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 listed 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 highlights cutting-edge innovations in soft contact lenses, including new materials, advanced optics, adverse event updates, and aftercare improvements.
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: 101164-CL
DISCLOSURES
Debarun Dutta, PhD, reports no conflicts of interest. James Wolffsohn, PhD, reports no conflicts of interest.
DISCLOSURE ATTESTATION
The contributing faculty member has attested to the following:
1. That the relationships/affiliations noted will not bias or otherwise influence his involvement in this activity;
2. That practice recommendations given relevant to the companies with whom they have 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
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NO-FEE CONTINUING EDUCATION
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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 ©2025. All rights reserved.
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Release date:November 1, 2025
Expiration Date: October 27, 2028
RECENT ADVANCEMENTS in soft contact lens technology have significantly improved both clinical outcomes and patient comfort. Innovations in biomimetic hydrogels and enhanced silicone hydrogel (SiHy) formulations have increased hydration and oxygen permeability, addressing common issues such as hypoxia-related changes; however, more work is needed to reduce contact lens-related dryness, discomfort, and irritation. Nanotechnology is being integrated to create antimicrobial surfaces, often embedded in the solutions of blister packs, while sustainable materials are gaining traction to reduce environmental impact.
Beyond material science, lenses are now being developed for therapeutic and diagnostic applications, including drug delivery and real-time health monitoring via embedded biosensors. Design improvements such as custom edge profiles, multifocal optics for presbyopia, and dual-focus soft lenses for myopia control are enhancing visual performance across diverse patient groups. Additionally, digital fitting technologies are enabling highly personalized lens solutions, ensuring optimal fit and function. These innovations collectively mark a transformative era in soft lens development, with implications for both routine vision correction and specialized ophthalmic care.
A multidimensional strategy now underpins the development and clinical deployment of soft contact lenses, reflecting their expanding role in modern eye care. Contemporary designs integrate highly biocompatible materials, frequently offered in daily disposable formats, to enhance ocular health and patient convenience. These lenses are engineered with advanced optical technologies to meet a broad spectrum of visual requirements, including single vision, toric correction for astigmatism, multifocal solutions for presbyopia, and peripheral defocus or contrast-reducing element configurations for effective myopia control. This comprehensive approach positions soft lenses as a versatile platform for addressing diverse refractive and therapeutic needs, aligning with the evolving expectations of both clinicians and patients. Below, the authors detail the latest and greatest innovations in soft CLs, which are having a substantial impact on the way we practice today. The authors explored recent innovations in lens materials, surface chemistry, adverse events, optics, myopia, and therapeutics.
Materials
Hydrogels and Silicone Hydrogels: Contact lenses began their journey with a humble polymethylmethacrylate (PMMA) material; though revolutionary at the time, PMMA had its limitations.1 Most notably, it didn’t allow oxygen to pass through to the eye. Next came 2-hydroxyethyl methacrylate (HEMA), a softer, more comfortable alternative that offered some oxygen permeability through its water content. But scientists and eyecare practitioners (ECPs) continued to push boundaries, leading to the development of SiHy lenses in the 1990s, designed specifically to maximize oxygen flow to the cornea. The secret of SiHy lens success lay in its chemistry, creating pathways that allowed oxygen to travel freely through the lens matrix.
But every innovation comes with its own set of challenges. The inclusion of silicone and sometimes fluorine made these lenses more hydrophobic. This change in surface properties affected how substances from the tear film interacted with the lens. Alternative approaches included “shielding” the hydrophobic surface with “plasma coating” or adding “internal wetting agent” to the lens matrix, rendering the surface hydrophilic.
Interestingly, while proteins such as lysozyme and albumin adhered less to SiHy lenses compared to HEMA,2 cholesterol showed higher deposition.3 This shift in deposition patterns raised new questions for ECPs.
