It’s almost Halloween. Have you decided what you’re going to be this year?
Well, whatever you decide your costume will be, we hope you have an enjoyable and safe Halloween! Naturally, at 20/20 Institute, we are passionate about helping people be happy and healthy with their vision, and this is the time of year that costume or theatrical contacts become pretty popular with folks using them as a finishing touch on their Halloween costumes.
There are all kinds of “looks” available, from fairy princess to vampire contacts and everything in-between, and you can find them in various stores and online. But beware, the effects of these contact lenses can be more impactful than simply making your Halloween costume that much better this year – they can have serious consequences to your vision. That’s why in this article we want to provide some explanation and guidance about these types of contacts to help you be happy and healthy with your vision if costume contacts are part of your outfit this Halloween.
Contact lenses in general have become so commonplace that sometimes people don’t think of them as a medical device. Contact lenses – even costume contact lenses – are regulated by the FDA because they physically touch the eye and improper use can have serious consequences. Therefore, even costume contact lenses require a prescription from an eye doctor to be sold legally in the United States.
Even people who have perfect vision should have an eye exam and receive a prescription before they buy and wear costume contacts. Just like it is important to follow a doctor’s instructions for a pill prescription, it is equally important to follow the instructions of a licensed eye doctor with regard to contact lens use. The FDA has published some helpful guidelines for Costume Contacts that are quite helpful to review this time of year.
Contacts look like a tiny piece of plastic, but they truly are much more complex than they might seem because they are worn on the cornea. The cornea is the clear, dome-shaped part of the eye in front of the colored part of the eye (iris). It forms the outermost protective layer of the eye, sharing eye protection duties with the eyelids, tears, the eye socket, and the white part of the eye called the sclera. It also acts as the eye’s outermost lens, and is responsible for about two thirds of the eye’s focusing power.
Maintaining the health and clarity of the cornea is absolutely critical to your ocular health and to your vision. Think of the cornea like you would the windshield of your car. If your windshield isn’t clear, you can’t see through it very well. Likewise, if the health of the cornea is compromised, vision can be compromised. Contact lenses are worn directly on the cornea, so they have the potential to harm the cornea and cause serious consequences if worn improperly.
FDA-approved contact lenses have several components. One important factor is the actual material the contact lens is composed of. Every part of our body needs oxygen to be healthy and perform its function, but since the cornea needs to be clear so that we can see through it, there are no blood vessels in our corneas. So, unlike the vast majority of our bodies, the cornea does not receive its oxygen or any other nourishment from the bloodstream. Instead, the cornea receives nourishment from the atmosphere, from the tears, and from a fluid in the front part of the eye that fills the space behind the cornea called the aqueous humor. Since the contact lens is placed right on the cornea, it is important that the contact lens does not prevent the cornea from receiving its nourishment.
Since the cornea receives the majority of its oxygen from the atmosphere, FDA-approved contact lenses are made of special materials that allow oxygen and other gasses to pass through the contact lens from the atmosphere to reach the cornea. This is referred to as the oxygen transmissibility of a contact lens material. Incidentally, this is extra important for people who wish to wear extended wear contacts where the contacts are inserted and not taken out for several days or more.
Extended wear contact lenses are made of high transmissibility materials that are intended to allow even more gas exchange through the lens. When a person “over-wears” their contacts, new blood vessels can start to grow into the cornea so that the cornea receives the nourishment that it needs in a different way. The downside of these new blood vessels is that they can grow across the cornea and can cause some loss of vision – similar to having a permanently cracked “windshield.”
Another significant factor that an Eye Doctor will take into account when prescribing a contact lens is the shape and size of the lens. Just like there are many different sizes of shoes to fit our individual foot size, eyes are not all the same size, so contact lenses are manufactured in various sizes to fit the different sizes and shapes of our eyes. If you wear the wrong size shoes, you won’t be able to get them on or your feet will hurt, right? Same concept for contact lens sizes, except that the consequences of the wrong size contact lens are much worse than wearing the wrong size shoe.
When a contact lens is fitted properly by a licensed eye doctor, the contact sits on the cornea loosely enough to be able to move a little when the person blinks. Eye doctors call this intentional movement of the contact lens translation, and it is critical to allow tears, which also nourish the cornea, to flow underneath the contact lens to the cornea.
If a contact lens is not fit by an eye doctor, wearing a contact lens that does not fit right can also cause serious problems such as scrapes and open sores on the cornea (Corneal Abrasions and Corneal Ulcers), which can lead to increased risk of painful and potentially blinding bacterial or fungal infections (Keratitis).
If a contact lens does not fit properly, it can end up suctioning onto the eye. Then, trapped debris, attempts to remove the lens, and the lens itself can harm the skin layer of the cornea. When the skin layer of the cornea is scratched or scraped, bacteria, fungus and other not-so-fun things can get nestled in that damaged area of the skin layer and start to grow. Serious corneal infections can lead to loss of vision and even require a corneal transplant as the only therapy.
If you are looking for some additional information online, the American Academy of Ophthalmology has a website for non-eye doctors called Eye Smart where you can get some great additional information about Costume Contacts.
So this Halloween, and every other day of the year for that matter, please be sure that if you are going to wear any type of contact lens, that you first visit your eye doctor and have an eye exam to get a prescription for the right contact lens for you. Then, follow the instructions for proper wear and care given to you by your eye doctor. Do this even if you have perfect vision and are planning to add some extra pizazz to your Halloween costume. Your eyes will thank you! Happy Halloween!!