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But with added convenience came an important -- and much overlooked -- drawback: Soft lenses may not be as safe as the rigid, gas-permeable type. And yet, most people -- about 85 percent of the 31 million contact lens wearers in the United States -- choose soft, according to the American Academy of Ophthalmology. (Fewer than 1 percent still wear the original old type of hard lens, and as one doctor says, they're all dying off.) An article in last week's Lancet confirms what many optometrists and ophthalmologists already know, and users do not: Soft-contact lens wearers are at higher risk for one of the worst eye infections -- microbial keratitis, a condition that although rare, can lead to blindness, or the loss of the eye completely. "I would like to suggest that each package of soft lenses should contain a warning on it saying 'Wearing these lenses may threaten your vision,'" says Aize Kijlstra, Ph.D., a coauthor of the study and professor of experimental ophthalmology at the University of Amsterdam. But there are no such warnings on soft lenses and many patients go through the entire procedure of getting contact lenses without ever knowing about this risk.

"Do [doctors] tell them about this? Absolutely no," says Dr. Dwight Cavanagh, the vice-chairman of ophthalmology at the University of Texas Southwestern Medical Center in Dallas, who has done many studies on the safety of contact lenses. "But even if people knew, they would still wear soft ... Consumers are perverse, they prefer the easy route -- convenience and comfort -- over safety."

In the Lancet study, researchers in the Netherlands surveyed 379 ophthalmologists across the country, and asked them to identify all cases of microbial keratitis that occurred in a three-month period; the type of lens the person used; and the person's wearing pattern -- whether a daily user, keeping the lenses in for fewer than 24 hours, or an extended-wear user who left them in for one to two weeks. Microbial keratitis is an infection of the cornea, which is the outer wall of the eye. Dr. Kam Cheng and his colleagues found that although rigid gas-permeable lens users can be at risk for corneal infections, the risk was more than three times higher for those who wore soft lenses for 24 hours at a time, and almost 20 times higher for those who wore extended-wear soft lenses. The study reported findings similar to those in a 1989 U.S. study -- a fact that the researchers say shows that new contact lens materials have not reduced the number of people contracting this infection. "Since millions of contact lens wearers are at risk, this complication is an important public issue," wrote Cheng and his colleagues in the study.

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