Pediatric and Teen CL Care

The Circle Lens Craze

By Christine W. Sindt, OD, FAAO

A few years ago, while speaking at a state optometric association, I stayed in the same hotel as an Anime convention. The hotel was crawling with hundreds of teens and young adults dressed as their favorite Japanese animation characters. They were all very nice and well behaved, as well as very passionate.

Fashion Frenzy

Anime characters have exaggerated beauty features, such as large eyes, small noses, and big hair. When Lady Gaga sported this look in one of her music videos, it sparked a national fashion desire beyond the character-loving groupies. To complete the anime look, teens, young adults, and even housewives are logging onto the Internet to order eye-enlarging contact lenses. These "circle lenses" have tints and patterns on the haptic portion of the soft contact lens, giving the wearer a doeeyed, cartoon-like look.

The problem, of course, is that these non-FDA-approved contact lenses are being obtained without the fitting and instruction of eyecare practitioners. There have been reports of "circle lens parties" at which worn lenses are being traded and swapped. Internet bloggers are spreading the word about circle lenses, even saying that eyecare professionals are making up the risks.

Because these lenses are not being imported into the United States by a distributer, but rather are being individually sold to consumers directly from Korea or China, it is unlikely that the Federal Trade Commission will be able to ebb the flow.

Make the Most of the Situation

Sometimes adverse situations offer the best opportunities to reconnect with our patients. Don't scare children and teens into compliance (I don't recommend showing pictures of devastating eye infections because this may frighten them out of lens wear), but rather give them and their parents real information.

When properly fit, contact lenses are an effective and safe form of vision correction; however, poorly fit contact lenses can adversely affect ocular health (Young and Coleman, 2001). Circle lenses are not FDA-approved, which means you cannot speak to the quality or acceptability of the manufacturing (such as lens design, optics, edge profile, dyes used, etc.) of lenses obtained through the Internet (Saviola, 2007). Yet, we know that people who purchase contact lenses through the Internet have a fourtimes higher adverse event rate (Stapleton et al, 2008).

Contact lenses purchased over the Internet place individuals potentially at risk for harmful eye care practices (Fogel and Zidile, 2008). This increased risk is likely due to poor compliance. Internet purchasers have fewer follow-up examinations with eyecare professionals and no one to go to in case of emergency. They also may not see these lenses as medical devices, but rather as cosmetics. As such, they may participate in more risky behavior such as not practicing good hygiene, not cleaning or using the correct care products, sleeping in lenses, improper lens storage, participating in "lens parties" at which lenses are shared, or they may not replace lenses on a healthy schedule—all of which have been associated with increased risk.

In essence, children don't know what they don't know, and a trip to their eyecare practitioner can help keep their eyes safe. This is an issue of public safety.

The American Academy of Optometry Section on Cornea, Contact Lenses and Refractive Technologies and The American Optometric Association Cornea and Contact Lens Section issued a joint statement regarding the concerns about circle lenses. To read it in its entirety, please visit www.aoa.org/x16126.xml. CLS

For references, please visit www.clspectrum.com/references.asp and click on document #178.

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Dr. Sindt is a clinical associate professor of ophthalmology and director of the contact lens service at the University of Iowa Department of Ophthalmology and Visual Sciences. She is also the chair-elect of the AOA Contact Lens and Cornea Section. She is a consultant or advisor to Alcon, Ciba Vision, and Vistakon and has received research funds from Alcon. You can reach her at christine-sindt@uiowa.edu.