DALLAS – Oct. 13, 2003 – The sale of unregulated and unmonitored contact lenses is a reckless endangerment of the ocular health of the U.S. public, warns the editor-in-chief of the scientific journal, Eye and Contact Lens.
In an editorial published in the journal's current issue, Dr. H. Dwight Cavanagh, vice chairman of ophthalmology at UT Southwestern Medical Center at Dallas, details the vision-damaging problems that can occur when contact lenses are worn without a doctor's prescription or monitoring.
"Letting an underage member of the family use these lenses without supervision is like giving them the car keys without a license and without an adult in the front seat," Dr. Cavanagh said. "Remember, a lot of permanent damage can be done after only a few hours of wear."
Cosmetic contact lenses that change eye color or appearance with designs are becoming increasingly popular among teens and young adults. These lenses that can often be purchased on the Internet and in mall specialty shops, flea markets and gas stations without a doctor's prescription may harm your eyes, Dr. Cavanagh said.
Buying contacts in this "one size fits all" manner without a prescription is dangerous and can be detrimental to eyesight, he added.
Ill-fitting over-the-counter contact lenses rub a patient's cornea, causing infection and damage that could lead to blindness, Dr. Cavanagh said. The lenses could also cause irreversible scarring, inflammation and even loss of the eye.
When a patient is prescribed contact lenses – regardless of whether the lenses are worn to correct vision – an ophthalmologist or optometrist examines the eye to make sure lenses don't aggravate existing problems. They measure the eye to ensure the best possible fit and teach the patient how to handle the lenses properly and how to keep them sterile. The doctor will monitor the patient to make sure problems don't develop later.
The risk for corneal ulcers – the most serious adverse affect of contact lenses and considered ophthalmologic emergencies – among prescription contact lens users is 1 in 2,500 for daily wear and 1 in 500 if patients sleep in the lenses. The risks are much higher in over-the-counter contact lenses because none of the regular safety procedures are followed, Dr. Cavanagh said.
Additionally there is an increased risk of infection. Contact lenses, prescribed or not, are pieces of plastic that prevent normal amounts of oxygen from reaching the eye. Use of lower oxygen-transmitting lenses can cause the cornea's epithelium – or outer layer of cells – to produce bacterial receptors that can bind harmful, infection-causing bacteria to the eye.
"By purchasing contact lenses over the counter, you would abrogate every single safety guarantee in place," Dr. Cavanagh said, adding that the same contact lenses could still be available through a doctor's office, even if the lenses weren't vision-correcting. "If you want blue or orange or yellow eyes, you can have it. Just go to a licensed professional to get them."
Currently the U.S. Food and Drug Administration has embargoed the sale of colored contact lenses over the counter while it decides their status as defined by the Medical Devices Act of 1976. Supporters of over-the-counter contact lenses are arguing that contacts are only medical devices when they are used to correct vision and, therefore, should not be regulated when they are only worn to change eye color or match a costume.
Still, the lenses manage to work their way to store shelves and are available over the Internet from companies based in countries where the lenses aren't regulated.
Doctors have no idea how many people are wearing these contact lenses because most of the evidence of complications has been anecdotal. The first scientific research on the topic, however, appears in the current issue of Eye and Contact Lens.
Cleveland researchers detailed six patients who suffered severe eye damage as a result of wearing over-the-counter contact lenses – two of them after wearing the lenses only a few hours. None of the patients had previously worn contact lenses to correct vision. Two became legally blind in one eye, and one required a corneal transplant for visual restoration.
Materials provided by University Of Texas Southwestern Medical Center At Dallas. Note: Content may be edited for style and length.
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