there are still options within some brands. Selection is more limited for individuals with astigmatic presbyopia, high hyperopia, and high astigmatism magnitudes, and may require more research to determine the ideal lens.17
Advanced technologies
Today’s daily disposable lenses utilize groundbreaking technologies that maximize comfort and performance—from optimizing how the lens integrates with the ocular surface to providing UV protection.
Aspheric optics and optimizing for pupil size
While conventional contact lenses offer a spherical front surface design (i.e., the same radius of curvature across the entire surface), aspheric lenses employ a more complex surface design in which at least one surface deviates from the spherical shape. In this way, aspheric lenses can mitigate aberrations (particularly spherical aberration), manipulate peripheral defocus, and modify the depth of focus.18-20
Aspheric lenses may also help to reduce accommodative micro-fluctuations, and so might be beneficial for contact lens wearers who frequently use digital devices or who experience eye strain with prolonged near tasks.21 In addition, though studies are ongoing regarding the best treatments for slowing myopia progression, multifocal soft contact lenses with aspheric optics have been shown to have a greater effect than those with concentric design for myopia control.22
However, it is important to note that most aspheric lenses are designed to minimize aberrations for the “average” patient. The degree of aberration can vary tremendously between patients based on ocular shape, pupil size, refraction, accommodation, and tear film. Advancements in technology like ACUVUE's Pupil Optimized Design have allowed manufacturers to build upon aspheric optics to optimize vision for patients.
Pupil Optimized Design combines with Hybrid Back Curve Technology, which leverages a combination of aspheric/spherical back curve to support the integrity of the optimized front surface optics while providing optimal centration across a broad range of corneal shapes,23 properly aligning the lens’ optical zone with the pupil.
This uniquely optimizes the optical design across variations in pupil size according to age and refractive error in order to deliver parameter optimization for multifocal lens wearers.23
UV Blocking
Prolonged exposure to UV radiation can increase the risk of patients developing cataracts and age-related macular degeneration,24 as well as pterygium and pinguecula, ocular melanoma, and photokeratitis.25 If all else is equivalent between two daily lenses, a lens that blocks UV may be preferable, particularly for a patient who spends significant time outdoors, or for ECPs who see patients in areas closer to the equator.
While UV-blocking contact lenses protect the cornea, lens, and retina from harmful radiation, to ensure that the entire eye and skin around it are protected, it is best to use them in addition to UV-absorbing sunglasses and eyewear.25
Class 1 UV-blocking contact lenses claim to block 90% of UV-A rays and 97% of UV-B rays, while class 2 contact lenses block 70% of UV-A and 95% of UV-B radiation.26 Johnson & Johnson, Bausch & Lomb, and CooperVision all produce daily disposable contact lenses with varying levels of ultraviolet (UV) protection that are considered either class 1 or class 2.
Wetting agents
Contact lens dropout and discomfort among digital device users are pain points for many ECPs. Troubleshooting contact lens discomfort is crucial but often difficult, as adjusting one component of a contact lens can invariably affect other factors. One of the contact lens components that can affect comfort and wearability for patients at risk of dropout are wetting agents
Wetting agents are classified as internal, surface, or releasable, and are added to a lens with the goal of allowing patients to comfortably wear their lenses for longer durations.27 Some soft contact lenses now elute wetting agents throughout the day (released wetting agents). In these lenses, wetting agents tend to differ based on the manufacturer and lens material.27
Blue light filtering
Blue light filtering technology is one of the newest innovations in contact lenses, including daily disposables. Patients who wear their contacts regularly for work and leisure—especially if they are among the high percentage of Americans who use their devices over 6 hours per day—might be good candidates for these filter options.
Approximately ⅓ of all visible light is defined as blue light, with the majority of it originating from the sun.28 The second largest source is artificial, including the light emanating from computer monitors/screens, smartphones, and LED televisions as well as fluorescent lights.28 A contact lens with blue light filtering technology may help to improve contrast sensitivity while reducing light sensitivity.29
When using a digital device, individuals blink less, further contributing to dry eye, ocular discomfort, and blue light scatter, which may impact visual clarity.28 There is additional evidence that a blue light filtering lens may improve tear stability in digital device users, which may be beneficial for those with dry eye.30
Notable new daily disposable options
ACUVUE OASYS MAX Sphere (Johnson & Johnson)
Launched in September 2022, the ACUVUE OASYS MAX was designed to address the needs of digital device users.31
The lens includes two primary features to meet this goal. The first is "TearStable Technology," a novel polymerization process intended to optimally distribute the wetting agent (polyvinylpyrrolidone or PVP) throughout the lens and surface, with the goal of reducing evaporation and prolonging tear film stability.
The second feature is the "OptiBlue Light Filter," which is designed to block 60% of blue-violet wavelengths, reduce light scatter and thereby improve visual clarity. (The lenses also block UVA and UVB rays.)31
In practice assessments, ECPs reported having a positive fitting experience with both the Acuvue Oasys 1-Day Max multifocal and spherical designs.32 In addition, patient testimonials include improvements in eye fatigue after digital device use as well as enhanced vision when driving under low light conditions.31
Dailies Total1 (Alcon)
Alcon’s Dailies Total1 was the first lens with water gradient technology, which is constructed of deleficon A (a new silicone hydrogel material) and is designed to mimic the corneal environment with water content reaching nearly 100% at the outermost surface to maintain surface lubricity.33
A European survey of contact lens wearers resulted in <90% of participants reporting that Dailies Total1 contact lenses were so comfortable they, at times, forgot they were wearing them.34
Additionally, Alcon’s proprietary SmarTears technology allows the Dailies Total1 to release phosphatidylcholine (PC), a naturally occurring tear component, responsible for reducing water evaporation from the ocular surface by stabilizing the lipid layer of the tear film.33
Dailies Total1 is also available in multifocal and astigmatism versions, with the toric version of the lens launched in March 2022.