One of the most important problems encountered with both hydrogel and SiHy lenses was that proteins accumulated on them. Even a slight buildup of protein could reduce oxygen transmission—a subtle effect, but enough to impact comfort and ocular health. Over time, protein accumulation has been linked to discomfort and even adverse events, reminding practitioners that every material choice carries consequences.4
As contact lens technology advanced, a novel solution emerged to improve comfort and hygiene and reduce surface deposits: daily disposable lenses. These lenses offered a fresh start each day, with reduced need for rigorous cleaning routines and fewer worries about buildup or contamination. Then, a complete rethinking of lens chemistry resulted in hydrophilic space within the lens matrix, making lenses more compatible with the eye’s natural environment. Maximizing water within the lens matrix or at the surface is a strategy commonly used to exploit the high oxygen permeability of silicone while masking its hydrophobic nature. This not only improved comfort but also helped maintain hydration throughout the day.5 To further combat dehydration, scientists introduced barrier technologies using ingredients that functioned as shields, locking in moisture and keeping the lens surface smooth and wettable.
Adverse Events and Novel Antimicrobial Materials: Although it is generally safe and effective, soft contact lens wear can occasionally lead to complications. The most serious complication is microbial keratitis (MK), which affects around 4 in 10,000 wearers of daily lenses annually and up to 20 in 10,000 wearers of overnight lenses and is commonly caused by bacteria such as Pseudomonas aeruginosa and Staphylococcus aureus.6
More frequently, contact lens wear is associated with inflammation (Figure 1), also driven by microbial adhesion. This affects approximately 5 in 100 wearers per year. To address it, antimicrobial solutions are being developed, such as silver embedded in lenses, lenses incorporating quorum-sensing inhibitors, and lenses functionalized with cationic antimicrobial peptides (AMPs).7,8 The AMP-coated lenses have undergone Phase III clinical trials, demonstrating a 67% reduction in bacterially driven inflammation, however the peptide was attributed to degradation of the AMPs by tear proteases. AMP mimics are being developed as an alternative that resist protease degradation and retain high broad spectrum antimicrobial activity.7
Lens Materials with UV Protection: For the last several decades, ECPs have been interested in the idea that contact lenses could protect the eyes from harmful ultraviolet rays. It seemed obvious that eyes are constantly exposed to sunlight and shielding them could prevent long-term damage. As research progressed, the importance of UV protection became even clearer.
Recent studies revealed that blocking UV radiation doesn’t just protect the eye’s surface, it may also help preserve its ability to focus.9 This suggests that wearing UV-blocking soft lenses over the long term could actually delay the onset of presbyopia, the age-related loss of near vision. These lenses also may serve as a barrier for the limbal region, a vital area at the edge of the cornea that houses stem cells, essential for corneal health.
Drug Delivery and Therapeutic Lenses: Utilizing soft contact lenses as drug delivery systems has been explored for a long time. The challenge has always been finding the right drugs and learning which diseases could benefit from this method. Compared to eye drops, only 5% of which reach the target, contact lenses offer enhanced bioavailability and more consistent dosing, provided drug loading is uniform across lenses. To achieve controlled release, drugs are encapsulated in carriers such as nanoparticles, cyclodextrins, and poly(lactic-co-glycolic acid) (PLGA) films, or their solubility is boosted using microemulsions, allowing for greater drug loading and gradual release.
