Can patients sleep in monthly lenses if the label allows extended wear?

Overnight wear is considered only with lenses approved for extended wear and still carries a substantially higher infection risk than daily removal, so many clinicians favor daily wear schedules.

How often should a monthly lens case be replaced?

Cases should be rinsed with solution (never water), air dried, and replaced roughly every 1–3 months or with each new solution bottle to limit biofilm and contamination.

What are common reasons for blur near the end of the monthly cycle?

End-of-cycle blur is usually deposit-related; stronger care systems or more frequent replacement (biweekly or daily) often improve optical clarity and comfort.

Which patients are better served by daily or biweekly lenses instead of monthlies?

Patients with recurrent inflammatory events, poor case hygiene, or deposit-related symptoms often do better in daily or biweekly lenses, even when monthly lenses might be cheaper on paper.

Monthly Replacement Contact Lens Guide

Thirty-day replacement schedule for reusable soft lenses

Monthly Replacement Contact Lenses

Clinical role and parameter advantages

Monthly replacement lenses remain a central modality in soft lens practice, particularly for full-time wearers and for prescriptions that demand broader parameter ranges. Many silicone hydrogel monthly portfolios provide high-cylinder toric options, extended plus and minus powers, and multifocal designs that may not be available in all daily or intermediate (biweekly/weekly) lines.

Parameter reach: Monthly lenses frequently offer the widest combinations of sphere, cylinder, and add powers within a brand family, making them a common choice for high ametropia and higher-cylinder toric fits.
Cost efficiency for full-time wear: For patients wearing lenses most days of the week and adhering to care guidelines, monthly lenses are typically less expensive per year than daily disposables, even when solution costs are included.

Hygiene, care systems, and solution compatibility

Successful monthly lens wear depends heavily on reliable care and replacement habits. Lenses should be rubbed and rinsed after removal to disrupt biofilm and remove deposits, then stored in fresh solution in a clean case. It is generally preferable to recommend a specific care system, such as a hydrogen peroxide regimen or a premium multipurpose solution, rather than leaving patients to select generic alternatives. Some silicone hydrogel materials are more prone to solution-related staining or discomfort with certain formulations, so matching the lens material and care system is an important component of the overall fit, alongside base curve and diameter decisions.

When monthly lenses are (and are not) the best choice

Monthly lenses are often an excellent option for motivated, full-time wearers who benefit from broad parameter availability and who can maintain consistent care and replacement schedules. They may be less ideal in patients with a history of poor case hygiene, recurrent inflammatory events related to deposits, or significant end-of-cycle symptoms, where more frequent replacement (biweekly or daily disposable lenses) may provide a safer or more comfortable alternative.

Monthly Replacement Sphere Contact Lenses

Brand	Material	Dk	BC	Dia	Sph / Steps
Acuvue Vita SiHyMonthly6	senofilcon C	147	8.4/8.8	14	+8.00 to -12.000.25, 0.50 over ± 6.00
Air Optix Aqua SiHyMonthly6	lotrafilcon B	110	8.6	14.2	+6.00 to -10.000.25, 0.50 over -8.00
Air Optix Colors SiHyMonthly2/6	lotrafilcon B	138	8.6	14.2	+6.00 to -8.000.25, 0.50 over -6.00
Air Optix Night & Day Aqua SiHyMonthly6	lotrafilcon A	175	8.4/8.6	13.8	+6.00 to -10.000.25, 0.50 over -8.00
Air Optix plus Hydraglyde SiHyMonthly6	lotrafilcon B	138	8.6	14.2	+8.00 to -12.000.25, 0.50 over +6.00/-8.00
Biofinity Energys SiHyMonthly6	comfilcon A	160	8.6	14	+8.00 to -12.000.25, 0.50 over ± 6.00
Biofinity/Biofinity XR SiHyMonthly6	comfilcon A	160	8.6	14	+15.00 to -20.000.25, 0.50 over ± 6.00
Extreme H20 Monthly Monthly6	hioxifilcon D	21	FlatMedianSteep	14	Flat: -0.50 to -6.00Median: +1.00 to +4.00, -0.50 to -8.00Steep: -0.50 to -8.000.25, 0.50 over -6.00
Miru 1month SiHyMonthly6	asmofilcon A	161	8.3/8.6	14	+6.00 to -13.000.25, 0.50 over -6.00
Proclear Monthly6	omafilcon B	21	8.2/8.6	14.2	8.2: -0.25 to -10.00, 8.6: +20.00 to -20.000.25, 0.50 over ±6.00
PureVision2 SiHyMonthly6	balafilcon A	91	8.6	14	+6.00 to -12.000.25, 0.50 over -6.00
Total30 SiHyMonthly6	lehfilcon A	154	8.4	14.2	+8.00 to -12.000.25, 0.50 over +6.00/-8.00
ULTRA SiHyMonthly6	samfilcon A	163	8.5	14.2	+6.00 to -12.000.25, 0.50 over -6.00

