Shakthi Mageshwaran R, B.Optom

Work-Integrated Fellow in Clinical Optometry, Sankara Nethralaya Academy, Chennai, India



 Contact Lens (CL) is increasingly used for refractive correction nowadays because it is cosmetically more appealing, provides a better field of view and visual acuity. Although it has a number of advantages, in accordance with the proverb “A coin has two sides”, it does have serious complications when it is not used with proper care and maintenance. As more and more individuals in today’s world resort to the use of products obtained through easier and faster means, online product purchase has reached its peak. In addition to this, the advent of technology in healthcare paves way for individuals to buy their contact lens online from unauthorized sources. This review is to address the complications due to contact lenses which are obtained from such sources.

Why People prefer online purchase of CL:

Contact lens users prefer to get them from unauthorized sources because of convenience of purchase. There are many factors associated with it, like travelling contingency, time pressure etc.(1). In addition to this, online market provides more advantages like discounts, special offers, availability of wide range of products (2) and so they go in for buying cosmetic or plano contact lenses from online and shop vendors (unauthorized sources) without the help of an eye care practitioner. As far as cosmetic contact lenses are concerned most commonly it was acquired from local unauthorized distributors (3) [Refer Figure 1].


Figure 1: The location of illegal decorative contact lens purchases. (Picture Source: Gaiser et al. 2017)



Necessary recommendations and instructions for wear and care, regular eye check-up and trial fitting are some of the advantages that online users miss because these vendors do not adhere to the proper protocol of selling contact lens and this may further lead to some complications such as ulcerative keratitis and corneal infiltrates (1). Complications due to online purchased cosmetic contact lenses include some of the sight threatening conditions caused by Staphylococcus Aureus, Pseudomonas Aeruginosa and Acanthamoeba (3). Significant risk factors leading to complications with CL users include a poor storage case hygiene, infrequent case replacement, absence of hand-washing, misuse of disinfection system, exposure to tap water, overnight or overwear of same contact lens for a longer time (4). However, these non-compliance issues might be more commonly found in customers who acquire lenses from unregulated sources which is also criticized by many (2,4,5). In a review, it was stated that 70% of the articles reported that the most common contact lens complication was Microbial keratitis (4). Some non-infectious complications include iritis, descematocele, corneal abrasions, and tight lens syndrome. Neovascularisation, corneal erosion, and superficial corneal pigmented iron lines were found among refractive CL users. The effects of online purchasing of contact lenses from various studies are summarised in Table 1.

S.No Article Conclusions from the Study
1. Fogel et al, 2008 People buying CL from the internet do not follow FDA CL regulations. Individuals with time pressure seem to trust more of online resources and buy products online.
2. Thite et al, 2015 Online purchase can never replace the advantages of buying the contact in a doctor’s clinic but it would be also advisable to consider online purchase but with more care.
3. Gaiser et al, 2017 Young adults are mostly involved in buying CL’s illegally. The unauthorized sellers don’t adhere to strict protocols and also don’t educate customers. CL-related complications are more often found in those patients buying from unauthorized sellers.
4. Young et al, 2014 Unregulated supply of CLs might result in the use of inappropriate lenses and increase the risk of poorer lens hygiene. They lead to further complications in contact lens wearers. Regulations can help mitigate this issue.
5. Chalmers et al, 2016 Purchase location had little influence on known risk factors for inflammatory complications with SCLs. Duration between eye checkups was also increased in case of SCL wearers who purchased it on the internet.

Table 1:  Summary on the effects of buying contact lenses online.


Guidelines and Recommendations:

 In order to mitigate the complications due to contact lens from unauthorized sources, certain guidelines and recommendations are required (4). They include the following:

  • Better education for current and prospective contact lens users regarding care and maintenance
  • Proper lens fitting with trial if possible
  • Follow-up care to be advised for all contact lens wearers
  • Stricter regulations of contact lens sale for all unauthorized sources



  1. Fogel, J., & Zidile, C. (2008). Contact lenses purchased over the internet place individuals potentially at risk for harmful eye care practices. Optometry-Journal of the American Optometric Association, 79(1), 23-35.
  2. Thite, N. (2015). Online Purchase of eye-care products—Is it just another fad??. Contact Lens and Anterior Eye, 38(5), 305-306.
  3. Gaiser, H., Ho, C., Janier, N., et al (2017). Practitioner perceptions of patients wearing decorative contact lenses purchased through unauthorized sellers. Eye & Contact Lens, 43(2), 135-139.
  4. Young, G., Young, A. G., & Lakkis, C. (2014). Review of complications associated with contact lenses from unregulated sources of supply. Eye & contact lens, 40(1), 58-64.
  5. Chalmers, R. L., Wagner, H., Kinoshita, B., et al (2016). Is purchasing lenses from the prescriber associated with better habits among soft contact lens wearers? Contact Lens and Anterior Eye, 39(6), 435-441.