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    Special effects contact lenses: Kids, don't try this at home

    Patients of all ages need your expertise to use special effects contact lenses


    While many eye-care professionals may experience a "monster" of a day, few can make that statement as literally as Jonathan Gording, OD. Dr. Gording's experience with fitting special effects (SPFX) contact lenses (CLs) for assorted creatures, aliens, and other characters for film and television productions also lends him insight about the proliferation of SPFX CLs on the Internet and in brick-and-mortar neighborhood stores.

    Dr. Gording
    "There's a whole legion of people out there who don't have a clue," he said. "When a patient comes to an optometrist with a problem and that patient says, 'I was wearing some lenses for Halloween,' the optometrist should be aware that the lenses may not have been everyday CLs."

    Connecting with the studios

    Dr. Gording first entered into practice in Los Angeles as a vision therapist, emulating the specialty of both his parents. After a few years, he joined a corneal specialist's practice in North Hollywood in the San Fernando Valley, a tertiary care facility to where many patients were referred by other ophthalmologists, optometrists, and opticians. One day, a make-up artist from a local film studio asked Dr. Gording if he could fit special CLs and then showed him some hand-painted samples.

    Black scleral contact lenses such as these were worn by actors in "The X-Files." (All photos courtesy of Jonathan Gording, OD)
    "They were considerably larger than most 'normal' CLs," Dr. Gording explained. "I shrugged my shoulders and said, 'I think I can fit anything.' I set out to uncover the basics, such as the different labs involved, where to get lenses painted, and where the labs get different raw materials. One job led to another. Next thing I know, I'm 'in the Rolodex.'"

    ScCLs for SPFX

    Savvy make-up artists are ordering scleral CLs (ScCLs), usually used by glaucoma specialists for post-trabeculectomy patients whose eyes are over-filtering or for early bleb leaks, Dr. Gording said, adding that hand-painted ScCLs also are used for patients with a damaged but still-functional eye.

    On a film set, a professional technician stands by to insert and remove the scleral contact lenses (pictured here) and applies artificial tears every 10 to 15 minutes.
    ScCLs have their own fitting requirements, he said. The lenses can fit nearly anybody; while one person can tolerate a 22-mm lens, however, another can accommodate a 24-mm lens, and yet another person can only handle a 20-mm lens. (The typical CL size is 14 to 15 mm in diameter.) When most opticians fit CLs, they may consider corneal measurements only because the peripheral flange is, for the most part, standardized.

    Differences also exist among the labs that make ScCLs, Dr. Gording said.

    Dr. Gording and a model during a photo shoot for Make-Up Artist magazine.
    "I'm in consultation with [a lab] right now. They've got this really nice material, and it's a great cut. But there are a lot of bubbles underneath the lenses in places that ought not to be there," he said.

    Some make-up artists even have tried to make their own lenses without using FDA-approved dyes or using dyes that lose their color if the lens is put into a saline lens-disinfectant solution, Dr. Gording said.

    Because of the rise of methicillin-resistant Staphylococcus aureus infections, he added, clinicians should be increasingly vigilant in their community of conjunctivitis and fungal corneal infections with any CL. Those problems initially can mimic or masquerade as normal infections and are diagnosed with cultures or confocal microscopy, which enables a practitioner to see infectious organisms in a patient's eye, Dr. Gording said, adding that corneal ulcers also should be noted for possible Streptococcus or Pseudomonas bacteria.

    Additionally, he said, ScCLs have a greater potential for conjunctival erosions, and the increased weight of ScCLs also poses a risk of corneal erosions under the eyelid, all the way up into the cul-de-sac, particularly if the lenses are of poor quality or are poorly fitted.


    Optometry Times A/V