<h3>By Dr. Mark S. Siegel</h3>
If you want your Halloween look to include cat, zombie or glow-in-the-dark eyes, or if you’d like to use lenses to change your eye color or appearance, obtain prescription costume contact lenses from an eye care professional. It’s crucial that your lenses fit properly, and your individual prescription can only be determined by an eye exam.

Skipping this step and buying lenses online or over the counter can set you up for serious eye problems, infections or even permanent vision loss.

<b>What are costume contact lenses?</b>

Costume contact lenses – also known as cosmetic or decorative contact lenses – are any type of contact lenses that are meant to change the appearance of your eyes. They include colored contacts, fashion lenses and lenses that can make your eyes look like vampires, animals or other characters.

Websites often advertise colored contacts as if they were cosmetics, fashion accessories or toys. With whimsical packaging and names, their targets are often teens and young adults. The truth: claims such as “one size fits all” and “no need to see an eye specialist” are misleading. Non-prescription contact lens sales are illegal.

<b>What’s wrong with costume contact lenses? </b>

Contact lenses should not be thought of as fashion accessories or makeup – they are medical devices that require a prescription from an eye care professional. The eyes are one of the most delicate and important parts of the body, so what you put in and on them must be medically safe and FDA-approved.

Many people buy these lenses to use as costume accessories to enhance their Halloween costumes, and shops as well as online retailers, actively market and advertise the lenses to innocent consumers unaware of the risks. These risks include dangerous infections that can lead to permanent vision loss and even require corneal transplants. This is why many ophthalmologists see a spike in patients coming to them with these types of injuries around Halloween.

<b>What damage can costume contact lenses cause?</b>

Non-prescription costume contacts can cause injuries such as cuts and open sores in the cornea, the protective clear layer in front of the iris and pupil. Corneal abrasions and corneal ulcers can cause potentially blinding painful bacterial infections (keratitis). These injuries can require serious eye surgeries such as corneal transplants, and in some cases lead to permanent vision loss.

One study found that wearing costume contact lenses increased the risk for developing keratitis – a potentially blinding infection that causes a corneal ulcer– by more than 16 times, compared to people who wear regular, corrective contacts. Unfortunately, 60 percent of patients who developed keratitis from wearing non-prescription costume contact lenses in this study suffered permanent vision loss.

Novelty products, like circle lenses, are not FDA-approved. Circle lenses can be particularly harmful, because the lens covers more of the eye than regular corrective lenses, which makes it very difficult for necessary oxygen to get through to the eye.

<b>Why are circle lenses illegal?</b>

Unlike regular, prescription contact lenses, circle lenses cover a bigger area of the eye, extending past the iris and onto the whites of the eye so that the iris appears bigger and the wearer has a “doe-eyed,” or Anime, look. In Korea, Japan, and other Asian countries there’s a subculture that seeks to mimic the “Ulzzang” look of Anime characters (cartoon figures).

Illegally sold circle lenses bypass several crucial safeguards, such as a lens fitting and instructions on how to properly clean contact lenses. And since the industry is unregulated, the lenses may not have been cleaned or disinfected properly before sale, again raising the risk of eye infections and vision damage.

<b>How many injuries occur each year from costume contact lenses? </b>

There are no comprehensive studies yet that tells us how many injuries occur each year from wearing costume contact lenses. However, we know anecdotally amongst ophthalmologists that we continue to see injuries of this type each year despite FDA regulations. In addition, a 2010 study published in Pediatrics indicated that at least 13,500 emergency room cases each year are due to contact lens injuries in children and teens.

<b>Why are stores and online retailers selling costume contact lenses without a prescription if it’s not safe?</b>

Although the practice has been illegal since 2005, today cosmetic contact lenses are still sold in shops and via online retailers to customers who are unaware that wearing these devices can result in serious eye injuries. Federal law classifies all contact lenses as medical devices and restricts their distribution to licensed eye care professionals. Illegal sale of contact lenses can result in civil penalties of up to $16,000 per violation. If you see contact lenses being sold by retailers not requiring a prescription, you can report the retailer to the FDA through its MedWatch program.

So if your Halloween includes costume contact lenses, please see your eye care professional to avoid an eye horror! Have a safe and happy Halloween.