Monthly Replacement Toric Contact Lenses

Brand	Material	Dk	BC	Dia	Sph / Steps	Cyl / Axis
Acuvue Vita for Astigmatism SiHyMonthly6	senofilcon C	129	8.6	14.5	+4.00 to -9.000.25, 0.50 over -6.00	-0.75 to -2.25pl to -6.00: -0.75 to -1.75 (10° full), -2.25 (10/20/70/80/90/100/110/160/170/180°)-6.50 to -9.00: -0.75 to -1.75 (10/20/70/80/90/100/110/160/170/180°)+0.25 to +4.00: -0.75 to -1.75 (10/20/70/80/90/100/110/160/170/180°)
Air Optix for Astigmatism SiHyMonthly6	lotrafilcon B	110	8.7	14.5	+6.00 to -10.000.25, 0.50 over -6.00	-0.75 to -2.2510° full
Air Optix plus Hydraglyde for Astigmatism SiHyMonthly6	lotrafilcon B	110	8.7	14.5	+6.00 to -10.000.25, 0.50 over -6.00	-0.75 to -2.2510° full
Biofinity Toric SiHyMonthly6	comfilcon A	116	8.7	14.5	+8.00 to -10.000.25, 0.50 over +6.00	-0.75 to -2.2510° full
Extreme H20 54 Toric Monthly6	hioxifilcon D	21	8.6	14.2	+4.00 to -6.000.25	Low Cyl, -0.65: (15/75/90/105/165/180°)Mid Cyl, -1.25: (10/20/80/90/100/160/170/180°)
Extreme H20 TORIColors Monthly6	hioxifilcon D	21	8.6	14.2	pl to -4.000.25, 0.50 over -2.50	Low Cyl, -0.65: (15/90/180°)Mid Cyl, -1.25: (10/90/180°)
Miru 1month Toric SiHyMonthly6	asmofilcon A	161	8.6	14	pl to -10.000.25, 0.50 over -6.00	-0.75 to -1.7510° full
Proclear Toric Monthly6	omafilcon B	25	8.4/8.8	14.4	+6.00 to -8.000.25, 0.50 over -6.00	-0.75 to -2.2510° full
Proclear Toric XR Monthly6	omafilcon B	39	8.4/8.8	14.4	+10.00 to -10.000.25, 0.50 over ±6.00	-0.75 to -5.75+6.25 to +10.00 & -8.50 to -10.00: -0.75 to -2.25 (5° full)+10.00 to -10.00: -2.75 to -5.75 (5° full)
PureVision2 for Astigmatism SiHyMonthly6	balafilcon A	91	8.9	14.5	+6.00 to -9.000.25, 0.50 over -6.00	-0.75 to -2.25(10° full)
Total30 for Astigmatism SiHyMonthly6	lehfilcon A	123	8.6	14.5	+8.00 to -10.000.25, 0.50 over ±6.001.00 for pl to +4.000.50 for -0.50 to -6.00 (-2.75cyl)	-0.75 to -2.75+8.00 to -10.00: -0.75 to -2.25 (10° full) pl to +4.00: -2.75 (10/20/30/70/80/90/100/110/150/160/170/180°) -0.50 to -6.00: -2.75 (10/20/30/70/80/90/100/110/150/160/170/180°)
ULTRA for Astigmatism SiHyMonthly6	samfilcon A	114	8.6	14.5	+6.00 to -9.000.25, 0.50 over -6.00	-0.75 to -2.75(10° full)

