A frequent conversation that I have with my patients is lifelong, healthy contact lens wear. My goal for every patient is to obtain optimal vision and comfort with their contact lenses and to be able to wear contact lenses for their entire life if desired. Contact lenses including decorative lenses and contact lenses prescribed for vision correction are classified by the United States Food and Drug Administration (FDA) as medical devices. Thus, an eye examination and valid prescription is needed.

A frequent conversation that I have with my patients is lifelong, healthy contact lens wear. My goal for every patient is to obtain optimal vision and comfort with their contact lenses and to be able to wear contact lenses for their entire life if desired. Contact lenses including decorative lenses and contact lenses prescribed for vision correction are classified by the United States Food and Drug Administration (FDA) as medical devices. Thus, an eye examination and valid prescription is needed.

It is pertinent to review handling with all contact lens wearers and to remind patients of tips for safe contact lens wear [1,2]. It is essential to wash and dry hands prior to handling contact lenses, do not use tap water to disinfect contact lenses, do not rinse contact lens cases in tap water, have caution when swimming and showering with contact lenses, avoid eye rubbing when wearing contact lenses and replace contact lens solution daily (do not top off lens solution). At every visit, we review solutions, wearing time, vision, comfort and contact lens compliance. An easy in office tip is to ask the patient to remove their contact lenses to see if hand washing is performed prior to removal. If not, it is a good opportunity to review the importance of proper hand hygiene.

In a case series of twelve novice contact lens wearers who were evaluated urgently for acute eye pain and redness after wearing plano decorative contact lenses, none of the contact lenses were dispensed by eye care professionals [3]. Four patients developed blinding infections due to the causative organisms staphylococci, Pseudomonas, and acanthamoeba that necessitated hospital admission. A penetrating keratoplasty was needed in one patient. In a survey of one hundred fifty-nine patients, thirty-seven (23%) used decorative contact lenses [3]. Lenses were obtained from an unlicensed provider 51% of the time. Education about lens care and handling was significantly associated with acquiring lenses from licensed providers (R = 0.74, P < 0.0001). Those who acquire lenses from unauthorized providers are significantly less likely to be instructed on appropriate lens use and care. Contact lens wearers may experience acute vision-threatening infections and inflammation.

It is vital to explain to our patients and the public that contact lenses are medical devices and require a valid contact lens prescription. If adverse events are seen, report them. There are many know sellers of illegal contact lenses in the United States. If any illegal sales of contact lenses are suspected or if any adverse events from illegal contact lenses are detected, it is important to report these activities on stopillegalCLs@aoa.org and to MedWatch, the FDA Safety Information and Adverse Event Reporting program (https://www.fda.gov/MedWatch/). Beyond contact lenses, we need to educate the public about the importance of an eye examination. We all know that a multitude of systemic conditions such as diabetes, hypertension, melanoma, to list a few, can be found with an eye examination. It is now for public education of the importance of a contact lens and comprehensive eye examination.

For additional information, I personally invite you to join the American Optometric Association Contact Lens & Cornea Section and the American Academy of Optometry Section on Cornea, Contact Lenses and Refractive Technologies. 


References

  1. Zimmerman AB, Richdale K, Mitchell GL, et al. Water Exposure is a Common Risk Behavior Among Soft and Gas-Permeable Contact Lens Wearers. Cornea. 2017 Aug;36(8):995-1001. doi: 10.1097/ICO.0000000000001204.
  2. https://www.cdc.gov/contactlenses/water-and-contact-lenses.html Accessed March 2019.
  3. Steinemann TL, Fletcher M, Bonny AE. Over-the-counter decorative contact lenses: Cosmetic or Medical Devices? A Case Series. Eye Contact Lens. 2005 Sep;31(5):194-200.