To investigate corneal changes after wearing cosmetic tinted contact lens and the recovery of corneal topography. Seven subjects took part in the study. Three cosmetic tinted lens types and one control soft contact lens were investigated (Crazy Lens, WildEyes, FreshLook, and SofLens Comfort). Lenses were worn for 1 hour. Corneal topography data were measured before lens wear, with the contact lens in situ and at 0, 10, 20, 30, 60, 90, 120, and 150 minutes after lens removal. Height data difference maps were calculated and corneal recovery measured. Visual acuity was taken before lens removal and at 1, 10, 30, 60, 120, and 150 minutes after lens removal. Subjective ratings of haloes and ghosting following lens wear were also recorded. For the Crazy Lens, concentric rings of steepening and flattening with a mean height change of 2.17 +/- 0.98 microm (P < 0.05) were found in the central cornea at a location corresponding to the edge of the clear pupil diameter. Corneal recovery after removal of the Crazy Lens took up to 150 minutes. Visual acuity loss in high luminance during Crazy Lens wear was 0.29 LogMAR (P < 0.01). For the WildEyes and FreshLook lenses, smaller changes in corneal topography and vision were found after 1 hour of lens wear. Patients who wear cosmetic tinted lenses need to be aware of the potential for reduced visual performance, both during lens wear and for several hours after lens wear.