Report cites risks associated with over-the-counter cosmetic contact lenses

October 13, 2003

SAN FRANCISCO--One patient needed a corneal transplant and another is legally blind after wearing over-the-counter cosmetic contact lenses. These are two of the patients discussed in a report published in the October issue of Eye & Contact Lens, the clinical journal of the Contact Lens Association of Ophthalmologists.

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: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 To find an Eye M.D. in your area, visit the Academy's Web site at

American Academy of Ophthalmology

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