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At a time when many eye care providers are thinking about adding lifestyle-enhancing services to their practices, it is worth noting how expanding the clinic’s contact lens (CL) offerings can be complementary. There is a category of patients, including those with plano or minimal glasses prescriptions, who want CLs solely for cosmetic reasons. Those interested in cosmetic CLs should be educated about the available options, including the dangers of using over-the-counter choices offered without a prescription.
OPTIONS FOR COLORED CONTACT LENSES
As with all CL modalities and platforms, patient selection is crucial for success. Cosmetic and colored lenses range from products that offer a complete change in the eye’s appearance to those with a more subtle appearance. Currently, there are no cosmetic options for multifocal patients or for those with greater than 1.00 D of astigmatism.
In some cases, making a small change to a patient’s appearance can have a dramatic impact. For example, the Japanese anime look—the appearance of very large eyes—is a popular beauty trend, especially in the Asian population. The Acuvue Define product line (Johnson & Johnson) has daily-wear option that makes the iris appear slightly larger. Many of my patients report that even though it is a subtle change, it makes a significant difference.
There are also options for patients who want a more dramatic change, including special purpose lenses (such as zombie and vampire lenses, baby eyes, and blackout lenses) and others with less tint for a more subtle change. Several companies even offer packages so patients can purchase their regular contacts plus a box of colored lenses.
The growing number of cosmetic contact lens options adds to the provider’s ability to customize contact lens options to suit their patients’ vision and lifestyle goals.
UNEXPECTED BENEFITS OF COLOR CONTACTS
The most common reason patients turn to colored lenses is for cosmetic purposes, however, these lenses may offer some unexpected benefits. Presbyopic CL wearers can struggle to insert their lenses. A slightly tinted or full-color lens is easier to see in this case, assisting with the insertion and removal process. The amount of tint does not have to be extensive to provide a benefit; I have a number of patients who chose colored lenses for this reason.
Colored lenses may be warranted for medical reasons. One of the options for patients who have suffered an ocular trauma is a lens that helps provide a more natural appearance to a damaged pupil or iris (HP Prosthetics; Alden Optical). It is by no means perfect, and close inspection reveals that it is cosmetically different than a normal eye. These prosthetic colored contact lenses, however, which are available in spheric and toric models, can provide significant psychological benefits for patients in addition to vision correction. Prosthetic options can help restore a balanced appearance in the color of patients’ eyes. Orion Vision Group manufactures custom-tinted contact lenses intended to approximate the bilateral eye color in patients with albinism, color-vision deficiencies, amblyopia, or other ocular anomalies.
Prosthetic lenses colored for cosmetic purposes can also be used as a shield to protect the eye in blind patients. Those with photophobic issues can also benefit from colored lenses, as the addition of color will help filter and occlude certain spectrums of light. Red-colored contact lens options help patients who are colorblind. These lenses do not correct colorblindness, they do enhance color perception, which is a visually meaningful benefit.
COSMESIS AND THE CL WEAR SCHEDULE
Regardless of the reasons patients have for choosing to use contact lenses, they expect that their decision will have only positive aesthetic consequences. For these and many other reasons, daily disposable CLs offer advantages over other modalities. Above and beyond benefits related to vision, comfort, and convenience, daily lenses are associated with greater patients’ compliance1 and less severe microbial infections compared with lenses with longer wear times.2 These characteristics explain why we see less redness and irritation and healthier eyes in patients using daily disposable lenses.
In some ways, educating patients about daily disposable lenses is reinforcing the cosmetic choice the patient is already making. If a patient does not want to wear glasses, then he or she does not want to deal with red, irritated, inflamed, and perhaps painful eyes. This is not to suggest that 2-week and monthly lens modalities have no role; in fact, optometrists should customize the lens choice for each patient based on his or her history, current lens modality, lifestyle needs, vision, comfort, and compliance. Daily lenses are positioned to give patients the best chance to achieve their refractive goals and reduce the possibility of encountering complications.
Within the daily CL category, several companies offer colored lenses for added cosmetic benefit. Some of my patients use colored lenses only part of the time, so having this option provides a convenience factor. There is a medical benefit to this because asking patients to properly store and clean reusable colored contact lenses would seem to invite the potential for microbial infection and other negative consequences.
Daily disposables offer so many significant advantages that they merit a conversation with all CL patients, regardless of whether the platform is multifocal, toric, refractive, or purely cosmetic.
Helping patients learn about cosmetic options in the CL market is an important service. Beauty, however, cannot come at the expense of health, so perhaps the greatest benefit we can provide to our patients is education. Discussing the pros and cons of the various modalities and platforms and informing them of potentially dangerous habits are equally important aspects of our duty to our patients.
Many individuals seeking cosmetic CLs ultimately purchase them online without ever consulting with an eye care specialist. One study suggested that as many as one in four individuals who use contact lenses for cosmetic purposes obtains their lenses illegally without a prescription.3 To say that this is dangerous behavior is an understatement. The risk of bacterial conjunctivitis, corneal abrasions, and other complications is much higher among individuals who have not been properly fitted or educated about how to care for and clean CLs.
Many patients do not take seriously that CLs are regulated medical devices that require a proper fitting. Failing to realize this can have devastating consequences for ocular health, up to and including blindness. The US Food and Drug Administration has offered strong warnings on this topic,4 and we should definitely be telling patients that CLs obtained without a prescription are not worth the risk. n
The author would like to thank medical writer Bryan Bechtel for his assistance on this article.
1. Solomon OD, Freeman MI, Boshnick EL, et al. A 3-year prospective study of the clinical performance of daily disposable contact lenses compared with frequent replacement and conventional daily wear contact lenses. CLAO J. 1996;22(4):250-257.
2. Papas E. Daily disposable contact lenses: the king in waiting? CL Spectrum. 2013; 28(1):14-15.
3. US Food & Drug Administration. ‘Colored’ and Decorative Contact Lenses: A Prescription Is A Must. http://www.fda.gov/ForConsumers/ConsumerUpdates/ucm275069.htm. Accessed September 27, 2016.
4. US Food & Drug Administration. Decorative Contact Lenses. Available at: http://www.fda.gov/MedicalDevices/ProductsandMedicalProcedures/HomeHealthandConsumer/ConsumerProducts/ContactLenses/ucm270953.htm. Accessed September 16, 2016.
Margie Recalde, OD, FAAO
• chief of optometric services at Eye-Q Vision Care in Fresno, California
• financial interest: none acknowledged