How to Buy and Wear Costume Contact Lenses Safely

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I remember when I first tried contact lenses. I was 14 years old, and I expected to pick up my trial pair and go straight home. Instead, I was led into a side room, where a technician showed me my lenses, still in their packaging, with the brand and lens powers listed on their foil coverings. She taught me how to identify whether they were inside or right-side out and how to insert the lenses, take them out, clean them, and store them. She emphasized the importance of always washing my hands before handling them, not sleeping with them in, and taking them out right away if they became uncomfortable.

It was a bit more than I’d bargained for. What was the big deal?

As I would learn years later, after entering the eyecare field myself, contact lenses are medical devices that require a prescription—even cosmetic ones that don’t have corrective power. That’s because a prescription is for more than the corrective power of the lenses; it also determines their fit.

Many people look to decorative contact lenses for cosplay or Halloween. Unfortunately, the lenses that many vendors sell—both online and in person—aren’t FDA approved. Selling contact lenses without requiring a prescription is not only illegal, but dangerous.

Read on to learn about the risks and how you can buy and wear specialty lenses safely.

The Importance of Regulation

Wearing lenses you’ve bought without a prescription is dangerous for two big reasons. First, they have not been fitted to your eyes by an eye doctor. According to the American Academy of Ophthalmology (AAO), poorly fitting contacts can be difficult to take out and cause serious injury. Second, they might be made from materials that are unsafe to put into your eyes. The AAO warns: “The chemicals used to color over-the-counter tinted contact lenses include chlorine and other harmful substances. These chemicals, known to be toxic to human tissue, can seep into your eye, possibly leading to vision loss.” As the FDA notes, other risks include eye infection, allergic reaction, corneal ulcers and abrasions, and even vision loss.

Someone who already wears glasses might be tempted to try to order contact lenses using their eyeglass prescription in an attempt to avoid the time and expense of a contact lens fitting. But in addition to a glasses prescription not including the curve and diameter measurements needed for contacts to fit properly, you may need slightly different corrective power because contacts are manufactured in a more limited range of corrective powers than glasses. For instance, if your eyeglass prescription reads –1.00 –0.50 × 095, you might end up with contact lenses of –1.00 -0.75 × 090, or  –1.00 –0.75 × 100,  or you might need –1.00 sph. (If these numbers are completely baffling, read more on how to understand an eyeglass or contact lens prescription.)

Even if you have worn contacts before, it is still crucial to have this fit checked. The shape of your eye can change over time, requiring lenses with a different diameter or base curve.

Properly prescribed contact lenses are not without risk, but they are heavily regulated by the FDA and the FTC. Many of the eye issues I witnessed during the eight years I worked in eyecare were due to patients overwearing and improperly caring for their lenses. But sometimes it was just plain old bad luck. I remember a patient who, as it turned out, was allergic to the material of the first contact lenses she tried. I spoke on the phone with several patients who fell asleep in their contact lenses and could not remove them upon waking. I myself have had to flush my eyes because I mistook a bottle of peroxide solution for rewetting drops one morning when I was more asleep than awake. (I don’t think I have ever disrobed and flung myself into the shower as quickly as I did the moment that solution hit my eyes. It is an experience I do not care to repeat.)

Risks associated with prescribed contact lenses are largely mitigated by patient care, education, and support from doctors and clinic staff. None of these mitigating factors exist for contact lenses sold illegally. Unfortunately, most people have no idea of the risks they are taking when they buy unregulated lenses—and many don’t even realize they’re illegal.

Worst-Case Scenarios

I had the great privilege of working with Dr. John S. Berestka, an ophthalmologist who specializes in treatment of cataracts, glaucoma, and the cornea. Although I no longer work in the field, I wanted to get his opinion as a corneal specialist on non-FDA-approved lenses and their risks.

“The risks listed by the FDA are the main ones, but they can be severe,” he confirmed. I asked whether he had firsthand experience with complications due to contact lens wear, prescription or otherwise.

“The worst corneal infection that I saw came from someone who bought a novelty contact lens at Spencer’s,” he told me. “It turned out to be a Pseudomonas infection that involved the entire cornea and eventually spread to the sclera. She was in constant pain for months and eventually had to be hospitalized for round-the-clock antibiotics at the University of Minnesota.” Despite a corneal transplant, doctors couldn’t save the patient’s vision. “My partners have seen other serious cases from novelty contact lenses,” Dr. Berestka added.

