House of Commons Hansard #62 of the 39th Parliament, 2nd Session. (The original version is on Parliament's site.) The word of the day was lenses.

Topics

(The House resumed at 1:30 p.m.)

Sitting Resumed
Business of Supply
Government Orders

1:30 p.m.

Conservative

The Acting Speaker Royal Galipeau

The House will now proceed to the consideration of private members' business as listed on today's order paper.

Health
Private Members' Business

March 7th, 2008 / 1:30 p.m.

Conservative

Patricia Davidson Sarnia—Lambton, ON

moved:

That, in the opinion of the House, the Minister of Health should regulate non-corrective, cosmetic contact lenses as medical devices under the Hazardous Product Act or the Food and Drugs Act.

Mr. Speaker, it is my duty to rise today and bring attention to a most serious matter, one that has been taken lightly for too long. Hopefully in my address today I will be able to successfully enlighten the House as to the severity of this matter.

Hopefully we can begin to have a fruitful debate on an issue that stems in part from a crucial lack of regulation due to a classification oversight. Today I will show the House how this very same lack of regulation is putting Canadians in communities from coast to coast to coast in a greatly elevated atmosphere of risk.

I am speaking, of course, of the issue of non-corrective cosmetic contact lenses regulation in Canada.

Today I have the privilege of being able to present to my fellow parliamentarians what we could consider the initial phase in opening up a larger debate on the various benefits of regulating non-corrective cosmetic contact lenses.

In the next few minutes, I ask members to listen to my words about the severity of this issue, because the first time I spoke with members of the Canadian Association of Optometrists, I was sincerely surprised at the underlying health issues associated with using these contact lenses. What is truly needed to alter the existing status quo toward non-corrective lenses is change within the essential classification policy.

In the past, prevailing conventional wisdom was that the coloured contact lenses that some of our high school age children have perhaps actually worn were not a Class II medical device. This is in direct contradiction to the fact that while non-corrective cosmetic contact lenses pose no refractive merit, they still possess the identical health risks that corrective lenses do and in fact are more dangerous than regular corrective lenses. This belief is shared by eye care professionals across the industry.

Countless individuals across all age barriers are consumers of these unregulated contact lenses and countless individuals are increasing non-repairable damage to their eyes without even knowing it.

Motion No. 409 states quite explicitly:

That, in the opinion of the House, the Minister of Health should regulate non-corrective, cosmetic contact lenses as medical devices under the Hazardous Products Act or the Food and Drugs Act.

This brings about the necessity of amending either the Hazardous Products Act or the Food and Drugs Act in order to bring non-corrective cosmetic contact lenses under the same regulation as corrective lenses.

As such, we can successfully alleviate the risks associated with the use of non-corrective cosmetic contact lenses. We can ensure that consumers of such a product are receiving professional supervision when it comes to matters of their vision. Thus, regulation is needed to ensure that non-corrective cosmetic contact lenses are properly fitted to the individual eye.

There is a simple reason why non-corrective lenses are more strenuous than corrective lenses for the human eye. For those who have never handled a contact lens before, I point out that they are incredibly light in weight. Thus, a contact lens maintains its light weight and possesses a strong refractive capacity by being composed mostly of water.

It is the nature of the refractive capacity that allows the contact lens to serve as a corrective lens. Because it alters a bodily function--in this case it allows the human eye to focus better and increase our overall field of vision-- it is recognized as a type II medical device.

Corrective contact lenses are quite comfortable. They breathe, although most opticians still advise that there is an associated risk of wearing even a corrective contact lens.

Recently, my executive assistant, on a visit to his optician here in Ottawa, was surprised to learn of non-repairable damage done to his cornea. He had been wearing a corrective lens with a cosmetic tinting to alter his eye colour, albeit slightly.

It was the thin layer of ink within the contact lens that suppressed his cornea's natural ability to breathe. Over time his cornea became scratched. This is also known as a torn cornea. As such, and at the request of his optician, my assistant switched to a corrective lens without the cosmetic tinting. This allows his eyes to breathe much easier during the course of a day, although his optician has advised him that he should ultimately consider ceasing to wear lenses on a daily basis permanently.

