Contact Lenses: Why it is ILLEGAL to buy lenses without a prescription

11:48 PM

Leave it to Friday to get my most shocking patient admittance of the week.  At this point in my career, not much is surprising me anymore.  People routinely admit to grossly overwearing contact lenses.  Heck, I have even seen people put their contact lenses in their mouth right in front of me before putting them in their eyes.  I talk to my patients about any risks in their contact lens practices, but not much takes me by surprise anymore.


Until today, of course.  Today I had a patient that wanted to talk to me about contact lenses.  We discussed her vision and her options, but she told me at this point she preferred to just keep getting her color lenses.  Of course, I had to figure out what she meant, since I knew she had never had a contact lens prescription before.  Apparently contact lenses are being sold in a rural area near the city where I practice in a quote "Chinese Meat Market."

Lovely.

Color lenses are fun, but are thicker and usually less
oxygen permeable than clear lenses, making them
an even larger risk to your cornea!  Appropriate
wear is essential to maintaining ocular health
The word is slowly getting around to buyers and sellers of these "over the counter" color and "effect" contact lenses that it is ILLEGAL to sell contact lenses to anyone without a prescription.  And a legal prescription has to specify exactly the name of the brand, the parameters of the lens, and the power of the lens.  In order for a contact lens prescription to legally be written, the lens must be evaluated by a licensed optometrist or ophthalmologist on the wearer's eye.  Yes, that means even novelty contact lenses with zero power require a prescription.

Why?

I don't need to litter this post with a lot of disgusting pictures; you have seen them all if you have read the contact lens posts on my blog (like this post).  Contact lenses are medical devices that are regulated by the Food and Drug Administration due to the high amount of complications and risk for permanent blindness that result from improper use.  Any seller of contact lenses that is doing so without using current prescription information is in violation of several FDA laws, and can incur a fine of $11,000.  When I tell this to patients, they are often shocked to learn of the amount of legislation involved with purchasing contact lenses legally.  To better illustrate why contact lenses are so dangerous, let me paint a picture:

Every time you put a contact lens on your eye, the corneal tissue underneath begins a slow process of suffocating, all the while being exposed to new bacteria and microbial species that love cool dark places like contact lens cases, but love eating away at your eye tissue even more.  Wow, contact lenses sound like fun right?  

I would say that usually 10% of my contact lens wearing patients that I see every day come in with eyes very
similar to this photograph in appearance.  The eye is starving for oxygen with new blood vessels growing all around the cornea.  These blood vessels bring scar tissue with them, and you can't see through scar tissue because it is no longer clear.  Don't let this happen to you.  If you notice that your eyes are routinely red and uncomfortable with contact lens wear, see a doctor as soon as possible and wear your glasses in the mean time!
In all honesty, when used as they are meant to be used, contact lenses will offer excellent vision without reducing the levels of oxygen to the eye to harmful minimums, and are getting safer with each passing year as companies improve their technologies for delivering oxygen and battling microbial parasites.  When you wear contact lenses for a long time, it is easy to forget that every time you put in lens in your eye, you are utilizing a medical technology that has only been available mainstream since the 1970s.  And let's not forget the first lenses were made out of a substance similar to bullet proof glass!  You wouldn't buy your blood pressure medication at a beauty salon or a flea market without a prescription, so don't treat your contact lenses with any less regard for your medical safety!

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10 comments

  1. I have also purchased a kit of contact lenses, but after consulting to my eye specialist. He has given me full info about my eye sight, lenses & also a written prescription for it. I am safely using contact lenses, also agree with your blog & saying this,that do not purchase contact lenses without prescription.

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  2. I have no plans of arguing with a doctor. ;) Our eyes are priceless and should be given proper care. Does this apply too with cosmetic lenses? From what I know, you can buy such even without prescriptions. I’m aware, though, that low quality contacts can cause the same complications as vision enhancer contacts.

    Maverick Pitt

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    Replies
    1. Hello and thanks for your post! Legally, if you are selling contact lenses in the United States, even cosmetic contact lenses fall under FDA jurisdiction and require a valid prescription. The prescription can say "zero" or "plano" power, but must specify the curvature parameters of the lens. Some online vendors get around these requirements by having their business address located outside of the States. The reason our federal laws require even cosmetic lenses to have a prescription is due to the high rate of complications from wearing ANY contact lens. Anything you put on the eye limits oxygen to the cornea (the top, central layer). It may seem like overkill, but I have seen too many complications in my young career already to not support these laws 100%. Hope that explains why these laws are in place and thanks for posting!

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  3. Hi! I'll be looking forward to visit this page again and for your other posts as well. Keep it up! Thank you so much for sharing us some information about this one. You have such a very informative and interesting page! In any response to a verification request, prescribers must correct any inaccuracy in the prescription, inform the seller if it’s expired and specify the reason if it’s invalid. Contact Parrelli Optical in Cambridge or Danvers for your prescription contacts today! Our eye care professionals are proud to serve those members of surrounding communities including Middleton, Peabody, Boxford, Topsfield, Somerville and Medford, MA. prescription contacts Beverly, MA

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  4. Polarized glasses are actually regarded as being the most beneficial regarding out-of-doors efforts with regard to they may have to be able to give exceptional comfort out of sunlight plus the dust and debris.

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  5. I like reading this blog. Thanks a lot for sharing such an informative blog. Keep sharing.

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  6. This fails to give any valid reason to as why it needs a prescription. Sure I can see how laws should force companies to make quality and safe contacts but I don't see how or why the laws would stop any of the ill effects of improper use. Laws for quality control and shipping yes but laws that restrict the purchases based off of if the prescription is on the person or not is just odd. I say it's odd because this won't stop poor overuse, faulty manufacturing, corner store vanity sellers, and etc. All it does is inconvenience the consumer. It's a lazy and overall a logical fallacy.

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    1. Hello and thanks for joining this conversation! I wrote this article a long time ago (2012) and I agree with you looking back at it from a 2019 lens that it doesn't present the higher level of scientific discussion that I've come to develop as a writer. With that being said, I still firmly believe that contact lenses should stay prescription medical devices. You are right that their designation as a medical device cannot stop people from overwearing them, but by having contact lenses regulated by the FDA it does require that a doctor take responsibility for the patients' care at a yearly interval to try to minimize the chance that a patient may develop serious side effects. As doctors we are legally responsible to verify that we've thoroughly assessed the health of the eye and found that it was healthy enough for contact lens wear, and that we've educated the patient on how to best clean their lenses and how often to throw them away. The law puts the responsibility for maintaining a patient's health and vision on the doctor instead of the responsibility being solely on the patient to be in charge of their medical care. A patient hasn't been given any training in medical school to be able to diagnose or detect the problems that a contact lens could cause that would lead to infection or blindness, so to me it makes sense that the legal system puts the responsibility on the doctor. The FDA does regulate quality of the contact lens, including faulty manufacturing, and cleanliness/hygiene standards for manufacturers and sellers of contact lenses. If lenses are being sold or manufactured in unsafe conditions, the FDA can fine or shut down those entities that are putting contact lens wearers at risk because a contact lens is classified as a medical device. Putting something in my eye every day, I personally feel safer knowing that the lenses I use have to meet these safety standards, just like I expect the bottle of antibiotics I get at a pharmacy when I'm sick to meet safety standards and regulations. As technology improves and doctors are able to better check the health of their patients remotely, I do believe that obtaining treatments and prescriptions across healthcare, contact lenses included, will become more convenient. But convenience cannot come at the cost of ethics and the Hippocratic Oath that doctors take to do no harm.

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