title: Practitioner Perceptions of Patients Wearing Decorative Contact Lenses Purchased Through Unauthorized Sellers.
abstract: OBJECTIVE
  To describe practitioner experiences regarding ocular complications in patients wearing decorative contact lenses, and to investigate the compliance of unauthorized distributors of decorative contact lenses to current Food and Drug Administration (FDA) and Federal Trade Commission (FTC) regulations. Also, to provide data to support a more targeted public health approach to reducing the incidence of illegal contact lens sales and associated ocular complications.
  
  
  METHODS
  An institutional review board-approved online survey was distributed through mass email to a list of 98 optometrists in the Boston, MA area. Concurrently, an empirical evaluation of independent, online decorative contact lens sellers who were not associated with FDA-approved contact lens manufacturers was performed to determine their adherence to FDA and FTC guidelines. The first 18 noncoincidental websites that resulted from a Google search for "costume contact lens sellers" and "cosmetic contact lens sellers" were examined as to the brands and parameters of lenses being sold, whether or not a valid prescription was required or verified, and if consumer education was provided.
  
  
  RESULTS
  Twenty-two optometrists completed the online survey. Seventy-seven percent of respondents reported having patients with complications from decorative contact lenses that were purchased both legally and illegally. The most common age group for complications was 18 to 25 years (61%). One third of complications were seen in first-time lens wearers, half of whom never received proper care instructions or were unaware that care instructions existed. One quarter of the lenses were purchased illegally with unlicensed stores being the most common place of purchase. Of the 18 online sites examined, 72% of sellers failed to adhere to FTC and FDA regulations.
  
  
  CONCLUSIONS
  A significant number of individuals who obtain contact lenses illegally from unauthorized sources are young adults. Most unauthorized sellers reviewed did not adhere to the proper protocol for selling contact lenses or instruct their customers on proper lens wear and care. A significant percentage of optometrists responding to the survey reported complications associated with contact lenses purchased through unauthorized sources, suggesting that the risk of contact lens-related complications increases when the lenses are purchased from one of these sources.
authors.affiliation: private practice (H.G., C.H., N.J., A.W.); and The New England College of Optometry (C.J., R.W.), Boston, Massachusetts.
authors.forename: Hilary
authors.initials: H
authors.lastname: Gaiser
authors.forename: Connie
authors.initials: C
authors.lastname: Ho
authors.forename: Nicole
authors.initials: N
authors.lastname: Janier
authors.forename: Amy
authors.initials: A
authors.lastname: Wee
authors.forename: Catherine
authors.initials: C
authors.lastname: Johnson
authors.forename: Ronald
authors.initials: R
authors.lastname: Watanabe
mesh_terms: D000293:Adolescent; D000328:Adult; D001291:Attitude of Health Personnel; D003132:Commerce / Q000331:legislation & jurisprudence; D003263:Contact Lenses, Hydrophilic / Q000009:adverse effects*; D003358:Cosmetics / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic / Q000592:standards; D014481:United States; D014486:United States Food and Drug Administration; D055815:Young Adult
chemical_list: D003358:Cosmetics