Colored cosmetic contact lenses: an unsafe trend in the younger generation

To identify the microbiological profile and evaluate the clinical course and outcomes in patients who developed severe infectious keratitis after colored cosmetic contact lens wear.

This case series includes 13 patients who developed severe infectious keratitis after colored cosmetic contact lens wear. A detailed history regarding contact lens availability and storage and handling techniques was taken. All patients underwent standard diagnostic microbiological evaluation followed by culture-guided topical antimicrobial therapy.

Of 13 patients, 8 were male and 5 were female, with mean age at presentation of 19 ± 3.8 years. All patients were emmetropic, and lenses were worn solely for cosmetic purposes. Seven lenses were dispensed without prescription or fitting from an unlicensed optical shop, 5 patients had shared lenses with friends/relatives, and 1 patient obtained the lens from the garbage. None of the patients followed the recommended contact lens handling and storage techniques. The causative microorganisms included Pseudomonas aeruginosa (54%), Staphylococcus aureus (25%), and Staphylococcus epidermidis (17%), with 1 case of viral keratitis. In 62% of cases, ulcer size was ≥5 × 5 mm and posttreatment corrected visual acuity was 6/24 or less. All patients responded well to topical antimicrobials, and none required surgical intervention.

Over-the-counter use of decorative lenses as a cosmetic aid is rapidly increasing. Easy and unmonitored availability of these cosmetic lenses is followed by severe sight-threatening complications in young emmetropic individuals.