TINTED SCLERAL contact lenses (CLs) were developed in the 1920s (Corneo et al, 2023) and first used in Hollywood during the late 1930s to change an actor’s eye color (Greenspan, 1969). Red-tinted soft CLs were introduced in the 1970s to improve color vision deficiency (CVD) (Zeltzer, 1974), followed by the mass production of cosmetic CLs in the 1980s. Tinted CLs have ocular and non-ocular applications, and their popularity is expected to increase.
Cosmetic CLs accounted for 1% of new fits in 2023 (Morgan et al, 2024) and comprise 2% to 10% of the soft lens market (Nichols and Fisher, 2024). The cosmetic CL market is expected to grow by 10.3% annually (The Business Research Company, 2024) because they can be worn for aesthetic or therapeutic reasons to improve the cosmesis of scarring and trauma (Cole and Vogt, 2006).
THERAPEUTIC APPLICATIONS
Therapeutic tinted CLs reduce photophobia and glare associated with ocular conditions, including iris coloboma and photoreceptor dystrophies (Fernandes, 2005; Severinsky et al, 2016). Tinted CLs can also help non-ocular conditions by alleviating photophobia associated with migraines and post-concussion symptoms (Shubert et al, 2018).
Amber CLs help track fast-moving objects, whereas gray-green CLs benefit outdoor activities (Erickson et al, 2009). These lenses improve contrast sensitivity and low-contrast visual acuity, provide faster visual recovery in sunny conditions, and subjectively improve glare (Erickson et al, 2009; Porisch, 2007) compared to clear lenses. Although the original tinted CLs were discontinued, a newer generation of tinted lenses is available (Fisher, 2023).
In a similar vein, photochromic CLs were named one of Time’s best inventions in 2018. Alternative methods of filtering high-energy visible light (HEVL) include CLs that filter 14% to 60% of blue-violet light (Renzi-Hammond, 2022; Mark’ennovy, 2018). Although photochromic CLs were recently discontinued, photochromic and HEVL-filtering CLs decrease light scatter, improve recovery time following exposure to bright stimulus, and reduce halos (Renzi-Hammond, 2022; Hammond et al, 2020; Renzi-Hammond et al, 2020).
Alternative methods of filtering light include turmeric-based pigment that blocks > 97% of HEVL (Sekar et al, 2019) and carbon black-tinted lenses with the drug cysteamine to improve photophobia and treat cystinosis (Dixon and Chauhan, 2019). However, further work is still required to test biocompatibility.
AMBLYOPIA AND COLOR VISION DEFICIENCY
Tinted, occlusive cosmetic CLs can improve the visual acuity of amblyopic children (Abu-Ain and Watts, 2023) and adults (Garcia-Romo, 2018). Newer methods of creating tinted CLs using organic powdered foods, like spinach, have been recently investigated (Sekar et al, 2019), which may have health benefits.
Red-tinted CLs approved by the U.S. Food & Drug Administration are available to improve color discrimination in people who have red-green CVD (Ilhan et al, 2020). Newer techniques for tinting CLs for CVD include different dyes and nanoparticles. Atto dyes are more cost-effective than nanoparticles, and the pink-tinted CLs improved the number of Ishihara plates identified by people with red-green CVD by 20% to 21% (Elsherif et al, 2021). Cheaper options include Piccassio alcohol inks incorporated onto CL surfaces using 3D printed molds to dye the pupil (Salih et al, 2023) and food powders to tint the entire lens (Sekar et al, 2019).
Dual-purpose gold nanoparticles provide CLs with a reddish hue to filter light, along with antibacterial properties (Jacob et al, 2024). Metasurfaces composed of gold nanorods have also been added to corneal CLs to improve color perception (Karepov and Ellenbogen, 2020). Although blue-yellow CVD is less common, silver nanoparticles create yellow-tinted soft CLs, which may benefit people with this condition (Salih et al, 2022) while also being antimicrobial resistant (Wilcox et al, 2010). All these new tinting methods need human testing for both performance and safety.
CONCLUSION
The future of tinted CLs looks bright, due to their varied applications in ocular and non-ocular conditions and elective use for aesthetics and sports.
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