Newsletter subscribe

Business, Features, Politics, Top Stories

Seeing Red Over Green: What the American Optometry Association is Lobbying Against

Posted: February 27, 2017 at 1:10 pm   /   by

Why should it be necessary – legally required – to go to a “bricks and mortar” eye doctor’s office to get your vision checked – and a prescription for new contacts or eyeglasses issued?

It’s 2017 – not 1917 – and apps such as Opternative and GlassesOn can check for refractive error via a 25 minute online test, which is then reviewed by an ophthalmologist licensed in your state. The doctor then writes a digital prescription – which you can use to shop for the best deal on new contacts or eyeglasses wherever you like.

You don’t have to leave your home – or take time off from work.

No driving for an hour – or waiting for another hour in the doctor’s office.

The online tests are diagnostically as accurate as an in-person eye exam and – the horror! – more convenient and less expensive.

Which is probably why The American Optometry Association is seeing red.

And lobbying hard to make such convenient and inexpensive competition illegal.

The claim is that it’s all about protecting patient’s health given there’s no evidence to support such claims, it seems to be all about money. About protecting the bottom line of traditional eye doctors – and lens manufacturers.

Online vision testing threatens to reduce vision care costs – and expand choices for patients.


Legislation to counter this evil has been put forward in Georgia and is under consideration in Oklahoma, Nebraska, Indiana and South Carolina.

In Virginia, legislation (SB 1321) sponsored by William Howell, Speaker of the House of Delegates, and Majority Leader Kirk Cox, would impose a ban on online vision testing – though it would at least require “bricks and mortar” eye doctors to issue prescriptions directly to their patients, so that they are free to shop around for lenses elsewhere and not be forced to buy them from the same doctor who wrote the scrip.

In a one-hand-washes-the-other kind of deal, some optometrists also sell lenses – and write prescriptions in-house for the brand of lenses they just happen to sell. Which just happen to be marked up and very profitable for the practice. Patients are steered into “one stop” shopping – and often end up paying more than they would have if they’d had the opportunity to shop around.

Or even knew they could shop around.

Many don’t. They assume they have to buy what the prescription says – and since the doctor sells what it says… .

The VA legislation is good in that sense; it (and similar federal legislation) would at least require that eye doctors make their patients aware that they do not have to buy a particular brand of lens – and that they are free to shop elsewhere for lenses, including online. The federal law would also require that eye doctors not engage in “blocking actions” to make it difficult for people to buy lenses online by hemming and hawing on approving the transaction, for example.

But why ban online vision testing?

If the tests are effective and safe – if a licensed eye doctor review the tests before writing the scrip – what, exactly, is the problem?

Is there any reason – other than protecting their turf  – for the AOA and bricks and mortar eye doctors to object to people using the latest available technology to check their eyes – and get a prescription – from the convenience of their homes?

For less money – and with less hassle?

One tactic the AOA has used to create fear in the public’s mind – and put pressure on lawmakers – is to confuse a vision check with an eye health exam – implying there’s a health risk if people are allowed to skip going to a doctor’s office to have their vision checked.

But a vision test is not an eye health test (e.g., a glaucoma screening) and there is no evidence to suggest that merely checking visual acuity is any more of a danger to otherwise healthy adults than it is for otherwise health adults to use a thermometer to check their temperature or one of those automated blood pressure machines that you can find at almost any supermarket nowadays.

Even the AOA concedes the point, admitting (here) that adults aged 18-60 don’t need on-site/”bricks and mortar” exams just to have a prescription for contacts or eyeglasses filled.

In Virginia, the state-level ophthalmologists’ association sent out an e-mail explicitly stating that none of their members knew of anyone who’d been harmed as a result of taking an online vision test.

Yet the bill is still in the hopper – in VA and elsewhere.


Because lots of dollars are on the line.

Because online eye exams threaten the profits of the bricks and mortar eye doctors – and also the lens providers whom they often have a too-cozy relationship with.

It’s crazy that, with health care costs rising like an irresistible tsunami, anyone could object to a new way of helping people see clearly, more conveniently – and for less money.

Eric Peters

Eric Peters

Eric Peters writes about cars, mobility and liberty.

He has been covering these topics for 25-plus years as a columnist and author, including several years as an editorial writer/columnist for The Washington Times and contributor to newspapers and magazines around the country, including the Wall Street Journal, Chicago Tribune, Detroit News and Free Press, American Spectator and many others.

His books include Automotive Atrocities and Road Hogs. His latest book, Doomed, will be available next spring.

Eric lives in rural SW Virginia - as far as he could get from Northern Virginia without actually leaving the state.
Eric Peters

Latest posts by Eric Peters (see all)

Leave a comment

Seeing Red Over Green: What the American Optometry Association is Lobbying Against