This week Optometry Australia warned consumers that their eyesight may suffer if they take contact lens prescribing into their own hands when purchasing from online retailers who don't require them to validate their contact lens prescriptions.
Consumers also need to be aware of new online contact lens retailers who specialise in selling one type of lens only.
People accessing these websites are able to swap from their currently prescribed contact lens to an alternative product without undergoing an appropriate review to determine if the lenses fit and provide optimal health performance on the eye.
This one-size-fits-all approach is concerning because one size and one type of contact lens material does not meet everyone’s eye health requirements.
Within Australia, prescription contact lenses are considered medical devices and therefore their supply is governed by the Therapeutics Goods Administration.
To be fitted for contact lenses requires a comprehensive eye examination with a registered eye health practitioner – such as an optometrist – who will conduct the relevant tests to prescribe lenses best suited to the patient’s particular vision condition, such as long or short sightedness, presbyopia or astigmatism.
Many people aren't aware that contact lens prescriptions are more complex than spectacle lens prescriptions as detailed size information (curvature and diameter) of the eye, along with a material choice for optimal health performance of the contact lenses need to be taken into consideration.
Contact lenses are not ‘one size fits all’ and must be properly fitted as lenses that are too tight can result in acute red eye, bound lenses and a risk of damage to the eye when the wearer is unable to safely remove them. Lenses which fit too loosely will be unstable on the eye and risk mis-location up under the lids where they become an infection risk.
Contact lens material is also critical and makes up a major component of prescriptions. Newer materials like silicon hydrogels are able to ‘breathe’ much better than older materials and let significantly more oxygen through to the front surface of the eye.
Lens breathability is particularly important for patients who require high powers (and consequently thicker contact lenses), as lack of oxygen to the eye can lead to blood vessels growing into the cornea (the clear window at the front of the eye), painful red eyes and an increased risk of corneal ulcers and permanent vision loss.
Different materials also carry a different electrical charge which affects the way protein or deposits are attracted to material and influence wetting, comfort and physiological response, and patients may develop a hypersensitivity to a particular material, which can lead to giant papillary conjunctivitis.
These are all complications that are typically checked in the aftercare period of the usual prescription process, and major reasons why purchasing contact lenses online without requiring to validate a prescription poses a danger to a patient’s eye health.
It's also important to know that not all brands are the same. Contact lens manufacturers often specialise in making lenses for different eye conditions. Yet when purchasing lenses online, a patient may not understand the nuances between brands, materials or differing prescription requirements.
This is putting a lot of responsibility on consumers to not only read their prescription correctly, but to understand the information that they are required to self-input.
Contact lens prescriptions are typically valid for a one-year period as regular ocular health assessment is essential to minimise risk of contact lens complications.
Regular review of the ocular surface with the use of slit lamp microscopes, along with proper instruction on handling and cleaning contact lenses is a critical part of the patient care provided by an optometrist.
Contact lenses are not toys. When prescribed correctly and when worn under the supervision of a trained health care practitioner they provide a safe and effective means of correcting vision. However, all contact lens wear carries with it the risk of potentially sight threatening complications, and regular reviews and appropriate fitting and aftercare by an optometrist helps to mitigate these risks.
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