Accordingly, the risks associated with wearing a lens over the cornea are greatly increased with the usage of a coloured contact. Thus, the damage to my assistant's eye could have potentially been far greater had he been wearing a non-corrective cosmetic lens. Yet, despite this increased risk, there are zero regulations for non-corrective contact lenses.

Wearers of these lenses almost always wear the lenses to alter their eye colour to a more desirable tone. This requires a thin layer of ink injected into the watery contact lens. This pocket of ink blocks the natural path of oxygen one would find in a corrective non-coloured lens.

Moreover, in 2003, the Contact Lens Association of Ophthalmologists reported that a contact lens, coloured or not, was a plastic foreign body that rests for hours, days or weeks on the most delicate and most important image-forming structure in the eye: the corneal epithelium.

Contact lenses are composed of tiny polymers that are cooked together by the miracle of modern chemistry into long, intertwined strands that form a curved plastic sheet. These units effectively create a barrier that prevents normal amounts of oxygen from reaching the eye.

As stated already, this process is much worse in coloured contact lenses, of which the majority of cosmetic lenses are.

The lack of oxygen to the cornea is extremely damaging. When one sleeps with these coloured lenses still placed over the cornea, oxygen starvation increases further potential for damage. During meetings with opticians, I have personally heard of stories whereby students in university, completely unaware of any risk, would wear disposable lenses, which were to be thrown out after a month, for longer than six months on occasion.

Again, the risk increases when we are discussing these terms in regards to non-corrective cosmetic contact lenses.

There are literally thousands of people across Canada right now doing damage to their eyes and they do not even know it. What is worse is that they will not know because they will never be made to see an optometrist in order to obtain non-corrective cosmetic contact lenses as they would be forced to under existing regulation for corrective contact lenses.

However, there is light at the end of the tunnel. Thanks to proactive studies into the damaging effects of non-corrective cosmetic contact lenses, we are now seeing research that indicates the strong risk of wearing these lenses. The industry has collectively united and organizations, such as the Canadian Ophthalmological Society, the Canadian Association of Optometrists and the Optician Association of Canada, have lobbied to see what type of regulatory controls can be applied to non-corrective cosmetic contact lenses.

Thus, for nearly five years the Canadian Association of Optometrists, also known as the CAO; the Canadian Ophthalmological Society, the COS; and the Optician Association of Canada have actively lobbied Health Canada to regulate non-corrective lenses under the auspices of the Food and Drugs Act regulations.

As a result of the lobbying efforts by the CAO, COS and the Optician Association of Canada, Health Canada commissioned a third party risk assessment of cosmetic contact lenses. This study determined that the risks associated with non-corrective cosmetic contact lenses were indeed sufficient enough to justify regulation by Health Canada.

However, to this day there has been a succinct lack of progress made on this health issue. This is despite numerous reports on the dangers of lack of regulation on the issue.

Motion No. 409 would open up the regulatory book and allow Health Canada to ensure that manufacturers of these contact lenses would be forced to assume a certain degree of stewardship responsibility for the distribution and sales of these non-corrective cosmetic contact lenses.

Without this regulation, studies, such as the 2003 review of “Ocular Complications Associated with the Use of Cosmetic Contact Lenses from Unlicensed Vendors” taken from Eye & Contact Lens: Science and Clinical Practice, vol. 29, issue 4, will be for naught.

This study used retrospective, observational and clinical settings to determine that coloured contact lenses being dispensed without a prescription or proper fitting procedures being utilized posed a sincere health risk. As such, the study was successful in calling attention to the unauthorized sale of cosmetic contact lenses.

Since the initial appearance of health issues related to non-corrective cosmetic contact lenses appearing on the radar of health and eye care professionals, there has been an influx of Canadian reviews by organizations such as CAO, COS and the Optician Association of Canada that show uninformed lens wearers are increasingly experiencing acute vision threatening infections and inflammations in addition to a ciliary flush in one or both eyes. This is in addition to the more common conjunctivitis.