Precision1 (Alcon)
Alcon’s Precision1, which hit the market in late 2019, is composed of a 51% water-content silicone hydrogel core surrounded by a permanent moisture layer of hydrogel polymers. These lenses were specifically designed with first-time contact lens users in mind to avoid dropout within the first year by addressing the common vision, comfort, and handling complaints.35
To improve both vision and comfort, they introduced SMARTSURFACE technology; this refers to a micro-thin (2-3 microns) layer of moisture anchored to the lens core that supports lens surface wettability, as the lens surface maintains more than 80% water.
The design also lends itself to a more optically precise tear film, which may enhance visual clarity. While the water gradient SiHy is similar to the Total1, the manufacturing process, along with utilized technology differentiate the Precision1 from the Dailies Total1.35,36
Of note, the Precision1 brand tends to be slightly more affordable for those patients in whom cost is a determining factor.
INFUSE (Bausch+Lomb)
The Bausch+Lomb INFUSE contact lens—so named because its material is infused with select ingredients—launched in August 2020. The SiHy daily disposable lens is composed of kalifilcon A and utilizes ProBalance Technology.
Using this trademarked contact lens hydration technology, developed by Bausch + Lomb, the lens is permeated with a range of ingredients known to improve ocular surface homeostasis and wettability; they include erythritol, glycerin, and potassium as well as moisturizers (poloxamine 1107 and poloxamer 181).37
In June of 2023, they added a multifocal INFUSE option for presbyopes to the line.
MyDay (CooperVision)
Initially launched in 2013, CooperVision’s MyDay lens family added Energys in March 2023.38 MyDay Energys employs comfilcon A material with Aquaform Technology, which aims for the optimal balance of high oxygen transmission and modulus along with high polymer compatibility to maximize wettability for comfort and diminish the symptoms of computer vision syndrome.38
MyDay Energys also features the trademarked DigitalBoost lens design with the goal of reducing eye strain and tiredness from digital devices. This single-vision aspheric design is formulated to alleviate strain by providing a +0.3D power boost by using multiple front-surface aspheric curves to simulate positive power across the entirety of the optic zone.39
A comparison of recent releases in daily disposable contact lenses
| Contact Lens | Manufacturer | Blue-Light Filtering | Aspheric Optics | UV Filtering | Wetting Agents | Lens Availability |
|---|---|---|---|---|---|---|
| ACUVUE OASYS MAX | Johnson & Johnson | Yes | No | Yes | PVP | Sphere, Multifocal |
| Dailies Total1 | Alcon | No | No | Yes | Phosphatidylcholine (PC) | Sphere, Toric, Multifocal |
| Precision1 | Alcon | No | No | Yes | Hydrogel polymers and >80% water | Sphere, Toric |
| Infuse | Bausch + Lomb | No | No | Yes | Poloxamine 1107, Poloxamer 181 | Sphere, Multifocal, Toric TBD |
| MyDay | CooperVision | No | Yes | Yes | Aquaform Technology | Sphere, Toric, Multifocal |
Table 1: Courtesy of Courtney Dryer, OD.
Based on my experience, both the Infuse and MyDay brands may perform well for those new to daily disposable lenses. The MyDay brand is available in a wide range of parameters for almost any contact lens wearer.
For more experienced lens wearers, those with dry eye, and digital device users, the Total1 or Acuvue Oasys Max lens are very comparable options and may come down to individual patient preference.
Patient selection for daily disposable contact lenses
Daily disposable lenses are likely to prove the best option and provide the highest level of comfort and performance for a variety of patients, including—but not limited to—those who:
- Suffer from allergies40
- Contend with dry eye disease41
- Have reoccurring giant papillary conjunctivitis (GPC)42
- Prone to digital eye strain43
- Are a child or adolescent44
- Compete as an athletes45,46
- Only wear lenses part-time47
In my practice, I have discovered that if asked directly, many patients with conventional replacement cycles admit their contact lenses become dry and less comfortable over several weeks or towards the end of the month, and this is a good jumping-off point to discuss daily disposables.
During this conversation, remember gender, age, systemic conditions, and ocular and systemic medications are also contributory factors for dry eye disease and its related discomfort, particularly in contact lens wearers,48,49 so make certain to attain a complete case history along with a thorough exam.
Elicit conditions and complaints that may be addressed with a change to daily disposable lenses by asking questions such as:50
- Are you having any problems with your current lenses?
- What contact lens solution do you use?
- Do you have any difficulty or confusion when inserting your lenses?
- Are you currently wearing the lenses you were most recently prescribed?
- Have you ever suffered a contact lens-related infection?
- Are your contact lenses comfortable in the morning?
- Are they less comfortable in the evening?
- How much time, on average, do you spend in front of a screen each day?
- How much time do you spend on outdoor activities?
- What improvement would you like in your lenses?
In conclusion
Today’s patients—with their active lifestyles, digital device use, and everyday visual demands—require more from their contact lenses. Despite relatively higher costs and parameter limits, the evolved lens design of today’s daily disposable contacts in conjunction with their broader prescription range and advanced technologies make them an excellent option for the modern lens wearer.
Taking all these factors into consideration, ECPs could feel comfortable in adopting daily disposable options as the cornerstone of their soft contact lens prescriptions.17
