Dangers of illegal contact lenses sales during Halloween

Over the counter contact lens sales is illegal in South Africa.

The South African Optometric Association warns consumers that wearing these contact lenses improperly can cause serious eye disorders and infections.

Due to the ocular health risk, the fitting and sale of contact lenses falls within the scope of profession and practice of registered optometrists in South Africa and is therefore regulated by the Health Professions Council of South Africa.

What are cosmetic contact lenses?
Cosmetic contact lenses are used to change the natural appearance of the eye.

They are made from porous plastic materials which have the ability to absorb liquid.
Cosmetic contact lenses are printed with an opaque pigment so that they can change the appearance of even very dark eyes.

They include coloured contact lenses, fashion or beauty contact lenses and costume or theatrical contact lenses.

The biggest problem with cosmetic contact lenses is that they are seen as purely cosmetic, without much consideration given to the potential health risks they pose.

The use of cosmetic contact lenses has been observed worldwide, mainly among teens and young adults.

Internationally, the use of cosmetic contact lenses is most evident over Halloween.

It is over this period that ophthalmologists report the highest incidence of contact-lens related injury among teens and young adults.

Improper, non-compliant use and unhealthy practices such as sleeping in lenses and sharing of cosmetic contact lenses between individuals have also been reported – often with serious consequences of irreversible vision loss and blindness.

When are cosmetic contact lens sales illegal?
In many countries, including South Africa, a comprehensive eye examination is required prior to fitting and supplying any type of contact lens.

This is a legislated professional act of a registered optometrist.

The distribution of contact lenses by unregistered persons is therefore illegal in South Africa.

A concerning development in recent years has been the sale of contact lenses by non-optometric unregulated vendors.

These lenses continue to be sold over the internet, fashion and beauty outlets and even at flea market stalls.

Due to the unregulated nature of these sales, little is known about the materials and processes used by the manufacturing companies from whom the lenses are obtained.

This means that the lenses may not comply with the standards set by the local (SABS) and international compliance authorities (e.g. ISO, FDA).

Cosmetic contact lenses are often advertised by online sales sites as “no prescription necessary” or “fits all sizes”, but the truth is that non-optometric distribution of these lenses place the wearer at a significant risk for irreversible vision loss.

What are the risks?
Contact lens-related vision loss is rare when the correct care and hygiene procedures are followed.

However, research has shown that unmonitored use of cosmetic contact lenses by individuals who have not been trained to use them, greatly increases the risk of permanent vision loss requiring serious surgery (corneal transplant or even the removal of the eye).

When inserted into the eye, the contact lens rests on delicate transparent tissue that covers the iris and pupil known as the cornea.

The cornea needs a good oxygen supply and healthy tears to function properly.

The ocular surface is also host to a variety of microorganisms (bacteria) that usually remain passive unless the ocular environment is disturbed.

When a contact lens is placed on the cornea, it reduces the oxygen supply and changes the tear composition.

It may also cause injury to the ocular surface and this can trigger disease-causing (pathological) microbial activity.

Scratches (abrasions) on the cornea from the contact lens can weaken the corneal defence and expose it to painful infections (keratitis).

The contact lens, if not properly cleaned and maintained, can easily become contaminated by bacteria and other contaminants.

Common symptoms of contact lens-related corneal infection include:
* Redness
* Burning and tearing
* Foreign body sensation
* Light sensitivity
* Blurry or hazy vision
* Sticky discharge
* Eye pain

How do we reduce the risk? Responsibilities of the optometrist
The best way to ensure the safe use of cosmetic contact lenses is to arrange for a contact lens consultation with a registered optometrist.

At this visit, the optometrist will determine whether the patient has any risk factors that could prevent them from wearing contact lenses.

Optometrists are not permitted to supply contact lenses to a patient without first conducting a thorough eye examination on that patient.

If the patient is a suitable contact lens candidate, corneal measurements will be taken to determine the appropriate curvature of the contact lens to ensure a good fit for oxygen supply and correct lens movement.

A suitable contact lens will be selected, not only on appearance, but also on the patent’s individual physiological requirements.

The optometrist will ensure that the contact lens provided is an approved product that meets the international quality and safety standards.

The appropriate lens-wearing schedule as well as a disposal and replacement schedule will be provided, based on both lens and patient factors.

Another important responsibility of the optometrist is advising the patient on hygiene and care of their contact lenses.

Good hygiene practices such as proper hand washing, correct lens handling and cleaning techniques, storage and disposal of lenses and storage cases must be emphasized.

The optometrist must be satisfied that the patient is able to insert and remove the contact lenses successfully before leaving the practice.

The final responsibility of the optometrist is to conduct a follow-up evaluation of the contact lens wearer, so that the contact lens may be observed on the eye and any changes evaluated.

This is also a good opportunity for the contact lens wearer to clarify any uncertainties and for the optometrist to amend any incorrect understanding or behaviour relating to contact lens compliance.

Even under the best circumstances, injury or infection may occur.

If any symptoms occur during the period of contact lens wear, the wearer must discontinue lens wear and seek advice from their optometrist or ophthalmologist immediately.

Any illegal sales and distribution of contact lenses should be reported to the nearest police station, the HPCSA or the SAOA.

To find your nearest SAOA optometrist, log onto www.saoa.co.za or contact 011 805 4517.