Other common issues that appear in association with contact lens use include: corneal abrasions, giant papillary conjunctivitis, corneal ulcers and microbial keratitis.

In all of my meetings with eye care professionals, I have noticed a common theme among the repeated calls to action on this issue. There are three main areas of concern recognized by eye care professionals.

It has been deemed essential that regarding a regulatory framework for non-corrective cosmetic contact lenses there should be a consistent legislative and regulatory framework for the federal regulation of contact lenses.

In addition to the call for a consistent legislative and regulatory framework of this issue, it was also deemed critical that there be a transparent, evidence and science-based process when changes are being considered to regulations that affect the eye care profession.

Moreover, it should be an inclusive process that takes into account the expertise of eye care professions, who have been calling attention to this serious issues for quite some time now.

Furthermore, supporters of Motion No. 409, within the eye care profession, are quite prepared to support any changes to existing parameters regarding the existing framework, and are willing to assist where necessary.

There is a reason why I am passionate about this motion and it has to do with our responsibility in this House to ensure the safety of Canadians, especially in regard to their own personal health.

Furthermore, the support of the various members of the CAO and COS is a testament to the commitment of qualified eye care professionals to ensure that this motion is properly supported.

It is also important to note that Health Canada is fully aware of the repercussions of this motion and, as such, is supportive in its views that non-corrective lenses must come under the same regulation as corrective lenses. Only with the support of the House is this possible.

I call on fellow parliamentarians today to support Motion No. 409.

Health
Private Members' Business

1:40 p.m.

Conservative

Rick Norlock Northumberland—Quinte West, ON

Mr. Speaker, I thank the hon. member very much for bringing this motion to our attention.

Like many Canadians, I was completely unaware that these coloured contact lenses were not regulated and shocked to hear of some of the results of wearing these devices, especially among our most precious resources, our young children and grandchildren.

The hon. member mentioned that this first came to her attention when her executive assistant went to the optometrist. What other diseases and damages can these lenses do to the eye and are they repairable, as far as her investigation into the matter is concerned?

Health
Private Members' Business

1:45 p.m.

Conservative

Patricia Davidson Sarnia—Lambton, ON

Mr. Speaker, the fact that the general population is unaware that there is no regulation is the largest issue that we are dealing with here. People are not aware that these lenses are not regulated. There are regulations in other countries. There are none in Canada.

In addition to the things that I have talked about, with the flow of oxygen which can cause swelling and ulceration of the cornea and ultimately infection, there can be an accumulation of debris such as dirt or dust if the lens is not properly fitted.

If there is no regulation, there is no one to teach proper fitting and do the proper fitting. An accumulation of debris can certainly damage the cornea and cause infection as well.

People may experience chemical or allergic reactions to the lens. I think we are seeing allergic reactions to different substances much more often in our society today.

If people are not taught the proper way to handle these lenses, they can be contaminated with micro-organisms. Again, we are looking at serious irritation or infection. There certainly are a lot of different issues that can affect people. Some of these conditions can be corrected and some are not able to be corrected. Serious damage can be done.

Some of the lenses can cause temporary changes in the shape of the cornea and that can affect people's vision and perception. Night driving can become a problem for some people.

The dangers are wide-ranging. Anyone who has vision as I do certainly knows that it is something we need to protect. I feel very strongly about this motion. I hope the motion is supported in the House.

Health
Private Members' Business

1:45 p.m.

Conservative

Rick Norlock Northumberland—Quinte West, ON

Mr. Speaker, I have one follow-up question and only because this is a serious issue. I suppose when a person is caught by surprise and something as serious as our eyesight is damaged, that would be the last sense anyone would ever want to lose. Our eyesight is one of the most precious senses we have.

I wonder if the hon. member could speak to the relationship between her motion and Health Canada's ability to be able to regulate cosmetic contact lenses. What have been the results of her investigation with that aspect of her motion?

Health
Private Members' Business

1:45 p.m.

