Pseudostrabismus secondary to use of cosmetic contact lenses

The DuraSoft 3 Colors cosmetic contact lens is manufactured with a pattern of opaque dots applied to its front surface in order to produce a change in apparent iris color. We fit ten subjects with the DuraSoft 3 Colors contact lens, and all were found to have pseudoexotropia. The deviation ranged from 10 to 22 delta (prism diopters) (average: 16 delta). The cause of the pseudoexotropia was creation of a pseudopositive angle kappa from lateral displacement of the contact lens. Physicians fitting the DuraSoft 3 Colors contact lens should pay special attention to centration characteristics during the fitting session in order to avoid creation of pseudostrabismus.