To compare the clinical performance of the Optima soft toric contact lens versus the CSI soft toric contact lens.Twenty-one patients (five affected by allergies) were followed at 2-week intervals for 4 months in a prospective, randomized, double-masked study comparing the Optima soft toric contact lens to the CSI soft toric contact lens.The patients preference evaluation revealed a statistically significant preference for the CIS toric lens in 14 of 16 variables including overall lens preference (P = 0.0001). The two remaining variables, lens awareness (P = 0.07) and foreign body sensation (P = 0.06), showed a trend toward a preference for the CSI toric lens. The less sensitive symptom ranking questionnaire revealed a significance for, or a trend toward, a significant difference in three of 10 variables, all in favor of the CSI toric lens. The mean degrees of axis rotation were 3.5* for the CSI lens and 7.6* for the Optima lens (P = 0.0001). Factor analysis identified a clustering of variables around specific ranked factors. Factors related to 1) allergy status (.93); 2) visual function (.87); 3) ocular surface (.82); and 4) refractive characteristics (.71) were most significant in determining the overall clinical performance of these toric lenses. Allergic patients significantly preferred the CSI toric lens for 15 of 16 variables, whereas non-allergic patients preferred the CSI lens for seven of 16 variables.The patient preference, symptom ranking, and axis rotation analysis of this study revealed a superior performance by the CSI toric contact lens when compared to the Optima toric contact lens. Allergic patients revealed an even stronger and statistically significant preference for the CSI lens when compared to non-allergic patients.