Conservative

Patricia Davidson Sarnia—Lambton, ON

Mr. Speaker, I have made my motion as broad an aspect as I can to give Health Canada a chance to address this the best way possible. I have asked for amendments to the Food and Drugs Act or to the Hazardous Products Act. That will leave it open for Health Canada to see which is the best way to go forward with the motion, so that non-corrective lenses can be regulated as a device.

Health
Private Members' Business

1:45 p.m.

Liberal

Glen Pearson London North Centre, ON

Mr. Speaker, I am pleased to rise in the House to support the initiative of the member for Sarnia—Lambton. We sit on the same committee and she always brings out some pretty good arguments. I am glad to support this motion.

Currently, decorative contact lenses are unregulated and considered a cosmetic. Thus, consumers can purchase these lenses on the Internet or even in retail stores. Studies have proven that contact lenses that are improperly manufactured or used without appropriate medical supervision can cause serious eye infections and even loss of vision.

The gift of sight is not something that we can take for granted. Furthermore, I believe this motion is put forward as preventive medicine. Given the burdens on our current health care system, every prevention is key in the fight against many diseases, including those which affect our eyes.

In January 2005, American legislators raised a concern about eye problems that consumers had experienced due to poor labelling and packaging of non-corrective cosmetic lenses sold right over the counter. The legislation they put forward is similar to the motion put forward by the member for Sarnia—Lambton and seeks to reclassify non-corrective coloured contact lenses as medical devices and allows the FDA to regulate the sale of these contact lenses.

The American legislation passed in July 2005 and was signed into law in November of that year. The American Optometric Association has applauded the introduction of this federal legislation.

Eye care professionals here in Canada also agree that this is something whose time has come. They agree that there must be legislation for the federal regulation of contact lenses. In their opinion, both corrective and non-corrective contact lenses should be considered medical devices and should be regulated accordingly.

The physical and other characteristics of those lenses are identical to corrective power lenses. The only difference is refractive power. More importantly, the very real health consideration associated with improper fit and the wearing of these lenses applies equally to both cosmetic and zero power lenses.

The legislators in the United States saw the importance of this and reached consent on it in 2005. I think it is time for all of us here in Canada to realize the dangers to people with these things being sold over the counter or on the Internet.

I want to commend the member for Sarnia—Lambton for putting this motion forward and we in the Liberal Party will be supporting her initiative.

Health
Private Members' Business

1:50 p.m.

Bloc

Luc Malo Verchères—Les Patriotes, QC

Mr. Speaker, I am pleased to speak to the motion introduced by my colleague from Sarnia—Lambton. This is the member I know from the Standing Committee on Health. It is the role of each member of this committee, on which I have the privilege of sitting, to raise awareness and bring up this kind of situation in which products could be sold before proper analyses or studies are done. I thank her for doing so.

What she is proposing today is that Health Canada should conduct more studies on the use of cosmetic contact lenses. The problem is that cosmetic contact lenses are considered to be cosmetic products instead of medical devices.

According to the optometric, ophthalmological and optical associations, the potential adverse effects of contact lenses on the user's health are the same whether they are corrective or cosmetic, since both types come in contact with the surface of the eye.

This is why these associations have been asking since 2000 for all contact lenses to be considered health products requiring more than cosmetic care. Since customers can purchase lenses without consulting a professional, eye-care professionals say that these people are endangering the health of their eyes. Currently, users of cosmetic lenses that are not prescribed by a vision specialist are thought to be more at risk than contact lens users who have consulted a specialist.

I would also like to recall the fact that in Quebec, various laws require consumers to have a prescription for corrective glasses and corrective contact lenses. Consumers are not required to consult a vision specialist for cosmetic lenses.

What the member for Sarnia—Lambton has brought up is that cosmetic contact lenses must currently respect the quality regulations set out in the Food and Drug Act specifically as they apply to cosmetic products. If the product presents a danger of any kind to the consumer, Health Canada must take action and issue a warning or have the product taken off the market. After Health Canada issued its warning, several pharmacies decided to pull cosmetic contact lenses from their shelves.

