Until today, of course.  Today I had a patient that wanted to talk to me about contact lenses.  We discussed her vision and her options, but she told me at this point she preferred to just keep getting her color lenses.  Of course, I had to figure out what she meant, since I knew she had never had a contact lens prescription before.  Apparently contact lenses are being sold in a rural area near the city where I practice in a quote "Chinese Meat Market."

Lovely.

The word is slowly getting around to buyers and sellers of these "over the counter" color and "effect" contact lenses that it is ILLEGAL to sell contact lenses to anyone without a prescription.  And a legal prescription has to specify exactly the name of the brand, the parameters of the lens, and the power of the lens.  In order for a contact lens prescription to legally be written, the lens must be evaluated by a licensed optometrist or ophthalmologist on the wearer's eye.  Yes, that means even novelty contact lenses with zero power require a prescription.

Why?

I don't need to litter this post with a lot of disgusting pictures; you have seen them all if you have read the contact lens posts on my blog (like this post).  Contact lenses are medical devices that are regulated by the Food and Drug Administration due to the high amount of complications and risk for permanent blindness that result from improper use.  Any seller of contact lenses that is doing so without using current prescription information is in violation of several FDA laws, and can incur a fine of $11,000.  When I tell this to patients, they are often shocked to learn of the amount of legislation involved with purchasing contact lenses legally.  To better illustrate why contact lenses are so dangerous, let me paint a picture:

Every time you put a contact lens on your eye, the corneal tissue underneath begins a slow process of suffocating, all the while being exposed to new bacteria and microbial species that love cool dark places like contact lens cases, but love eating away at your eye tissue even more.  Wow, contact lenses sound like fun right?  

I would say that usually 10% of my contact lens wearing patients that I see every day come in with eyes very similar to this photograph in appearance.  The eye is starving for oxygen with new blood vessels growing all around the cornea.  These blood vessels bring scar tissue with them, and you can't see through scar tissue because it is no longer clear.  Don't let this happen to you.  If you notice that your eyes are routinely red and uncomfortable with contact lens wear, see a doctor as soon as possible and wear your glasses in the mean time!

In all honesty, when used as they are meant to be used, contact lenses will offer excellent vision without reducing the levels of oxygen to the eye to harmful minimums, and are getting safer with each passing year as companies improve their technologies for delivering oxygen and battling microbial parasites.  When you wear contact lenses for a long time, it is easy to forget that every time you put in lens in your eye, you are utilizing a medical technology that has only been available mainstream since the 1970s.  And let's not forget the first lenses were made out of a substance similar to bullet proof glass!  You wouldn't buy your blood pressure medication at a beauty salon or a flea market without a prescription, so don't treat your contact lenses with any less regard for your medical safety!

WEARING TIME

Please, please, please.  Follow the wearing time that your doctor prescribes for your contact lenses.  Your doctor is not just making up a number; the number of days to wear your lenses is an exact medical prescription, not just a loose recommendation. Contact lenses go through rigorous studies by the FDA, and based on their performance they get approved for a certain length of wearing time.  Your doctor will tell you whether your lens is approved for daily, 2 week, or monthly wear.  There is NO soft contact lens currently on the market that is approved for longer than 1 month of wear (unless you are in a few special order exceptions).  There is only 1 contact lens approved by the FDA for 30 days of extended wear (sleeping in the lens): Air Optix Night and Day.  If you are sleeping in your lenses every single night, you are putting yourself at great risk for a vision threatening complication.  There is no doctor who is ever going to tell you to "wear this lens until it hurts or your eye gets red."  I hear a lot of patients say that is when they dispose of their lenses; but lets be honest, there is no way anyone can possibly think that wearing a lens until your eye hurts is a good idea!    Your eye hurts and turns red if the corneal nerves are damaged or the health of the eye is compromised by oxygen deprivation or bacterial invasion.  If you are waiting until there is actual discomfort, your eye has already suffered significant damage.

PROPER CLEANING

There are a ton of multipurpose solutions on the market, and they all do a great job of killing bacteria. (For more information on solutions, click here) It is best to rub your lenses gently for a more thorough clean after removing them for the night.  Never reuse solution for multiple nights; the used solution is full of bacteria and other contaminants cleaned from your lenses!  Throw your contact lens case away every 3 months to keep the microbial levels of the case low.  NEVER clean your lenses with tap water, saliva, or any other liquid not designed for contact lens use.  Do not try to make your own solution unless you are a trained chemist who makes contact lens solution for a living.  It is not just water and salt to taste.  Just, no.  Don't do it.

I always put it to my patients this way: How much money are you really going to save if you have to be treated for an infection?  Any corneal ulcer or infectious event is going to require several follow-up treatment visits, so believe me, unless you have a really great insurance plan, getting treated for an infection is VERY expensive.  Not to mention that your eye may never fully recover.

FOR THE OD READERS:

A lot of discussion has been made over the findings from research like staingrid.com.  We still don't have a full understanding of what contact lens solutions provide the best health benefits for what contact lens materials.  If you have a patient with an infiltrative event, you can participate in an online study at http://www.thecontactlenssolution.com/.  Log on to this website to report the name of the contact lens and the solution your patient was using.  With time, researchers with the site hope to collect enough data to find correlations between particular lens materials and solution interactions.  We can only learn more if ODs report their findings!

Still wanting more?   Click here for 5 REASONS TO NEVER OVERWEAR YOUR LENSES.  More horrifying pictures will ensue.