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Soft toric contact lenses have been available to eye care practitioners for over 30 years – a search of the literature reveals articles written on this subject dating back to 1978. Of course, the lenses available today have benefited from substantial improvements in reproducibility, material technology, modality, design and availability of refractive powers. So with all of these improvements, are all astigmatic patients now benefiting from the superior vision and comfort afforded to them by wearing modern soft toric lenses? The literature would suggest that this may not be the case and this article seeks to answer the concerns and likely causes which prevent practitioners from offering these options to more of their astigmatic patients.