That being said, Health Canada has already examined the possibility of considering cosmetic contact lenses as medical devices, just like corrective contact lenses. Heath Canada officials concluded that, under current legislation, cosmetic contact lenses must still be considered a cosmetic product.

The motion put forward by my colleague from Sarnia—Lambton raises several questions concerning the terms and objectives of this motion. Do eye care professionals want this product to be regulated in order to explain to consumers basic rules regarding hygiene, use and the dangers of contact lenses, whether cosmetic or corrective? Is the product dangerous because of its poor quality or because people do not know how to use it properly?

The information and facts provided by the hon. member for Sarnia—Lambton seem to suggest that cosmetic contact lenses should be provided on prescription only, in order to ensure their proper use. The complexity of this problem lies in the fact that there is not enough information about the use of cosmetic contact lenses and the health problems they have actually caused.

However, it is clear from information obtained from various eye care professional associations and Health Canada, as well as from the information provided by my colleague, that the improper use of cosmetic contact lenses may pose a risk to health, including the health of adolescents.

It has been shown that adolescents have a tendency to share lenses, which immediately increases the risk of developing various types of eye infections. Does this mean that the product itself is dangerous or that the improper use of the product poses a danger to young people? To ensure more appropriate use of cosmetic lenses by youth, practical health and hygienic advice should be provided by an eye specialist when these products are sold.

However, this is far from being a matter for federal regulation given that the services of eye specialists, as I explained before, are governed by provincial professional codes.

For this reason, the Bloc Québécois would like to note, first of all, that the health of eyes is vital. Consequently, it is important to clearly define the objectives of this motion and its implications for legislation governing medical devices.

Health
Private Members' Business

1:55 p.m.

NDP

Judy Wasylycia-Leis Winnipeg North, MB

Mr. Speaker, I am pleased to stand up on behalf of all my colleagues in the New Democratic Party and offer our unequivocal support for the motion and to congratulate the member for Sarnia—Lambton.

This is a very important initiative on the part of the member and it ought to be supported by everyone in the House. In fact, I believe, Mr. Speaker, that you undoubtedly will find, at the end of this debate, unanimous support for the motion because it makes sense. It makes sense because it protects Canadians.

The motion would ensure that this medical device, the lenses that may only be used for cosmetic purposes but are put in our body and create problems, would be regulated. It is as simple as that. It would ensure that a product, which is put on the market that could harm the health and well-being of Canadians, would be regulated and that there would be some onus of responsibility on the part of these corporations that are flooding our markets with devices that have only cosmetic value, but could cause harm to our citizens. They must be held to account.

We recently talked about new products in the area of tobacco, cigarillos designed to entice kids to start to smoked. They are not regulated because they are a cigar product, not a cigarette product.

It goes without saying that we must look at this area. In fact, when we look at some of the medical fallout from these unsupervised decorative lenses, people will know what we are speaking about. There are corneal ulcers, conjunctivitis, corneal edema, allergic reactions, corneal abrasion, reduction in visual acuity and contrasensitivity.

In 2002 the food and drug administration warned consumers about these cosmetic lenses. It said that there was serious risk of permanent eye injury, potentially leading to blindness presented by non-corrective, decorative contact lenses distributed without a prescription and without proper fitting by an eye care professional. That is six years ago.

In 2005 the United States finally did amend the federal food and drug cosmetic act to establish that all contact lenses, regardless of whether they were cosmetic or not, would be covered under the protections of that act.

In the United States all contact lenses must be approved and issued under the guidance of a qualified prescriber. We are saying the same should happen in Canada. Health Canada still distinguishes between corrective and non-corrective lenses, even though the health implications for their use are virtually identical.

We obviously support this. I congratulate the member for Sarnia—Lambton. I also congratulate the Manitoba Association of Optometrists, which contacted me about the importance of this issue, and all the associations of ophthalmologists, optometrists and opticians throughout the country that have spoken out on this issue long and hard.