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Let me pause a moment here to emphasize this: The worst corneal infection that a corneal specialist has seen was from novelty, nonprescription contact lenses. Yes, I had heard about these kinds of cases, but they always seemed far-flung and rare almost to the point of urban legend. To have a doctor I knew and once worked for describe, in detail, a case he managed brought home to me how serious of a risk novelty contact lenses present.

I worked in ophthalmology during my last year in eyecare. I saw a lot of gnarly stuff, much of it age related, much of it bad luck. I helped care for patients suffering from orbital fractures and other blunt force injuries. I did a workup for a patient who had a scratch on his cornea so large, it looked like a piece of glass was wedged in the front of his eye. I teched for patients suffering from shingles, pink eye, herpes simplex, and much, much more. Many if not most of these patients regained their vision at least somewhat, if not completely. And yet a single novelty contact lens caused a patient to lose her vision despite intensive medical intervention.

Safe Shopping

Contacts in realistic and mildly unnatural eye colors, like Freshlook Colors or Air Optix Colors, are available from almost any licensed contact lens distributor or optical clinic—like 1-800 Contacts, Walgreens, Coscto, or Target Optical. Novelty lenses can be more difficult to source safely, and many websites sell them illegally.

How can you tell whether a vendor is selling contact lenses legally? Thankfully, it’s pretty easy to tell: If they don’t require a prescription before you make your purchase, then they are selling contact lenses illegally. In researching websites for this article, I lost count of the number that allowed me to add contacts to my cart and proceed right to checkout. In fact, I found only two novelty contact lens vendors that required me to enter a prescription and eye doctor or clinic information: Lens.com and 1-800-GET-LENS. Before they sell you lenses, they will verify your prescription with the doctor you list.

But what if there is no legal vendor for the lenses you want?

Look, I get it. I am a cosplayer myself, and a bit of a perfectionist. I understand the desire to get the look of a cosplay just right, even down to the eyeballs. It can be hard or downright impossible to find an FDA-approved seller for blackout, zombie white, or yellow cat-eye lenses. But Dr. Berestka is clear and to the point: “I would never wear one of these lenses, except for the approved versions.”

I understand the frustration at all the red tape and the temptation to purchase those lenses that are just right for Alastor, or Raven from Teen Titans (I wanted a pair that would glow!), or Geralt, or any number of characters whose distinctive eyes would be the capstone of your cosplay. But I won’t downplay the risks. You only get one pair of eyes, and there are no do-overs. Don’t risk it for a few hours of the perfect cosplay.

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Care and Keeping

Whether they’re corrective or cosmetic, it’s important to wear your contacts safely.

New contact wearers must learn how to insert and remove their lenses, much like I did, and how to keep them clean and safe. Wash your hands before handling your lenses, whether putting them in or taking them out. Always work in the same order, right to left or left to right, in order to avoid mixup, especially if you wear a different prescription in each eye. This builds muscle memory and will keep you consistent when you are inserting and removing your lenses. In fact, one time I inserted my right lens, but had to take it out again, and I immediately tried to remove my left lens and poked myself in the eye because I had not even inserted it yet! Muscle memory is a powerful tool.

If you use extended-wear contact lenses, always clean your contact lenses with contact lens solution before putting them in their case. Most contact lenses are approved for two-week or monthly replacement; I myself wear daily disposable contact lenses so that I do not have to clean and keep track of when my contacts need replacing. Do not let tap water, saliva, or any other liquid touch your lenses besides solution specifically made for them, and replace your case every month or two if you wear the lenses regularly.

Unless you wear contacts that are approved for overnight wear, you should not sleep in them—not even to take a nap. Your cornea needs oxygen to breathe and stay healthy, and sleeping in your contacts deprives your cornea of oxygen and can also put you at risk of developing an eye infection. You should also avoid swimming or bathing in your contact lenses. Bacteria that live in water can get trapped between your lens and your eye, causing infection. If you do swim with you contact lenses in, wear goggles and, if possible, take your contacts out right away and clean them thoroughly when you exit the water.

Developing these habits will help to keep your eyes healthy and will keep your contact lenses comfortable and clean. If you do develop irritation, or suspect an eye infection, call your eye doctor right away. Many ocular maladies require antibiotics or steroids, and taking action sooner rather than later can save you a lot of pain. When in doubt, call your eye clinic. They will be happy to help.

Whether you wear contact lenses, glasses, or have perfect vision, your eyes are the window to your world and ought to be protected.

So whether it’s for Halloween or your next convention, be safe and have fun—and whatever choices you make, I hope you at least make them with eyes wide open.