A pair of costume contact lenses may complete a Halloween look, but lenses obtained without a prescription can be dangerous.

Thomas L. Steinemann, MD, professor of ophthalmology at MetroHealth Medical Center in Cleveland and spokesperson for the American Academy of Ophthalmology and Prevent Blindness America, is a cornea specialist and sees patients with contact lens-damaged eyes on a regular basis.

Healio/OSN spoke with Steinemann about why costume contact lenses can be dangerous and how people can safely obtain lenses.

Healio/OSN: What are some of the problems one might encounter if they buy contact lenses for a Halloween costume without a prescription?

Steinemann: They probably run the risk of the lens not fitting, and what happens when a contact does not fit is that it is painful. You could get a scratch on your eye, or you can get inflammation in the eye. Sometimes lenses that are sold without a prescription are even counterfeit or contraband, and a lot of those lenses, according to a study done a few years ago, are contaminated. They are not packaged sterilely, or they are even repackaged or black-market lenses. It is not worth it to end up with the potential for a blinding infection. What if you get a blinding infection? We can treat it, but after that, all bets are off. After the infection clears, you might be left with a blinding scar or lose vision in some fashion long term.

We are not going to discourage people from wearing a lens, but do it the right way. Go see a licensed eye care professional who can assess your eyes and the fit of the contact and, more importantly, write a prescription. Basically, do not ever go anywhere that does not require a prescription, even for a colored, costume or Halloween contact lens, because those lenses are more likely to not fit you and to be problematic. More importantly, the fitter should give you pertinent instructions on how to wear it safely and comfortably and how to take care of it.

Healio/OSN: What kinds of infections are commonly seen with nonprescription lenses?

Steinemann: All of these costume lenses are soft lenses. Just like a soft lens that someone would wear for vision correction, a soft lens has a high water content and is basically a squishy piece of soft plastic. It binds bacteria very well. The bacteria we see most often in these soft lenses are Pseudomonas. Another common one is Staphylococcus. If you are more inclined to never care for your lens or do more foolish things with it, there is the potential for fungal infections or even infections with a parasite called Acanthamoeba, which again, is ubiquitous. It is found everywhere: water supplies, tap water, hot tub water, lake water, ocean water. If you wear your contacts in those environments, you are putting your eye health at risk.

Healio/OSN: Have you ever seen a patient with damage from these kinds of lenses or improper care?

Steinemann: All the time. I don’t know necessarily that I see them more often at this time of year because I see them so often anyway. This is almost a daily occurrence in what I do as a cornea and external disease specialist. The story is usually the same: contact lens overwear, misuse, sleeping in contact lenses. Those types of scenarios are extremely common. Contact lenses are deceptively comfortable, so they are easy to forget. We all cut corners to save time or money, and that is how it gets started.

Healio/OSN: Do you think that people who buy nonprescription lenses at a costume store are less likely to take proper care of them?

Steinemann: I absolutely think so. If you are buying contact lenses at a costume store, flea market or beauty parlor, it is a pretty good bet that the person selling you those lenses is not going to be giving you proper instructions, and that is a recipe for disaster.

Healio/OSN: Do you have any advice for people looking for costume contact lenses?

Steinemann: Play it safe. Do it the right way. Go to your local licensed eye care professional, an ophthalmologist, optometrist or optician. These are people who will help you to do it the right way. It is an assessment of fit, but more importantly, it is the instructions. Colored lenses are no different from prescription lenses because you have a responsibility to your eye to wear them correctly. If you choose this, please do it the right way and get some instructions. A lot of the colored lenses do not breathe. Because they are impermeable, they are probably a little more unhealthy than a clear lens. There are a lot of reasons I think people need to know the rules of the road, so to speak, especially the casual wearer.

Colored lenses should probably not be worn more than 4 to 6 hours at a stretch because of the risk for corneal hypoxia and discomfort with prolonged wear. Also, wearers should never expose any contact lens to water, such as swimming, showering, rinsing and storage.

Healio/OSN: Do you have anything else to add?

Steinemann: Contact lenses are ubiquitous. They are part of the billion-dollar industry of Halloween celebration. There are a lot of people out there who are trying to put the finishing touches on a great costume. What we are saying is to do it safely and understand that you have a responsibility to the health of your eyes when you are wearing any kind of contact lens.

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