Risky contacts

Without a prescription, buying contacts can be unhealthy


Published: Thursday, January 9, 2003 at 6:01 a.m.
Last Modified: Thursday, January 9, 2003 at 1:11 a.m.
When a teenager wants to look cool, she sometimes swaps fashions with friends, like sweaters, hair accessories and, these days, even contact lenses.
Trouble is, the same lenses that can make your eye a vivid green can also turn it pink with an infection like conjunctivitis or worse - even permanent eye damage - if you wear a lens fitted for someone else or improperly use your own.
"If you ever think about people touching eyes, it's gross," said optometrist Dr. Albert Morier. "But they sure don't think about taking out a blue contact and saying, 'Try this on.' "
An increase in problems caused by misuse of cosmetic lenses caused the U.S. Food and Drug Administration to issue an alert in the fall of 2002 warning consumers not to purchase the contacts without a prescription.
Lenses dispensed by prescription are fitted properly and come with instructions on how to use them, including proper cleaning.
The FDA said it would direct Customs officials to detain decorative lenses at U.S. ports of entry and it would seize lenses on the market that violate federal law.
Still, FDA officials remain in discussion over whether to take the contacts, which don't correct vision, off the agency's list of regulated medical devices. That has some eye care professionals worried that people - especially the young - could get their hands on the lenses even more easily.
"I can't even believe that it's coming up for discussion," Morier said of the debate at the federal agency. "Here in the cornea department, we see routinely problems related to contact lens wear."
Colored contact lenses are safe when properly worn, eye care professionals said. Those on the market appeal to a broader range of consumers because they look more natural than ever.
Others create theatrical effects, such as cat's eyes. And at $35 to $45 for three pairs - for the simplest, one-color variety - they are more affordable than ever.
Rise Van Iderstine has worn contacts successfully for more than a decade ago, when a pair cost hundreds of dollars.
"I just love 'em. I like the compliments you get," said Van Iderstine, 52, who says she enhances the color of her normally light blue eyes with violet lenses. People often do double-takes when they see her, she said. "And then finally they say, 'You have the most beautiful eyes.' And I sometimes don't tell them the truth."
In addition to making her eyes somewhat purple, Van Iderstine's lenses also correct her vision. So she regularly visits doctors for eye exams. She dutifully follows instructions on how to care for them, she said. That's a prescription for healthy lens wear, eye care professionals said.
If not properly worn, all contact lenses - whether or not they correct vision - can cause a host of problems. One big problem with cosmetic lenses is that younger people are wearing them, and not always correctly, eye care professionals said.
Eye-care shop manager Linda Miller said she sees parents who let children as young as 8 get the lenses. One of Miller's customers over the past year was an eighth-grader who shared her contacts, and a case of pinkeye, with most of her classmates.
The FDA has received reports of people developing corneal ulcers from wearing the lenses for too long, according to its October alert. Other risks from improper wear include infections, allergic reactions, vision impairment and eye loss in extreme cases.
Even with FDA regulations and warnings still in place, cosmetic contacts already are available without a prescription. The lenses are sold at flea markets and convenience stores, according to the federal agency. They also can be bought online.
Ophthalmologists and optometrists here said they did not know of many legitimate stores in the region that dispense the decorative lenses without a prescription, but they are aware some teen-agers buy and resell them to each other.
Some young customers are surprised when eye care professionals say they must have a prescription to get a pair.
"One of the reasons the cosmetic lenses are readily available without a prescription is because the FDA doesn't do a good job of enforcing federal law, said Tom Henteleff, legal counsel for the Contact Lens Council, a group representing manufacturers.
"The question is: Does the FDA really go out and enforce where an individual organization is dispensing them without a valid prescription?" Henteleff said. "And FDA has not been very aggressive in doing that."
Meanwhile, teens and young adults are asking for them. Eye care professionals stressed that parents should not use age alone as a guideline for whether their children should be trusted with the lenses. Maturity level and willingness to take on responsibility are the important factors, they said.
One parent probably made the right call in not letting her college-bound 17-year-old son get a pair, Miller said.
"She didn't feel her son was responsible enough," Miller said. "She said, 'His 14-year-old brother, fine. This kid can't keep his room clean; he's not getting contacts."'
People of all ages need to be diligent in cleaning and caring for their contact lenses to avoid problems, Morier said. That goes for the type that corrects vision as well as the type that doesn't.
"You know people who say they drink and drive all the time and never had a problem?" Morier said. "It's the same thing with contact lens abuse. You've never had trouble, your wife's never had trouble. But you will."

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