Things to be Aware of with Online Eye Exams, Online Frame Vendors, and Online Contact Lens Vendors
Optometry is a unique profession in that as an optometrist, we both work in a medical and retail setting. We take care of not only keeping your vision clear, but also your eye and whole-body health, as well as selling glasses, contact lenses, and other eye-related items. Our passion is to not only make sure you see well, but that you also feel great about the way you look in your glasses (or can enjoy the freedom from your glasses if contacts are a good solution for you as well).
At ModernEyes Eyecare + Eyewear, we strive to stay on top of the latest technology whether it is a new piece of equipment that helps us assess your eye health, or new innovations in contact lenses or glasses lenses. As technology advances in the eye care field, some of the "newest, latest, & greatest" options sound amazing and tempting on the surface, but they may not be all that you think they are. Consider the following a "Buyer Beware" so that you can make a wise decision when it comes to caring for your eyes.
(#1) Online Eye "Exams"
Prescription (Refraction) Limitations
The concept is great in the sense that you wouldn’t need an appointment to have your prescription renewed, but this technology is still lacking in accuracy. Most optometry offices have an auto-refractor. This instrument gives us a preliminary estimate of your prescription, but we almost never prescribe what the machine spits out. This is because we have both objective and subjective components to our vision. Subjective vision is the part where we ask you which is better, because we want your preference, not be because there is a true right or wrong answer. (See our blog on that if the "1-or-2" part of an exam stresses you out by clicking here.)
In optometry school, we spend years learning the art of subjective refraction to compliment the scientific, machine or light-based objective refraction. Online "exam" or "refractions" simply can't do that as well because it is an automated process, rather than a real person using skills and critical thinking to determine the best prescription for you. They basically function by comparing your new preferences selected through their app with your old glasses prescription. If they are close, they run with it. If they aren't, they recommend you see an optometrist anyway.
Eye Health Limitations
These online companies also have no real way to check the physical health of your eyes. As an optometrist who does a comprehensive exam, I check your eyes for signs of inaccurate focusing (can lead to fatigue and headaches), dryness, complications of contact lenses (small infections, growth of new blood vessels into the cornea), cataracts, retinal problems such as holes, tears, or detachments, as well as identifying potential whole-body health issues like diabetes, high blood pressure, high cholesterol, brain tumors, just to name a few. This simply can’t be done when a real person is not looking at your eyes. Check out this article for more information.
(#2) Online Glasses Frame Vendors
The Fit and Measurements
Again, I love this concept. You pick out three or four frames you think you like, they mail them to you to try on. It sounds pretty great. But, if you have a stronger prescription or a progressive lens (no-line bifocals), your measurements must be extremely accurate for your glasses to work properly. If you come into the office to select your frames, our opticians can take those personalized measurements just for you instead of using an algorithm to place the bifocal or center of the lenses. Our opticians are also highly skilled at making sure the frames fit you well, particularly around the temple and behind the ears, and most critically on the nose. If the bridge (nose part) of the glasses isn’t a proper fit, your glasses will not be comfortable all day.
For more details and statistics about "what could go wrong" with ordering glasses online, check out this great article.
In some cases, the metals and acetates these bargain frames are made of are also lower quality than the frames most offices have in their opticals, so if you go this route, you need to understand this risk. Additionally, there may not be a great warranty either. At our office, all of our frames have a manufacturer warranty, as do the lenses we put in your glasses. We pass this along to you, free of charge. If you are still worried about problems, we participate in a third-party insurance program, called SpecProtect, that insures your glasses for one year from the purchase date. You simply pay a copay to have them replaced if they break and the break isn’t considered a manufacturer defect.
(#3) Online Contact Lens Vendors
They May Obtain Contact Lenses via Questionable Means
These are a little tougher to talk about without mentioning names. Many of the super inexpensive contact lenses vendors are what are called "grey market" vendors. They are selling contacts that they obtained from doctors buying the lenses in other countries at a lower price that the doctors here in the U.S. have to pay due to the currency value differences. The big company then buys contacts off these doctors in other countries and sells them to the consumer for crazy low prices.
The other issue with some websites is that they are selling contacts with a much shorter shelf life than optometry offices provide. When you order contacts from our office, most of the time, the contacts won’t expire for 3-5 years. Many online sites sell you contacts that expire right around a year from when you purchase.
Brand and Prescription Swapping
There are also a handful of monthly subscription-based vendors to be wary of, particularly the ones that sell only their own brand of lenses, and not the specific brand, size, curve, and powers your optometrist recommends. The ones that only sell their brand of lenses are typically using 25+ year old lens technology that many patients do not find comfortable, nor are they terribly healthy for your eyes due to very low oxygen transmission to your eye. I’ve had a few patients try these services who wear astigmatism contact lenses, and the company subbed out a non-astigmatism lens. The patient is then left wondering why his/her vision is so much worse than before. It is also technically illegal to sell someone contacts without a valid prescription, and these companies send you "trials" for free. They claim they contact your doctor for approval, but of the several patients I have had try these types of sites, not once have I been contacted.
For a more in-depth look at how these lenses differ from the brands your optometrist recommends, this article has some great information. You may be surprised.
In some cases, you may not even be saving much money with these lenses. Most of the contact lens manufacturers we use have excellent rebates that can be combined with your vision plan if you have one. We are always happy to provide our prices along with any currently available rebates, so that you can factor that in to the decision.
I never want someone to have complications from contact lenses, and I don’t like using scare tactics, but these old-technology lenses aren't fit in most optometry offices for a reason: they simply aren’t the safest and healthiest for your eyes. Contact lenses are medical devices that can cause real, permanent damage to your eyes if not used properly. Unfortunately, they are not very regulated and aren't treated like most other prescriptions you receive where you get X-quantity with X-number of refills and if you want a different brand, you must see your doctor.
We try to be as competitive as we can with regard to pricing our contacts, but sometimes huge companies get such large bulk buying discounts that we don’t receive as a small business, so we don’t have as much wiggle room when it comes to price. I know many other optometrists agree that we aren't as much concerned about the bottom line with contacts as we are with making sure we keep your eyes healthy so you can wear contacts long into your life and/or stay a candidate for refractive procedures such as LASIK.
We Really Do Care About You
Many of the online companies paint the small business owner and doctor as a money-hungry scammer with super inconvenient hours and policies. I can’t speak for everyone, but most of the optometrists I know are genuinely good and ethical people who are far more concerned about your eye health and whole-body health than we are about making lucrative money. We fight against what we call "destructive technology" because we genuinely care about YOU, and truly fear that these online alternatives could be risking your health and safety.
Of course, optometry practices are businesses with overhead that must be covered. They must pay their bills and pay their employees. Furthermore, the optometrist-owners generally would like to contribute to their family's livelihood, and most optometrists also have hefty student loans to pay back. As a result, the business cannot be run as a charity. Yes, most optometry offices also sell glasses and contact lenses, but the reason is not to price-gouge or even simply offer a convenience. In most cases, the reason is because we truly want to come alongside you to help you make the best decisions for your eye health and vision that fits your lifestyle. At ModernEyes Eyecare + Eyewear, we strive to provide high quality exams, recommendations, and products. We hope you’ll give us a chance to serve you and your loved ones.