Some approaches modify the lens material itself using molecular imprinting to create drug-specific binding sites, while ionic additives enhance interactions with charged drugs. Vitamin E coatings have also been explored as biocompatible barriers to slow drug diffusion.10 The range of drugs tested includes antimicrobials, anti-inflammatories, immunomodulators, anti-glaucoma agents, and anti-allergy medications, with studies spanning lab experiments to animal models. A major milestone was reached with the commercial release of a daily disposable lens delivering ketotifen fumarate, approved in Canada, Japan, and by the US Food and Drug Administration,11 but recently this has been discontinued globally.12
Theragnostic: Soft contact lenses are being investigated as tools to monitor health and deliver treatment in real time. By integrating microfabrication and sensing technologies, these smart lenses could detect changes in the eye and respond by releasing medication—without the need for invasive procedures. For example, in dry eye disease (DED), these lenses may monitor tear biomarkers such as matrix metalloproteinase-9 (MMP-9) and protease inhibitors in tears. When levels rise, the lens could trigger drug release, providing relief precisely when needed. For glaucoma, contact lenses have been designed to track intraocular pressure (IOP).13 By combining this sensing capability with drug delivery systems, future lens designs could detect elevated IOP and automatically release pressure-lowering medication without manual intervention.
Smart lenses equipped with glucose sensors are also under investigation for diabetes management. These lenses can monitor tear glucose levels, and recent studies have demonstrated that ultra-thin electronics embedded in the lens material can enable both continuous monitoring and controlled drug release.14 In animal models of diabetic retinopathy, this technology successfully delivered treatment in response to real-time glucose readings.
These innovations represent a promising leap forward in personalized, noninvasive health care, where a simple contact lens could become a powerful diagnostic and therapeutic device. Though still emerging, these innovations hint at a future in which contact lenses become personalized health platforms, detecting, responding, and treating conditions seamlessly, all while sitting comfortably on the ocular surface, providing refractive correction.
Advances in Contact Lens Optics
Over the past several decades, contact lens technology has evolved well beyond its original purpose of providing a convenient alternative to spectacles. Advances in optical design, alongside material science and manufacturing precision, have transformed contact lenses into highly sophisticated medical devices capable of correcting complex refractive errors, enhancing vision quality, and even reducing future visual impairment.
One of the most significant advances has been the development of multifocal and extended depth-of-focus (EDOF) lenses for ameliorating presbyopia.15 Unlike the original bifocal contact lenses, modern multifocal and EDOF optics distribute light more efficiently across different focal ranges, reducing the compromises between near, intermediate, and distance vision. Computational modeling and wavefront-guided design have enabled lenses that minimize visual disturbances such as halos and glare, leading to better adaptation and higher patient satisfaction.16
Toric contact lenses have also seen substantial improvements. Earlier versions often rotated unpredictably on the eye, compromising vision for people with astigmatism, especially those who have a higher cylindrical correction. Advances in stabilization techniques now ensure more consistent orientation. Combined with high-precision lathing and molding technologies, these innovations provide sharper, more stable vision across a broader range of astigmatic prescriptions.17
Another frontier has been the integration of wavefront-guided and customized optics. Traditional lenses correct lower-order aberrations like myopia, hyperopia, and astigmatism, but higher-order aberrations can significantly impact night vision, contrast sensitivity, and overall visual quality. Using corneal topography and aberrometry, manufacturers can now design customized contact lenses that counteract individual optical imperfections, particularly in scleral and rigid corneal lenses. This level of personalization is especially valuable for patients who have keratoconus or postsurgical irregular corneas.17
Contact lenses are also being designed with myopia control optics, a rapidly growing field given the global rise of myopia. Based on the animal studies that showed that the eye grows less with positive defocus (an image shill in front of the retina) and that the control is localized in the peripheral retina, peripheral defocus optics have been added to contact lenses to alter the retinal image profile, resulting in a slowing of axial elongation when these lenses are worn by children.18,19 Clinical studies have shown these multifocal designs can significantly reduce the rate of myopia progression, offering a promising public health intervention.
