Myths vs. Facts
The American Optometric Association (AOA), the lobbying group representing optometrists, and some contact lens manufacturers have been spreading myths about online prescription renewal in an effort to promote legislation that would ban the services in many states. Below are some of their false claims and the facts that refute them.
Myth: Contact lens wearers need to have an annual comprehensive eye exam to detect potential health issues such as diabetes, glaucoma or other chronic diseases.
Fact: The American Academy of Ophthalmology (AAO), the world’s largest association of eye physicians and surgeons, recommends that asymptomatic adult patients without risk factors for eye disease receive a comprehensive in-person eye exam every 5-10 years if they are between the ages of 18-40; 2-4 years for patients age 40-54; 1-3 years for patients age 55-64 years; and 1-2 years for patients age 65 years and older. AAO guidance does not state that contact lens wearers need an annual comprehensive eye exam, but instead that: “contact lens wearers should have a contact lens examination every 1 to 2 years to monitor for adverse effects of contact lens wear and for an update on healthy practices for contact lens wear and care.”
Whereas the American Optometric Association (AOA) cites the need for a comprehensive eye exam every year to screen for eye disease, there is insufficient data to determine whether more frequent comprehensive eye exams are needed for contact lens wearers. There is no evidence that contact lens wearers with more infrequent comprehensive eye exams are at any higher-risk for cancer, glaucoma, diabetes, retinal vascular disease or any other chronic diseases than the general population. So, for most healthy adult contact lens wearers, they do not necessarily need to return to an eye care provider’s office for a comprehensive exam on an annual basis.
Myth: Using online vision testing to renew a contact lens prescription can lead to issues or even damage to a patient’s eye.
Fact: : Leading online prescription renewal service providers have already served hundreds of thousands of patients across the country and not had a single health-related incident reported from any customers that resulted from using this service. The eye doctors who review vision test results for online customers would not stake their medical license or their reputation on a technology that was a danger to patients. The AAO has cited refractive assessment tools as something that would pose a low risk to patients.
Myth: Online vision tests are just apps or kiosks that rubber stamp a patient’s existing prescription without careful review by an eye care provider.
Fact: Online vision testing services do not use automated technology or software to write prescriptions; they use technology to connect patients with licensed eye doctors. These eye doctors review a patient’s medical history, current prescription, comfort level, and in some cases video of the eyes, in addition to the vision test results, before using their medical expertise and professional judgment to renew the patient’s prescription. Every medical decision is made by a board-certified eye doctor exercising their independent judgment. Notably, more than a third of patients who attempt to renew a prescription through these services are disqualified during screening due to medical or other reasons, and are referred to local eye care providers for in-person exams.
Myth: Online vision testing undermines the doctor-patient relationship which is necessary for proper medical care.
Fact: No one would argue that a doctor-patient relationship is not a valuable part of medical care. However, it is important to recognize that all contact lens patients must go to an eye care provider for a comprehensive exam in order to receive their initial prescription. Following that initial comprehensive exam, the eye care provider selects a unique brand and fit of lens for the patient and the patient goes through a one-to-two week trial period, before returning to the provider for a further assessment and final prescription. Considering this rigorous process to receive an initial prescription, for most healthy adults, there is no need to return to an eye care provider’s office on an annual basis simply to renew a contact lens prescription.
Myth: Online vision testing companies are not FDA approved and are therefore unsafe.
Fact: The FDA does not provide a pathway for the approval of online prescription renewal services. However, online vision testing companies have had long dialogues with the FDA and have appropriately registered their services with the FDA. All providers utilizing these services hold active, medical licenses in the states they are delivering care to patients, and remain under the regulatory and disciplinary authority of those states. There are no known reports of adverse events, medical malpractice claims or medical board complaints in the more than one million tests completed. The AAO has cited refractive assessment tools as something that would pose a low risk to patients.