One patient needed a corneal transplant and another is legally blind after wearing over-the-counter cosmetic contact lenses, according to a report by Case Western Reserve University researchers.

The over-the-counter contact lenses, which are illegal in the United States, are not worn to correct refractive errors. Instead, they are tinted to change the appearance of eye color or have various shapes and designs, ranging from animal eyes to sports team logos.

"Many people mistakenly think decorative contact lenses are just like sunglasses," said one of the report's authors, Thomas L. Steinemann of the MetroHealth Medical Center Eye Clinic and an associate professor of ophthalmology at Case. "If you're not wearing the lenses to correct refractive errors, you don't need a prescription. This is a dangerous misconception.

"People who wear lenses purchased from unlicensed vendors have been given no instructions and often practice risky behavior," Steinemann added. "They don't clean or disinfect the lenses. They sleep in them. They swim in them. They even swap them with their friends."

A total of six patients, from 14 to 32 years of age, are discussed in the observational case report published in a recent issue of "Eye & Contact Lens," the clinical journal of the Contact Lens Association of Ophthalmologists.

The patients, five females and one male, experienced vision-threatening problems after wearing contact lenses purchased from unlicensed vendors, including gas stations, beauty salons, video stores, corner stores and flea markets. They did not receive any instructions on how to properly care for or wear the contact lenses. And all of them were sold individually as contact lenses without a prescription, an examination or a fitting by an eye care professional such as an ophthalmologist.

According to the case report:

• One 14-year-old patient nearly lost her eye after contracting a serious bacterial infection. She was hospitalized for four days and was left with a corneal scar that affected her vision. The patient later required a corneal transplant and will need regular observation and treatment for the rest of her life.

• A 24-year-old woman became legally blind from corneal scarring in one eye after she developed conjunctivitis (pink eye) and was treated for herpes simplex and bacterial keratitis. She reported wearing disposable contact lenses for approximately six months, often sleeping in them.

• A 32-year-old man scratched his cornea while trying to remove costume contact lenses. He had developed painful inflammation from a lens that did not fit. This required multiple treatments over several weeks.

Problems that may result from this risky behavior include corneal abrasions, epithelial keratitis, infectious ulcers and the blinding Acanthamoeba organism. Although no cases have been documented, the report also suggests HIV transmission is a potential risk among those who exchange their contact lenses with others.

Another co-author on the paper from Case is Loretta B. Szczotka, from the department of ophthalmology at University Hospitals of Cleveland.

Return to the online edition of the 11-6-03 Campus News.