I congratulate the member for her vision and foresight on this issue. I wish her well. I think she is proposing to have this addressed under the Food and Drugs Act or under the Hazardous Products Act. I support either venue and I wish her luck on this initiative.

If and when we pass this motion, I wish her luck in convincing her colleagues in the government to act on it. At the time when we are dealing with such an issue, her own government is busy trying to move away from the precautionary principle, the do no harm principle, and leading us down a path of progressive licensing on all kinds of products, which means we lessen our vigilance on the front end and pretend we will take some actions after these products are on the market.

As we know, when it comes to something like unregulated contact lenses, the harm is done, the damage is done and it cannot be corrected. We cannot go back. We have to act in the first instance and ensure that when products are put on the market, they do not harm Canadians.

Health
Private Members' Business

2 p.m.

Conservative

Rick Norlock Northumberland—Quinte West, ON

Mr. Speaker, previously I asked my hon. friend from Sarnia—Lambton a few questions. I think everyone here today is pleased to know that she has been on this issue and has stirred up enough interest that we will do something about it, and I know we will.

One of the things I was shocked about is the products have been available in the Canadian market for some years and have never been the subject of regulatory framework. As I said, I am glad the proposed motion is intended to address particular safety concerns relating to the importation and sale of these non-corrective lenses.

We sometimes think we save a few dollars when we go to direct consumer sale of items such as this, but we fail to realize that these types of products eliminate the interaction between the consumer and the health care professional with regard their proper use and care. That includes in these instances cleaning, disinfecting and storing the lenses between use.

Therefore, it is good now that we will subject these non-corrective cosmetic lenses, hopefully, to the requirements of the medical devices regulations. It will require manufacturers of these products to meet pre-market safety, effectiveness and quality requirements. Manufacturers would be responsible for various post-market activities, including record keeping, complaint handling, mandatory problem reporting and recalls. As part of these requirements, the manufacturers would also need to provide adequate instructions for the use, so consumers could use the product correctly.

Product labelling would also include necessary warnings, precautions and contradictions to educate and inform consumers regarding potential risks and benefits of non-corrective lenses.

We are advised that the minister supports the policies contained in Motion No. 409 and agrees that the potential risk of non-corrective contact lenses be managed by the provisions of the medical devices regulations, following an amendment to the Food and Drugs Act.

Health
Private Members' Business

2 p.m.

Charleswood—St. James—Assiniboia
Manitoba

Conservative

Steven Fletcher Parliamentary Secretary for Health

Mr. Speaker, it is with pleasure that I rise in the House today to speak in support of Motion No. 409, a proposal to regulate non-corrective cosmetic or decorative contact lenses as medical devices under the Hazardous Products Act or the Food and Drugs Act.

Over the past several years associations, such as the Canadian Association of Optometrists, have met with the Medical Devices Bureau, Health Products and Food Branch Directorate and also the Product Safety Bureau (Cosmetic Division), Healthy Environment and Consumer Safety Branch.

Health Canada has examined the legislative authority of the Food and Drugs Act and the Hazardous Products Act.

In 2000 it was concluded that non-corrective contact lenses did not clearly fall into the category of a cosmetic product, a medical device or hazardous product and that more scientific evidence was needed.

Therefore, that brings us to this motion. I will not repeat what has already been said. I will just say that I commend the member for bringing forward this motion. I think the fact that it received unanimous consent is an indication of the member's foresight and an example of how this Parliament can work.

Have a good week-end!

Health
Private Members' Business

2:05 p.m.

Conservative

Patricia Davidson Sarnia—Lambton, ON

Mr. Speaker, I will be very brief. I take this opportunity to thank my colleagues in the House for speaking on this issue today and for the support that they have shown thus far. I certainly hope Motion No. 409 is successful today.

Health
Private Members' Business

2:05 p.m.

Conservative

The Acting Speaker Royal Galipeau

The question is on the motion. Is it the pleasure of the House to adopt the motion?

Health
Private Members' Business

2:05 p.m.

Some hon. members

Agreed.