Applications and Aftercare
Contact lens practice has evolved over several decades, shaped by experience, tradition, and clinical intuition. Despite this, some contact lens care aspects still lack validation through evidence-based science. A recent review, for instance, questioned the value of measuring vertical palpebral aperture (VPA) in contact lens patients, suggesting there is no clear evidence of its benefit.20 New contact lens wearers often require closer monitoring, especially during the first 2 months after fitting, due to a high dropout rate.21 However, with recent advancements in lens materials and a significantly reduced rate of inflammatory events, many ECPs have adopted a more streamlined approach. These advances underpin a recent report that shows there is no clinical justification for recommending a gradual adaptation period for neophytes with modern reusable soft contact lenses, which ECPs have done traditionally.22
Overall, the findings contribute to growing evidence that such guidance is unnecessary in routine soft lens wear.22 For patients fitted with daily disposable lenses, a 1-day fitting followed by annual follow-up has become common practice. These follow-ups may be conducted in person or through scheduled telephone check-ins. Expanding telehealth technologies offer ECPs a convenient way to triage potential complications and monitor patients’ ocular health through video consultations and analysis of signs and symptoms.23 A paper presented at the 2025 British Contact Lens Association annual meeting showed that soft spherical and toric daily disposable lenses of the same material and design show no clinically significant fit differences, even with power variations up to ±2.00DS.24 This enables ECPs to fit initial lenses more flexibly, reduce repeat visits, and optimize trial lens use without compromising clinical outcomes.
Summary
In the last 2 decades, soft contact lenses have advanced significantly in comfort, safety, and functionality. SiHy materials now allow high oxygen transmission, supporting healthier, longer wear. Daily disposables have become popular for their hygiene and convenience. Innovations in optics such as myopia control lenses, multifocal designs, and digital customization have expanded clinical applications. These innovations have transformed contact lenses into not just vision correction tools, but platforms for ocular health management and wearable technology.
References
1. Lippman JI. Contact lens materials: a critical review. CLAO J. 1990;16(4):287-291.
2. Bohnert JL, Horbett TA, Ratner BD, Royce FH. Adsorption of proteins from artificial tear solutions to contact lens materials. Invest Ophthalmol Vis Sci. 1988;29(3):362-373.
3. Hatou S, Fukui M, Yatsui K, Mochizuki H, Akune Y, Yamada M. Biochemical analyses of lipids deposited on silicone hydrogel lenses. J Optom. 2010 Jul;3(3):164-8. doi: 10.1016/S1888-4296(10)70023-6
4. Babaei Omali N, Heynen M, Subbaraman LN, et al; Performance of Contact Lens Solutions Study Group. Impact of Lens Care Solutions on Protein Deposition on Soft Contact Lenses. Optom Vis Sci. 2016 Aug;93(8):963-972. doi: 10.1097/OPX.0000000000000928
5. Efron N, Morgan PB, Cameron ID, Brennan NA, Goodwin M. Oxygen permeability and water content of silicone hydrogel contact lens materials. Optom Vis Sci. 2007 Apr;84(4):328-337. doi: 10.1097/OPX.0b013e31804375ed
6. Szczotka-Flynn LB, Shovlin JP, Schnider CM, et al. American Academy of Optometry Microbial Keratitis Think Tank. Optom Vis Sci. 2021;98(3):182-198. doi:10.1097/OPX.0000000000001664
7. Kalaiselvan P, Konda N, Pampi N, et al. Effect of Antimicrobial Contact Lenses on Corneal Infiltrative Events: A Randomized Clinical Trial. Transl Vis Sci Technol. 2021;10(7):32. doi:10.1167/tvst.10.7.32
8. Dutta D, Willcox MD. Antimicrobial contact lenses and lens cases: a review. Eye Contact Lens. 2014;40(5):312-324. doi:10.1097/ICL.0000000000000056
9. Wolffsohn JS, Dhallu S, Aujla M, et al. International multi-centre study of potential benefits of ultraviolet radiation protection using contact lenses. Cont Lens Anterior Eye. 2022;45(6):101593. doi:10.1016/j.clae.2022.101593
10. Jones L, Hui A, Phan CM, et al. CLEAR - Contact lens technologies of the future. Cont Lens Anterior Eye. 2021;44(2):398-430. doi:10.1016/j.clae.2021.02.007
11. Johnson & Johnson Vision. Johnson & Johnson Vision receives approval of world’s first and only drug-releasing combination contact lens for vision correction and allergic eye itch: ACUVUE® Theravision™ with ketotifen. PR Newswire. March 24, 2021. Accessed September 29, 2025. https://www.prnewswire.com/news-releases/johnson--johnson-vision-receives-approval-of-worlds-first-and-only-drug-releasing-combination-contact-lens-for-vision-correction-and-allergic-eye-itch-acuvue-theravision-with-ketotifen-301254442.html
12. Johnson & Johnson Vision. Product Discontinuations - ACUVUE® Theravision® with Ketotifen. 2024. Accessed September 29, 2025. https://www.jnjvisionpro.com/en-ca/discontinued-products/.
