Online Eye Exams: Blinded By Convenience?

By ACSH Staff — Jan 25, 2016
An advancement in online optometry is giving patients in need of a doctor's eye exam another option. Easy, convenient and affordable, this newest approach simplifies the check-up and prescription process. But without overall eye care being addressed, any hoopla over this kind of internet access might be premature.
Eye Chart via Shutterstock Eye Chart via Shutterstock

Doctor visits are essential to our health. But we're all busy, and appointments eat up time and money. Work absences. Travel. Waiting rooms. Fortunately, as far as eye care goes, there's a potential new solution that could revolutionize the way we experience a check up. But is it really all its hyped-up to be?

The most recent advancements in optometry have taken patients out of the exam room and placed them back into their very own homes. What's more, the appointment doesn't require an appointment at all, nor does it even require the presence of a doctor. So, contact wearers and bespectacled folks, prepare to rejoice! Because ocular check ups sans the optician are poised to become the new "it" thing.

It all started with the launch of Opternative, a company founded with the idea that "glasses and contact lens prescriptions should be accessible and affordable." According to its website, the self-administered eye exams involve a smartphone, a computer and take just 25 minutes. What follows is an ophthalmologist-approved, digital prescription delivered to your inbox within 24 hours that you can take to your local eyeglass retailer (LenseCrafters, Cohens, Pearle Vision, etc.)

Here's how it works:

Once on the computer and signed into your account, a link is sent directly to your smartphone with step-by-step instructions. At varying distances from your computer, you'll cover one eye at a time while answering questions such as, "Which line is sharper?" or "Which of these four shapes is different?" To answer, simply tap from the options that appear on your smartphone, which will then prompt you to the next task.

And Opternative isn't the only player in this movement away from traditional office-based care. Sterling Optical offers online screenings that help patients identify nearsightedness, astigmatisms and overall eye health. Although it's not clear if there's also the option of sending results to a practitioner to obtain a prescription.

But while Opternative and Sterling Optical tout ease and convenience, there is also a downside. Home-based tests are limited to what s called the refractive test an exam that simply measures a person s need and prescription for eyeglasses and/or contact lenses.

Dr. Geoffrey Goodfellow, of the Illinois College of Optometry, told back in July that measuring and testing for glasses and contact lenses is just one part of a routine eye exam.

So, what are the implications?

It s possible that these companies although their intentions are good could actually be fueling a problem by oversimplifying the criteria necessary for maintaining good eye health. A proper eye exam requires a litany of tests retinal exams, visual field tests and glaucoma screenings to name a few. These exams necessitate a practitioner's presence. In his same interview with Fox News, Dr. Goodfellow echoes this sentiment:

[Human ophthalmologists] can actually diagnose diabetes in the eye, high blood pressure, as well as other systemic and metabolic problems that the patient may not know that they have.

Furthermore, despite growing evidence of vision impairment as a serious public health issue 1.6 million adults suffer from macular degeneration while 20.5 million live with cataracts people's perception of the need for eye exams is at an all-time low. Home-based exams will likely perpetuate this trend.

The Center for Disease Control reports that regular, comprehensive, eye examinations are essential for the timely treatment of eye disease. Though easy and convenient, unfortunately, the refractive exam is just the tip of the of the vision-test-iceberg. It does not lend itself to diagnoses this is essential for us to know, especially since most ocular conditions are asymptomatic. People go years without knowing there's an issue, which can result in irreversible damage, and damage, that if detected, earlier might otherwise have been avoided.

Still, if you're curious about home-based refractive exams, take a look around on the internet and see what's being offered.