The over-the-counter contact lenses, which are illegal in the United Stated, are not worn to correct refractive errors. Instead, they are tinted to change the appearance of eye color or have various shapes and designs, ranging from animal eyes to sports team logos. Problems associated with illegally sold contact lenses were first reported by the American Academy of Ophthalmology, the Eye M.D. Association, in July 2002. The Academy received reports from a Myrtle Beach, S.C. ophthalmologist who treated several patients for eye problems after they wore contact lenses purchased from local beachwear stores.
All decorative contact lens are not illegal, however, all contact lenses, whether corrective or decorative, need to be fitted and monitored by an eye care professional. Editor-in-chief of Eye & Contact Lens, H. Dwight Cavanagh, MD, Ph.D., F.A.C.S., said, "This report underscores the need to continue to view contact lenses as medical devices. They need to be fitted and prescribed by licensed health care professionals. As seen in this report, the unregulated sale of contact lenses represents a grave danger to the public."
"Many people mistakenly think decorative contact lenses are just like sunglasses. If you're not wearing the lenses to correct refractive errors, you don't need a prescription. This is a dangerous misconception," said one of the report's authors, Thomas L. Steinemann, MD, of the MetroHealth Medical Center Eye Clinic in Cleveland and associate professor of ophthalmology at Case Western Reserve University's Department of Ophthalmology. "People who wear lenses purchased from unlicensed vendors have been given no instructions and often practice risky behavior. They don't clean or disinfect the lenses. They sleep in them. They swim in them. The even swap them with their friends."
Six patients, from 14 to 32 years of age, are discussed in the observational case report. The patients, five females and one male, experienced vision-threatening problems after wearing contact lenses purchased from unlicensed vendors, including gas stations, beauty salons, video stores, corner stores and flea markets. They did not receive any instructions on how to properly care for or wear the contact lenses. And – all of them were sold individual contact lenses without a prescription, an examination or a fitting by an eye care professional such as an ophthalmologist. According to the case report:
- One 14-year-old patient nearly lost her eye after contracting a serious bacterial infection. She was hospitalized for four days and was left with a corneal scar that affected her vision. The patient later required a corneal transplant, and will need regular observation and treatment for the rest of her life.
- After falling asleep with her contact lenses still on, a 19-year-old woman awoke to burning and light sensitivity in both eyes. She said she had been buying the contact lenses from open-boxed sets without a prescription for the past five years and had worn contact lenses continuously for up to five months on previous occasions.
- Another 19- year-old-woman, who complained of light sensitivity and burning in her right eye, said she purchased her over-the-counter contact lenses from gas stations, hair salons and corner stores for years, along with her friends, teenage sisters and mother.
- A 30-year-old woman continued to wear her contact lenses, despite experiencing worsening symptoms over a two-week period that included right eye pain, tearing, light sensitivity and redness. In an attempt to relieve the redness and lubricate the lenses she used over-the-counter eye drops before finally seeking medical treatment.
- A 32-year-old man scratched his cornea while trying to remove costume contact lenses. He had developed painful inflammation from a lens that did not fit. He had purchased the contact lenses for Halloween a week earlier at a flea market. This required multiple treatments over several weeks.
- A 24-year-old woman became legally blind from corneal scarring in one eye, after she developed conjunctivitis (pink eye) and was treated for herpes simplex and bacterial keratitis. She reported wearing disposable contact lenses for approximately six months, often sleeping in them.
The report says the demand for decorative contact lenses continues to increase, particularly among teenage girls and young women, with consumers spending approximately $180 million on them so far. Colored contact lenses are one of the fastest growing segments in the contact lens market. Because of the growing market, the report states: "American young people remain at risk as a major target of the unauthorized sale of decorative contact lenses."
Problems that may result from this risky behavior include corneal abrasions, epithelial keratitis, infectious ulcers and the blinding Acanthamoeba organism. Although no cases have been documented, the report also suggests HIV transmission is a potential risk among those who exchange their contact lenses with others.
The American Academy of Ophthalmology is the world's largest association of eye physicians and surgeons--Eye M.D.s--with more than 27,000 members worldwide. For more information about eye health care, visit the Academy's partner Web site, the Medem Network, at www.medem.com/eyemd. To find an Eye M.D. in your area, visit the Academy's Web site at www.aao.org.
Journal
Eye & Contact Lens Science & Clinical Practice