The document discusses a study conducted by the Association of Regulatory Boards of Optometry (ARBO) on complications from contact lenses purchased without a valid prescription. ARBO has collected 234 cases since 2003 and found the most common complications were corneal edema, stinging, and neovascularization. On average, each case resulted in $365 in costs. The data has been used to advocate for legislation requiring a valid prescription to purchase contact lenses.

1. Association of Regulatory Boards of Optometry www.arbo.org

4. COMPLICATION(S) DUE TO CONTACT LENSES DISPENSED WITHOUT A VALID PRESCRIPTION REPORTING FORM Tel: (314) 785-6000 • Fax: (866) 886-6164 • E-mail: arbo@arbo.org Reference Letters and/or Numbers for Your Personal Use Only: (which does not identify the individual patient) __Burning __Dry Eye __Conjunctivitis __Foreign Body Sensation __Corneal Distortion __Giant Papillary Conjunctivitis (GPC) __Corneal Edema __Itching __Corneal Epithelial Defect __Keratitis __Corneal Infiltrate __Neovascularization/Pannus __Corneal Opacity __Ocular Inflammation __Corneal Ulcer __Pain __Discharge __Stinging __Other (please comment) Treatment Plan: Outcome: __Lubricants __Return to Pre-Incident Status __Antibacterial Topical/Oral __Short Term Vision Loss __Antibacterial/Anti-Inflammatory/ __Permanent Vision Loss Topical/Oral __Surgical Intervention __Penetrating Keratoplasty __Other (please comment) __Other (please comment) Financial Impact to Patient/Health Care Resources Utilized Medical Costs (Out of Pocket) $_________________ Medical Costs (Third Party Payer) $_________________ Sick Days Lost $_________________ Loss of Income due to Office Visit, $_________________ Total or Partial Disability, etc. Date: ____________ Doctor: ______________ Phone:___________

5. Current Reported Results (n=234) CL Complication Signs and Symptoms : Corneal edema (37%) Stinging (36%) Neovascularization or pannus (36%) Pain (35%) Burning (35%) Foreign body sensation (32%) Corneal epithelial defect (32%) Conjunctivitis (29%)

6. Current Reported Results (n=234) CL Complication Signs and Symptoms (continued) : Ocular inflammation (27%) Corneal infiltrate (25%) Corneal distortion (23%) Keratitis (21%) Corneal ulcer (20%) Giant Papillary Conjunctivitis (GPC) (17%) Dry eye (18%) Itching (13%)

7. Current Reported Results (n=234) CL Complication Signs and Symptoms (continued) : Discharge (12%) Corneal opacity (12%) Blurred vision (5%) Iritis (1%) The reported signs and symptoms that increased from the 2005 report were: conjunctivitis, corneal ulcer, and corneal opacity.

8. Current Reported Results (continued) CL Complication Treatment Plans required : Antibacterial/anti-inflammatory topical/oral meds (40%) Lubricants (33%) Antibacterial topical/oral meds (26%) Refit correct contact lenses (9%) Decrease/discontinue contact lens wear (5%)

9. Current Reported Results (continued) CL Complication Outcomes : Short-term vision loss (18%) Returned to pre-incident status (18%) Permanent vision loss (8%) Permanent scarring (3%) Penetrating keratoplasty (1%) Since 2005, Permanent vision loss increased.

10. Current Reported Results (continued) CL Complication’s cause financial impact: Average Out of Pocket cost from patient $98.18 Average Third Party Payment for office visit's $158.33 Average Patient Loss of Income $108.92 ---------------------------------------------------------------------------------- Total Cost per incidence $365.43 Since 2005 Total costs increased 34%

11. ARBO supports on going Public Protection ARBO realizes the ongoing research has provided important information to entities involved in setting health care policy, rules, and regulations for patient eye health. ARBO encourages the Federal Government to continue its effort to police and eliminate the ability to purchase a contact lens without a valid prescription.