As Halloween approaches, Meridian optometrists warn fellow citizens of the dangers of over-the-counter Halloween contacts and how even short-term use of these devices can permanently affect the eyes.
The Food and Drug Administration’s (FDA) informational article “Focusing on Contact Lens Safety” defines contact lenses as medical devices, which are regulated in sale and marketing by the FDA itself. This article also warns against using “Over the Counter (OTC)” contact lenses or costume contact lenses, which are not fit precisely for the wearer’s eye and are created by companies unregulated by the FDA.
While there are some companies which sell legal, prescription costume contact lenses, unregulated contact lenses are illegal to sell because there are dangers to wearing a contact lens which is not fitted for the wearer’s eye.
Dr. Jennifer Dooley of Primary Eyecare of Meridian, has been working to ensure properly-fitted and safe contact lenses for her patients.
“When it comes to contact lenses, the biggest thing I think patients don’t understand is they’re not just cosmetic or over-the-counter,” Dr. Dooley said. “They are a medical device regulated by the FDA, and they need to be treated as such. A poor fit could result in a corneal abrasion, conjunctivitis, or corneal infections. These could eventually lead to a decrease in vision, or in worst-case scenario, blindness.”
For regular contact lens wearers, optometrists provide a yearly contact lens fitting evaluation in order to get specific readings which determine a patient’s contact lens prescription. Measurements taken during this fitting include the shape of the cornea and the curvature of the eye. After taking these readings, an optometrist often allows a trial period for patients if they are using a contact for the first time, allowing them a test period with the new medical device.
Cosmetic contacts sold over the counter are sold for a “spherical” eye, Dooley said, but not all eyes are spherical. Many people have what is called an astigmatism.
“If you think of a normal eye without astigmatism, the cornea is like the shape of a basketball,” Dr. Dooley said. “It’s a perfect circle with all powers being the same. With an astigmatic eye, the cornea is like the shape of a football. There are different powers based on which axis you are looking at in the eye. So, contacts have to fit properly. They are not one-size-fits-all. You can’t put a spherical contact lens on an eye with astigmatism because it won’t fit right or see as well as we want it to.”
When contact lenses do not fit properly, they can cause an array of detrimental results. For a fit that is too loose on the surface of the eye, the contact lens can slide around and cause discomfort. The lens will move upon blinking, which can get in the way of the wearer’s vision.
When a contact lens is too tight, the lens can hug the eye too closely and restrict oxygen from reaching the cornea. Dr. Dooley said this can lead to redness, discomfort, and possible infection. Complications with either of these could also lead to permanent loss of vision.
“If you get an abrasion to the cornea, think of it as an open wound, like a scratch on your arm,” Dr. Dooley said. Bacteria can get in and create infection. When we talk about a bacterial ulcer, these lead to permanent scarring on the cornea. If the scar is centrally located, that will forever reduce a patient’s best corrected vision. I don’t think a lot of people know this. Most think if they get an infection, it will heal, but if the scarring is central, the patient will never see 20/20 again.”
The coloration within the lenses, Dr. Dooley said, can also pose a problem. In order to cover more surface of the lens, companies restrict the amount of space through which the eye can see, causing a reduced visual field. Sanitation is also not guaranteed when it comes to packaging in over-the-counter Halloween contact lenses. Companies which sell prescription contact lenses also provide prescription costume contact lenses, which are safely packaged and FDA-regulated.
Working in eye care, Dr. Dooley said she sees patients who abuse contact lenses on a regular basis. Many patients wear their contacts past the recommended wear time and tend to sleep in their lenses. Both of these can pose problems to the contact lens wearer even when they are wearing the correct prescription for their eyes.
“Proper care of contact lenses is very important. Contacts have a recommended wear time for a reason. The materials and moisturizers in the lenses have a lifespan. If a patient is stretching out the wear time, the lens will no longer be as comfortable and could possibly lead to scratches or infections of the eye.”
Sleeping in contacts can result in the same problems as too tight of a fit as this habit greatly reduces the amount of oxygen getting to the cornea.
“Another important note is to never buy contact lenses from anywhere besides an eyecare provider or a company that requires a prescription,” Dr. Dooley said. “Halloween brings a lot of dangerous and illegal selling of contact lenses from places such as salons, beauty stores, Halloween stores, online retailers, and even gas stations. If the lenses are not FDA-regulated, there is no way of knowing what the lenses are made of and what they are packaged in.”
In order to protect the eyes, patients are encouraged to have a contact lens evaluation to check for any changes in their eye shape each year, respect the lifespans and rules of contact lenses, and contact their eye doctor if they have any questions or concerns.