13. Mansouri K, Weinreb R. Continuous 24-hour intraocular pressure monitoring for glaucoma—time for a paradigm change. Swiss Med Wkly. 2012;142:w13545. Published 2012 Mar 28. doi:10.4414/smw.2012.13545
14. Park J, Kim J, Kim SY, et al. Soft, smart contact lenses with integrations of wireless circuits, glucose sensors, and displays. Sci Adv. 2018;4(1):eaap9841. doi:10.1126/sciadv.aap9841
15. Bakaraju RC, Tilia D, Sha J, et al. Extended depth of focus contact lenses vs. two commercial multifocals: Part 2. Visual performance after 1 week of lens wear. J Optom. 2018;11(1):21-32. doi:10.1016/j.optom.2017.04.001
16. Morgan PB, Efron N, Papas E, et al. BCLA CLEAR Presbyopia: Management with contact lenses and spectacles. Cont Lens Anterior Eye. 2024;47(4):102158. doi:10.1016/j.clae.2024.102158
17. Nguyen MT, Wright MH, Hall B, Brunson PB. Patient Satisfaction with a Novel Daily Toric Contact Lens in Individuals with Previous Lens Failures. Clin Ophthalmol. 2025;19:1229-1236. doi:10.2147/OPTH.S510740
18. Berntsen DA, Ticak A, Orr DJ, et al. Axial Growth and Myopia Progression After Discontinuing Soft Multifocal Contact Lens Wear. JAMA Ophthalmol. 2025;143(2):155-162. doi:10.1001/jamaophthalmol.2024.5885
19. Chamberlain P, Hammond DS, Bradley A, et al. Eye growth and myopia progression following cessation of myopia control therapy with a dual-focus soft contact lens. Optom Vis Sci. 2025;102(5):353-358. doi:10.1097/OPX.0000000000002244
20. Wolffsohn JS, Dumbleton K, Huntjens B, et al. BCLA CLEAR - Evidence-based contact lens practice. Cont Lens Anterior Eye. 2021;44(2):368-397. doi: 10.1016/j.clae.2021.02.008
21. Efron N, Morgan PB. Rethinking contact lens aftercare. Clin Exp Optom. 2017 Sep;100(5):411-431. doi: 10.1111/cxo.12588
22. Wolffsohn JS, Ghorbani-Mojarrad N, Vianya-Estopa M, et al. Fast versus gradual adaptation of soft monthly contact lenses in neophyte wearers. Cont Lens Anterior Eye. 2022;45(4):101469. doi:10.1016/j.clae.2021.101469
23. Nagra M, Vianya-Estopa M, Wolffsohn JS. Could telehealth help eye care practitioners adapt contact lens services during the COVID-19 pandemic? Cont Lens Anterior Eye. 2020;43(3):204-207. doi:10.1016/j.clae.2020.04.002
24 Coates A, Olner C, Dhanabalan C, Dutta D. Assessment of impact of soft contact lens power on fit. Poster presented at: BCLA 2025. June 5-7, 2025, Birmingham, United Kingdom. coopervision.co.uk/bcla/5