General
Fashion Contact Lenses FAQ - 12/31/2009
As a result of its ongoing investigation to the illegal sale of contact lenses in the Commonwealth of the Northern Mariana Islands, the Office of the Attorney General has interviewed local eye care professionals. As a service to the press and consuming public, the OAG has compiled this list of Frequently Asked Questions and answers. This is not intended as specific medical advice, and people are encouraged to direct any questions to a licensed medical professional.
"Contact lenses are in direct contact with the eye. Because of this, they carry significant medical risks if they are not fitted properly or if they are not properly cared for. A dirty pair of glasses, for example, may blur or distort the vision, but a dirty contact lens can result in a serious infection that can damage or even destroy the eye. A few years ago, a patient on Saipan was sold ill-fitting contact lenses without a prescription, and developed a corneal ulcer that nearly led to permanent vision loss. She was treated by Dr. Khorram and myself, and fortunately we were able to save her eye. Dr. Khorram and I subsequently testified at a hearing of the Medical Profession Licensing Board regarding this case. When I was the director of the contact lens service at Loma Linda University School of Medicine in California, I saw several blind eyes that were caused by contact lens complications. This is fortunately rare, but the risk is the reason that federal and CNMI law and regulations require contact lenses to be sold only by prescription." - David Hardt, O.D. "Since contact lenses sit on the surface of the eye, the lens must be fit to the eye. If the fit is not correct, there is definite risk of causing damage, which can include blindness."- Dr. David Khorram, MD "Contact lenses interact with the eye surface. When an eye doctor fits contact lenses, he looks at several factors to optimize that interaction. Contact lenses are capable of permanently damaging the eye, and there are cases of blindness which have resulted." -Dr. Mark Robertson, OD 2. If the box says -0.00, do you still need a prescription? "Yes, there are typically three numbers associated with a CL perscription. The one most people are aware of is the power, which usually is pretty close to the prescription in your glasses. But in reality, the two other numbers are more important since they are the ones that make sure the lens fits your eyeball correctly. One of these numbers is a measure of the curve of the lens, and the other is the diameter of the lens. Together, they determine how tightly or loosely a lens fits on your eye. You don't want a lens to be either too tight or too loose, because it can cause damage. Think of shoes. If they're too tight, or too loose, they can cause difficulties. The problem with contact lenses, however, is that they can be comfortable, and still be too tight or too loose and be causing permanent damage. That's why it's important to get the lenses fit properly. "- Dr. David Khorram, MD "Yes. A contact lens prescription includes not only the power of the lens, but also the curvature, diameter, material/brand, etc. A lens with a power of 0.00 is like a piece of window glass -- it doesn't change the focus of light passing through it. A lens with no power, if it does not fit properly, carries exactly the same risks of a lens with a different power. " - David Hardt, O.D. "[T]he reason for a need for prescription stems from the fact that the lens interacts with the eye. A poorly fitting -0.00 lens is much more dangerous to wear than is a well-fitting "visual-corrective" contact lens." -Dr. Mark Robertson, OD 3. What is the advantage to obtaining a prescription for contact lenses compared to just buying them from a non-licensed merchant? "First of all, ANY wear of contact lenses entails some risk. Being fit by a competent professional is only the first step in increasing the safety. At least as important is properly caring for the lenses AND seeing the fitting professional frequently for follow-up evaluations. Eye doctors fitting contact lenses are trained for the following: i. evaluating eye health to see that the patient is likely to be able to wear contact lenses safely and successfully. ii. evaluating the lenses on eye to make sure that the fit is optimal. iii. knowing what to look for in follow-up visits to catch unanticipated changes early. iv. educating patients as to risks so that the patients make informed choices." -Dr. Mark Robertson, OD "Contact lenses can only be sold by prescription. … The issue is whether they are supplied accurately according to a written prescription for a licensed doctor. … [A]s a practical matter frequent errors may be made if contact lenses are supplied by people that aren't very familiar with them. " - David Hardt, O.D. "Well, it's required by law that you have a prescription to purchase contact lenses, which indicates how vitally important it is. The main thing is that the prescription ensures the lens is fit correctly to your eye. The other thing I would add, is that once you have a prescription, you can buy the lenses anywhere, including from the internet. The prescription needs to be renewed annually, because even lenses that fit well can over time cause problems, and it's important to make sure things remain healthy. We ask our patients to come in at six month intervals for a courtesy lens check to make sure the fit is still healthy."- Dr. David Khorram, MD 4. Where are the licensed places in the CNMI to get prescriptions for contact lenses? "You can get a prescription for contact lenses from any licensed ophthalmologist or optometrist in the CNMI. Dr. David Khorram, MD and Dr. Mark Robertson, OD are available at Marianas Eye Institute, and the Hardt brothers are optometrists available at Hardt Eye Clinic." "- Dr. David Khorram, MD Hardt Eye Clinic - Beach Road Office (between MegaByte and Triple-J Motors) 235-2030, Fax 235-2033 Hardt Eye Clinic - Kagman Office (same building as Kevin's Video and Kagman Post Office) 256-2020, Fax 256-2015 Marianas Eye Institute - Beach Road (across from 13 Fisherman Park) 235-9090, Fax 235-9091 5. Do these places (see answer to #4) also sell fashion lenses? "Yes. And once the prescription is established, THEN the patient can purchase the lenses elsewhere (over the internet, etc.). But, wherever they purchase the actual lenses, it is important that they return to their fitter for frequent evaluation." -Dr. Mark Robertson, OD 6. How much does a prescription for lenses generally cost? How much does a set of fashion lenses generally cost? "There are a very large variety of contact lenses available. Almost all the contact lenses we use are disposable, and vary in price from about 50 cents per lens to around ten dollars per lens. The most popular lenses are single use disposables that cost 50 to 75 cents each (about $1 to $1.50 per use for two eyes) and two-week disposables (discarded every 14 days) that cost around $4.00 per lens. For very complicated cases, we occasionally use custom designed contact lenses that can cost up to $250 or $300 per lens. Fitting the contact lenses, including training in proper care and handling and follow-up visits to make sure the lenses are adapted to properly, is necessary when the contact lenses are initially purchased. At Hardt Eye Clinic, the fee for this service varies with the type of lenses required, but in most cases is less than $100. … " - David Hardt, O.D. "For a non-complicated case, Marianas Eye Institute charges $90 for the fitting. Except in unusual cases (where trial lenses are not available due to the patient's needed parameters being unusual), this INCLUDES the first set of lenses. Most lenses nowadays are then sold in multipacks of 6 lenses, usually around $45 per multipack. Again, if the patient has unusual eye parameters the cost can be more. " -Dr. Mark Robertson, OD 7. If a person has purchased and is wearing lenses without a prescription, what should that person do? Should she immediately stop wearing the lenses? What else? "They should call for an appointment, or walk in at any of the eye clinics, for an eye examination. They should bring the contact lenses to the examination. In some cases, the lenses may fit well and they could continue to wear the same type of lens. In other cases, the lenses may need to be changed to avoid problems. In a few cases, there may be a medical condition of the eyes that makes any contact lens wear risky and ill-advised. Contact lenses obtained without a prescription should not be worn until they can be evaluated by a doctor. " - David Hardt, O.D. "They should take the lenses out, and stop wearing them until they are able to get a contact lens fitting. "- Dr. David Khorram, MD "Certainly the safest thing to do is to stop wearing the lenses. If the person is interested in obtaining contact lenses, she first needs to establish that her eyes are healthy, and then be fitted with appropriate lenses. " -Dr. Mark Robertson, OD
The Honorable Governor Benigno Fitial