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They're an especially popular fashion accessory with teenagers, for obvious reasons. Cosmetic contact lenses come in a kaleidoscope of colors and designs that can match your clothing or mood. Their glamour and appeal is enhanced by the fact that they're worn by movie and rock stars.

Eye experts are concerned because many teenagers don't bother to purchase these tinted contacts from an eye-care professional. They buy them on the Internet, at flea markets, video stores, at the beach, costume stores and other unlicensed outlets.

Federal law says contact lenses, including cosmetic varieties, can only be sold by licensed vendors to people with prescriptions. However, many stores simply turn a blind eye to those rules.

Buying cosmetic contact lenses from these illegal outlets can lead to serious eye problems, says Prevent Blindness America (PBA).

The eye health risks include bacterial infections, eye pain, swelling, decreased oxygen flow to the cornea, conjunctivitis (pink eye), loss of clarity, corneal scratches and corneal ulceration. However, many teenagers don't understand such dangers.

"They just think of them as makeup, a fashion accessory, which they're not. When you stick a foreign object in your eye, then it's not the same as makeup," says PBA spokeswoman Betsy van Die.

Cosmetic contact lenses have the same risks as regular contact lenses, and require the same kind of care and caution.

"If a kid is just sticking these in their eyes just because they want to look cool, then they're not taking the same kind of precautions," van Die says.

"If you don't go to an eye-care professional for contact lenses, then you're not going to get a proper fit. It's because of the improper fit that a lot of these problems will occur," she says.

Cosmetic contact lenses are medical devices that must be prescribed by an eye-care professional, stresses Dr. Thomas L. Steinemann, an ophthalmologist and director of the division of ophthalmologic surgery at MetroHealth Medical Center in Cleveland.

"What you have currently have is a naive, uninformed consumer-patient who makes the purchase of a medical device illegally without a prescription from a vendor without a license, without an eye exam, without a fitting, without proper instruction on safe handling and care of the contact lenses, and without follow-up. That's a recipe for disaster," Steinemann says.

He's seen the consequences firsthand. That includes teenager Robyn Rouse. She bought colored contacts at a video store, and developed a pseudomonas bacterial infection in one eye.

"It is probably one of the most feared infections in the eye because it can destroy the eye rapidly," Steinemann says.

He had to perform a corneal transplant on Rouse to repair the damage caused by the infection.

"She's darn lucky she didn't lose her eye. She's doing reasonably well, but that's a pretty heavy price to pay for a youthful indiscretion when you're 14 or 15 years old," Steinemann says.

He says teenage girls seem to be the main consumers of the colored contacts.

Cosmetic contacts have been a hot topic recently with news reports that the U.S. Food and Drug Administration (FDA) was considering deregulating cosmetic contact lenses by listing them as a cosmetic instead of medical device. That would make it legal to sell them without a license or prescription.

"Our stance is that it would be very foolish, especially from a consumer standpoint, to change the policy. Contact lenses are not cosmetics, they're not makeup. You cannot view something that is put in the eye as the same thing as lip gloss or mascara or anything like that," van Die says.

FDA spokeswoman Sharon Snider says the FDA is not considering any move to change the status of cosmetic contacts.

"We haven't made any decisions on cosmetic contact lenses, but no deregulation is planned. And whatever we do down the road, our intention will be to protect the public health, whatever is needed to do that," Snider says.

Both van Die and Steinemann say public education about cosmetic contacts is essential. PBA offers the following advice:

• Always see a licensed eye-care professional to be fitted for contact lenses and always wear them under the supervision of an eye-care professional.

• Clean and disinfect contact lenses according to instructions.

• Store contact lenses in a clean storage case.

• Use water-soluble cosmetics or those that are labeled safe for use with contact lenses. Don't apply skin creams or moisturizers too close to your eyes.

• Never buy contact lenses without a prescription.

• Don't wear contact lenses when you sleep.

• Don't wear opaque contact lenses if you have night vision problems.

• Never share or trade contact lenses with other people.

• Get immediate medical attention if you have eye pain, irritation, redness, blurriness or visual changes.

What To Do

For more information about all kinds of contact lenses, go to Prevent Blindness America.

Here's more on the debate surrounding the possible deregulation of cosmetic contact lenses.