Febrary 28, 2005
Whether you wear contacts to help you see (corrective contact
lenses), or to help you get the look you want (cosmetic contact
lenses), it is important to note:
fitted by an eye care professional is very important because the
cornea (clear outer layer of eye) can vary in shape, and eyelids
interact with contact lenses in different ways, she explains.
... Examination by slit-lamp microscope is particularly important,
because even if lenses feel fine to a patient, fit may be improper
and even potentially dangerous. ... Although there are plenty
of reputable sites that offer quality lenses, removing the eye
doctor from the process is risky because contact lens wearers
should undergo yearly eye exams to look for changes in eye health,
explains Dr. Thakrar. ... Also, buying online doesn't provide
a way for the patient to be checked after a few weeks to be sure
the new lenses fit without irritation or infection."
Even if you get the lenses
from a doctor -- and the doctor helps you fit them -- "[d]aily-wear
lenses should never be worn as extended-wear lenses. Misuse can
lead to temporary and even permanent damage to the cornea. People
who wear any type of lens overnight have a greater chance of developing
infections of the cornea. These infections are often due to poor
cleaning and lens care. Improper over wearing of contact lenses
can result in intolerance, leading to the inability to wear contact
Having the prescription
lenses not fit just right can be "potentially dangerous."
Misuse of the contact lenses (even those you have had properly
fit) "can lead to temporary and even permanent damage to
With those risks associated
with the contact lenses that are already regulated, ophthalmologists
are even more concerned with the unregulated contact lenses that
are being worn for cosmetic reasons and available everywhere from
accessory shops to gas stations.
"The College of
Optometrists urges wearers, and those contemplating buying Cosmetic
Plano Contact Lenses (non-prescription contact lenses with colours
and/or patterns on the surface), to take precautions before, during
and after, wearing these lenses. Like all contact lenses, these
novelty lenses sit directly on the front surface of the eye and,
as such, should be firstly fitted properly by a qualified optometrist
or dispensing optician. Wearers must also take note that contact
lenses cut down the amount of required oxygen to the eye and if
worn in smoky, hot and airless environments such as night-clubs,
where cosmetic lenses are increasingly popular, there can be increased
discomfort to the eye. The longer such lenses are worn, the higher
the risk in causing damage to the eye. It is also important that
wearers take proper care in cleaning and disinfecting these novelty
lenses and their storage cases. The incorrect use of contact lenses
can lead to serious optical complications, including Acanthamoeba
keratitis, a potentially blinding condition caused by not
cleaning contact lenses or their storage cases properly."
blinding" consequences, there are those who are doing more
than just urging wearers to be careful.
legislation regulating cosmetic plano contact lenses was reintroduced
in Congress on January 26 ... The Academy [American Academy
of Ophthalmology] initiated efforts to regulate cosmetic plano
contact lenses following several reports of teenagers who developed
serious eye problems after using nonprescription cosmetic lenses
purchased from flea markets, beauty parlors, gas stations and
other unauthorized vendors. ..."
So, what is meant by
"serious eye problems"?
"Dr. [Thomas] Steinemann
[a member of the American Academy of Ophthalmology] authored a
case report of six patients treated for complications related
to these lenses ... Two of his patients developed blinding complications,
requiring lengthy hospital stays. One 14-year-old patient needed
a corneal transplant after wearing cosmetic lenses without the
supervision of an eye care professional; the other patient remains
legally blind. Dr. Steinemann recently documented another 11 cases,
and three of those patients developed blinding complications requiring
hospitalization. Dr. Steinemann presented these findings earlier
this month at a meeting of the Contact Lens Association of Ophthalmologists."
It is easy to understand
why doctors with patients who develop "blinding complications
requiring hospitalization" are concerned. Doctors want to
help their patients.
If doctors are unaware
that their patients are using an unregulated (yet, potentially
harmful) product, what can they do? What if cosmetic contact lenses
were regulated and available by prescription only? Would that
solve the problem?
Corrective contact lenses
are now available by prescription only, yet they can also be ordered
over the Internet.
are unaware that contact lenses, even costume lenses not intended
to correct vision problems, need to be fitted by an eye care professional
and properly maintained. Most of the problems involve bacterial
infections and scratches on the cornea. Without supervision, consumers
-- particularly teenagers -- do not properly clean the lenses,
fail to remove them before sleeping, (which cause a five-fold
increase in the risk of bacterial infection) or share them with
Not only do all contact
lenses "need to be fitted by an eye care professional,"
they also need to be "properly maintained"?
Whether cosmetic or corrective,
"[c]linical studies suggest that the extended use of contact
lenses, particularly overnight, seriously increases the risk of
developing corneal ulcers. This condition is called ulcerative
keratitis. An ulcer can perforate or scar the cornea in a day
or two, leading to permanent scarring of the cornea or even blindness.
... Smokers are eight times more likely to develop corneal ulcers
than non-smokers, no matter which type of contact lenses they
wear. Anything that causes dry eyes, including antihistamines,
birth control pills, alcohol and air travel, can make contact
lenses uncomfortable, and can increase the risk of an eye infection.
In addition, environmental contaminants, such as dust, smoke,
sprays and pollen, can irritate the eyes when you wear contacts."
Legislation is in the
works to regulate cosmetic contact lenses. These unregulated products
have damaged the eyes of users, and the doctors who have cared
for these patients want to protect future users.
Questions of the Week:
Will legislation be enough to solve the problem? Do you think
that most teens and young adults are aware that there is a health
risk associated with the use cosmetic contact lenses (or even
the improper use of corrective contact lenses)? How will legislation
to regulate cosmetic contact lenses affect the choices of those
who really want to use them? What additional risks can patients
who choose to get contact lenses from an alternative source encounter?
Whether or not the legislation
passes: How would you create an education campaign to reach your
peers? What do they need to know about the risks involved with
the use of unregulated contact lenses? What do they need to know
about the proper use of both regulated and unregulated contact
lenses? Why is "where" people get contact lenses important?
How could you present this material in a way that would get your
audience to understand the possible risks and consequences of
improper use? Is there any other information potential users might
need in order to make informed decisions?
Please email me with any ideas or suggestions.
Note: Due to increasing amounts of SPAM sent to this account, please include "QOW" in the subject line when sending me email.
I look forward to reading
what you have to say.
Health Community Coordinator
Access Excellence @ the National Health Museum