Monthly Replacement Multifocal Contact Lenses

Brand	Material	Dk	BC	Dia	Sph / Steps	Add
Air Optix Aqua Multifocal SiHyMonthly6	lotrafilcon B	110	8.6	14.2	+6.00 to -10.000.25	Lo/Med/Hi
Air Optix plus Hydraglyde Multifocal SiHyMonthly6	lotrafilcon B	110	8.6	14.2	+6.00 to -10.000.25	Lo/Med/Hi
Biofinity Multifocal SiHyMonthly6	comfilcon A	128	8.6	14	+6.00 to -10.000.25, 0.50 over -6.00	D / N+1.00/1.50/2.00/2.50
Miru 1month Multifocal SiHyMonthly6	asmofilcon A	161	8.6	14.2	+6.00 to -13.000.25, 0.50 over -6.00	Low (+1.00)
Proclear Multifocal Monthly6	omafilcon B	17	8.7	14.4	+6.00 to -8.000.25, 0.50 over -6.00	D / N+1.00/1.50/2.00/2.50
Proclear Multifocal XR Monthly6	omafilcon B	21	8.4/8.8	14.4	+20.00 to -20.000.25, 0.50 over ±6.00	D / N+1.00 to +4.00, (0.50 steps)
PureVision2 for Presbyopia SiHyMonthly6	balafilcon A	91	8.6	14	+6.00 to -10.000.25	Low (+0.75 to +1.50)High (+1.75 to +2.50)
ULTRA for Presbyopia SiHyMonthly6	samfilcon A	163	8.5	14.2	+6.00 to -10.000.25	Low (+0.75 to +1.50)High (+1.75 to +2.50)

Monthly Replacement Multifocal Toric Contact Lenses

Brand	Material	Dk	BC	Dia	Sph / Steps	Cyl / Axis	Add
Biofinity Toric Multifocal SiHyMonthly6	comfilcon A	116	8.7	14.5	+10.00 to -10.000.25, 0.50 over ± 6.00	-0.75 to -5.755° full	D / N+1.00/1.50/2.00/2.50
Proclear Multifocal Toric Monthly6	omafilcon B	21	8.4/8.8	14.4	+20.00 to -20.000.25, 0.50 over -6.00	-0.75 to -5.755° full	D / N+1.00 to +4.00, (0.50 steps)
ULTRA Multifocal for Astigmatism SiHyMonthly6	samfilcon A	114	8.6	14.5	+4.00 to -6.000.25	-0.75 to -2.75-0.75 to -1.75 (10° full), -2.25 to -2.75 (10/20/70/80/90/100/110/160/170/180°)	Low (+0.75 to +1.50)High (+1.75 to +2.50)

Monthly Contact Lens FAQs

Can patients sleep in monthly lenses if the label allows extended wear?: Only lenses specifically approved for extended or overnight wear should be considered for sleeping in, and even with those designs, overnight wear is associated with a substantially higher risk of microbial keratitis and inflammatory events compared with daily removal. Many clinicians prefer a daily wear schedule, with lenses removed before sleep, even when an extended wear indication exists, reserving true overnight wear for clearly defined clinical scenarios and with appropriate informed consent and follow-up.
How often should a monthly lens case be replaced?: Lens cases are a common source of bacterial and biofilm contamination in reusable systems. After each use, the case should be emptied, rinsed with fresh disinfecting solution (never tap water), and allowed to air dry. Most guidelines recommend replacing the case every one to three months, or whenever it appears damaged or discolored. Providing a new case with each solution bottle is a practical way to support this schedule.
What are common reasons for blur near the end of the monthly cycle?: Progressive blur or fluctuating vision toward the end of the month is often related to deposits and surface changes. Protein, lipid, cosmetic residues, and environmental contaminants can accumulate on the lens, reducing wettability and altering the optical surface. If this occurs consistently despite appropriate care, options include switching to a hydrogen peroxide cleaning system, moving to a biweekly replacement schedule, or considering daily disposables to provide a fresh surface each day.
Which patients are better served by daily or biweekly lenses instead of monthlies?: Patients with recurrent CLARE or infiltrative events, poor case hygiene, inconsistent replacement, or significant deposit-related symptoms are often better candidates for daily disposables or biweekly lenses. Similarly, highly allergy-prone wearers or those with demanding schedules that make care routines unreliable may benefit from more frequent replacement, even if monthly lenses would be more economical on paper. Modality decisions should weigh ocular surface status, adherence, and parameter needs alongside cost.