Under UK legislation that took effect from June 30 2005, zero-powered or ‘plano cosmetic’ contact lenses (non-corrective contact lenses designed to change the colour or appearance of the eye) are regulated in a different way from powered lenses.

Zero-powered lenses can only be supplied by or under the supervision of a registered optometrist, suitably qualified dispensing optician or medical practitioner. Supervision requires the registered person to be present on the premises, aware of the procedure and in a position to intervene if necessary. The seller/supplier must also make arrangements for the wearer to receive aftercare.

There is no legal requirement to give a patient a written specification after fitting with zero-powered lenses but the College of Optometrists and Association of British Dispensing Opticians have advised their members that it is in the patient’s best interest to do so.

Cosmetic contact lenses are effective for changing eye colour and are also used in various therapeutic applications, such as masking disfigured eyes. With plano cosmetic lenses, biocompatiblility with the eye is at least as important as it is with conventional prescription lenses, if not more important, since they may allow less oxygen to reach the surface of the eye than clear lenses, in addition to disrupting the tear film. Appropriate handling, cleaning and disinfection techniques are essential and it is important to comply with the recommended wearing times and frequency of lens replacement.

There have been reported cases of serious corneal ulcers and infections associated with wear of plano cosmetic contact lenses. Corneal ulcers can progress rapidly, leading to internal ocular infection if left untreated. Uncontrolled infection can lead to corneal scarring and vision impairment. In extreme cases, this condition can result in blindness and eye loss. Other risks associated with the use of these lenses include conjunctivitis (an infection of the eye), corneal swelling, allergic reactions, corneal abrasion from poor lens fit and a reduction in vision, resulting in interference with activities such as driving.

However, it should be stressed that problems with plano cosmetic lenses are generally associated with poor compliance and hygiene, and with unregulated lens sales. As with all contact lenses, provided they are handled and cared for properly and only used according to the prescribing practitioner’s recommendations, the risk of eye infection is very low.

Consumers should understand that plano cosmetic contact lenses, like contact lenses intended for correction of vision, present serious risks to eye health if they are distributed without proper fitting by a qualified eye care professional, careful instruction and ongoing clinical care.

REFERENCES

1.       Snyder RW, Brenner MB, Wiley L et al. Microbial keratitis associated with plano tinted contact lenses. CLAO J, 1991;17:4 252-5.

2.    Steinman TL, Fletcher M, Bonny AE, et al. Over-the-counter decorative
contact lenses: cosmetic or medical devices? A case series. Eye & Contact
Lens, 2005;31:5 194-200.