Coloured contact lenses bought online: why they are risky for teenagers

Halloween is a few weeks away, the year-end parties follow, and somewhere in a teenager's phone there is an advertisement for lenses that turn brown eyes blue, or green, or a cat's yellow. They are easy to order, and they look like make-up. They are not make-up.

Below is what the law in Malaysia now says about buying them online, what the eye-safety bodies say goes wrong, and what to do if your teenager has already tried a pair. I would like you to leave with a way to talk about it, not a lecture to give.

Can my teenager legally buy coloured contact lenses online in Malaysia?

No. On 25 March 2025 the Medical Device Authority (MDA) stated that the online sale of optical appliances and contact lenses on any e-commerce platform is prohibited. It cited the Medical Device Act 2012, section 30 of the Optical Act 1991 and the Medical Device (Advertising) Regulations 2019. The penalty for a seller is a fine of up to RM200,000, up to two years in prison, or both.

The MDA also said that only registered opticians or optometrists may provide and dispense them, because both need a prescription. Its warning to buyers is direct: buying online without the advice of a registered optician or optometrist cannot guarantee your safety and exposes you to eye health risks.

The statement speaks of contact lenses in general and does not carve out coloured or costume ones. So a pair sold through a social-media shop or a marketplace is a pair that should not have been offered to you. The penalties are aimed at sellers, and the reason given is safety.

But coloured lenses are only cosmetic, aren't they?

They sit on the front of the eye, which makes them a medical device, whatever the packet says. The United States Food and Drug Administration (FDA) states that decorative lenses are medical devices and that all contact lenses, decorative ones included, must be prescribed by a doctor. The American Academy of Ophthalmology (AAO) says costume lenses need the same precautions as regular ones.

A lens has to sit properly on an eye that has been measured. One that is too tight or too loose, or one that is sold without a fitting, can scratch the front of the eye. The AAO lists poorly fitted lenses as a cause of corneal abrasions (scratches), corneal ulcers and bacterial keratitis, which is infection of the cornea, the clear front window of the eye.

The colour does not change what a lens is, and nothing about a party makes it safer.

What is wrong with the lenses sold online?

There is no fitting and no professional oversight, and some have been tested and found contaminated. The AAO reports an FDA analysis of 300 coloured lenses sold illegally online: bacteria were found in about 60% of them. That was in the United States, on lenses bought without a prescription, and I cannot say what the figure would be in Malaysia. But it tells you what a lens with no fitting and no oversight can carry.

The eye department of HCTM UKM, the Universiti Kebangsaan Malaysia teaching hospital, warns that buying lenses from night markets, mall kiosks and online sellers is very dangerous, because of counterfeit lenses that do not meet safety standards. The AAO adds that people who buy from unauthorised sellers are less likely to be taught how to use and care for the lenses.

So there are two separate problems, and they add up. The lens itself may not be clean or well made, and the wearer may never have been shown how to handle it.

What can actually go wrong with the eye?

The damage that worries eye doctors is an infection of the cornea, which can be fast, and can leave a scar over the clear window you see through. The FDA lists corneal abrasion, allergic reaction, decreased vision, infection and blindness as risks of decorative lenses. The AAO says eye infections can become serious very quickly, and that sometimes the damage is not reversible. Its clinical statement also describes cases that ended in a corneal transplant.

One infection is worth naming. Acanthamoeba keratitis is caused by a microscopic organism found in water. The US Centers for Disease Control and Prevention (CDC) describes it as an eye infection that typically affects healthy people and can cause permanent vision loss, and says most people in the United States who get it wear contact lenses. The FDA links it with exposing lenses to any water, tap, bottled, distilled, lake or ocean, and calls it a corneal infection that is resistant to treatment and cure. It advises removing lenses before swimming.

That is why the water rules in the article on contact lenses for children and teens matter, and why a party at a pool or a beach is a particular worry. I do not have a Malaysian figure for how often it happens, and I will not guess one. Permanent vision loss is reason enough to avoid it.

Why is this a particular problem for teenagers?

Because the things that make lens wear safer are the things a party skips. The AAO lists them: never share lenses, wash hands, store the lenses properly, replace the case, and have an annual eye examination. HCTM UKM adds that lenses should be worn no more than 8 hours a day and never slept in or swum in. A teenager who has bought a pair for one night has usually been told none of that.

I do not have figures on how many Malaysian teenagers wear coloured lenses, and I would not claim a number. What the sources describe are the risks of the lenses themselves, and those do not depend on age.

The rule I would give a teenager is simple, and it is about the eye, not about obedience. A lens is either fitted by someone who has examined your eyes, or it is not, and the price of skipping that step is paid by the cornea. A red eye can come from something mild or from an infection, and red eyes after swimming shows how hard it is to tell the two apart by looking.

Her eye is red after wearing them. What do I do?

Take the lens out, do not put it back, and have the eye seen the same day. The FDA advises that redness, pain that does not go away after a short time, or decreased vision means seeing a licensed eye doctor right away, and that an untreated infection can lead to blindness. Its general contact lens advice adds discomfort, tearing, light sensitivity, itching, blurred vision or swelling to the list, and says the lenses must stay out until the eye has been examined.

HCTM UKM's advice is to see an eye specialist promptly and to bring the lenses, the solution and the case, and I would follow it. The lens and the case can help the doctor work out what happened. Leave the choice of treatment to the doctor.

Do not wait for it to settle overnight. A teenager may say it is only a bit sore, and the AAO's own advice is to seek immediate care for redness, swelling, discharge, pain or discomfort. If you are unsure who to see, who checks a child's eyes lists the routes.

Can a teenager get coloured lenses the safe way?

Yes, through an eye examination and a fitting with a registered optician or optometrist, which is the route the MDA describes. A fitted pair with a care routine is a different thing from a pair from an online shop. Whether it is right for your teenager depends on their eyes and on whether they can keep to the routine every night, and that decision belongs to whoever examines them.

For a one-night costume, I would say the safest choice is to skip the lenses, because a lens that is not fitted and not cared for is the version that hurts eyes. Face paint, a wig and a good story cost the eyes nothing.

If your teenager has already bought a pair, do not make it a punishment. Ask them not to wear them, keep them out of the bathroom drawer and out of a friend's hands, and book an eye examination if there is any question about the eyes. You are trying to keep the eyes safe, and a teenager who does not fear a punishment is more likely to tell you about a red eye early.

Common questions

References

1. Medical Device Authority Malaysia · Kenyataan media: larangan penjualan alat optik dan kanta lekap secara dalam talian (25 March 2025) · mda.gov.my
2. American Academy of Ophthalmology · Halloween and cosplay: colorful contacts eye safety · www.aao.org
3. US Food and Drug Administration · Decorative contact lenses: Halloween and more · www.fda.gov
4. American Academy of Ophthalmology · Cosmetic contact lenses: a potential threat to vision, clinical statement (2025) · www.aao.org
5. US Centers for Disease Control and Prevention · About Acanthamoeba keratitis · www.cdc.gov
6. US Food and Drug Administration · Contact lens risks · www.fda.gov
7. HCTM UKM Jabatan Oftalmologi · Di sebalik keindahan kanta lekap · hctm.ukm.my

By Dr Chan Li Yen. General information only. It does not replace a consultation. If you are worried about your child's eyes or vision, please see an eye doctor.