Online vision testing causes stir within eyecare community

Chicago-Patients can now easily receive an eye exam in the comfort of their own home thanks to Opternative, a new online vision test.

CEO Aaron Dallek said he and Steven Lee, OD, founded the online exam to provide an option for otherwise healthy patients who may not require a yearly exam, but may still need a new prescription, Optometry Timesreported.

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“(The) eye exam is a refraction-only exam and not an eye-health exam,” Dallek explained. “It is estimated that 70-75% of the world population needs some form of vision correction. Many people don’t have access to a refractive eye exam and the refractive eye exam we launched can help these people.”

Aaron DallekThe company offers the online vision test through its website, Opternative.com. The test takes about 25 minutes, and patients can take the test via a computer or smartphone. An ophthalmologist verifies the prescription, and it is provided digitally to the patient within 24 hours.

Patients can receive a prescription for glasses or contact lenses for $40 or for both for $60.

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“(We wanted to) make eye-care services more accessible, affordable, and convenient for patients around the world,” Dallek said.

Patient satisfaction is guaranteed, however if a patient is not happy with the way he or she sees with the glasses or contact lenses they received using the Opternative prescription, the company will recheck the prescription, Dallek explained. If the company cannot correct the problem, Opternative will offer a full refund.

“There is no risk in trying the Opternative eye exam,” Dallek stressed.

The test is currently available in 27 states, but the company has plans to expand to more states soon.

While patients may be jumping for joy for the ability to get their eye exam and prescriptions on their own time, the eye care community is split over their reaction to the online refraction test.

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Photo credit: Opternative

Ophthalmologists, Dallek said, have welcomed Opternative with mostly open arms.

“We’ve spoken with many ophthalmologists about our technology, informing them on how it works and recruiting them to join our network of doctors,” Dallek said. “To many ophthalmologists, our technology is a great way to help more patients.

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“So in our experience, they are very interested in what we’ve built and are very supportive of how we’re using it to help patients,” he continued. “We’re very happy to have the support of the ophthalmology community and we look forward to developing even stronger relationships with the community as we expand our offering.”

Bruce Goldstick, MD, owner of Eye Physicians in Chicago, sung the online exam’s praises, saying telemedicine is here to stay.

“I think Opternative has an outstanding product that has intrigued me, and I think it provides a great convenient, affordable way to provide high quality prescriptions for glasses or contacts,” said Dr. Goldstick, who also sits on Opternative’s advisory board. “This is the beginning of telemedicine for ophthalmology.”

Furthermore, Ophthalmology Times Editorial Advisory Board Member Andrew G. Lee, MD, commented that he also believes online exams and telemedicine are the wave of the future.

However, Dr. Lee said he remains hesitant to fully embrace Opternative, as online testing continues to have several complications-such as false negatives and positives, or telling sick people they are healthy-that could greatly impact patient safety.

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“Online things are interesting from a technique standpoint, but they can be dangerous if you disconnect the doctor from it,” said Dr. Lee, who is also chairman, department of ophthalmology, Houston Methodist Hospital. “(Opternative) probably is the future . . . (but) I’m not sure it’s ready for primetime just yet because there are so many variables that go into the test.”

Michael Repka, MD, MBA, medical director for governmental affairs for the American Academy of Ophthalmology, had a more optimistic outlook for the online exam.

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"The Academy supports the use of new technology for improving efficiency and widening access to eye care,” Dr. Repka said. “The Academy is open to the use of online refractive exams for adults ages 18 to 40 with healthy vision so long as an ophthalmologist or optometrist is required to write the prescription.

“It is also crucial that the online provider clearly emphasizes that users should still have their eye health monitored through a comprehensive eye exam at least every 5-10 years,” he continued. “However, it may be best if online refractive exams are not used by people who have never had a comprehensive exam, but instead used by existing patients-for example, offered as a follow-up service for patients in the year or years after they received a comprehensive exam.”

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On the other hand, the optometric community had far fewer nice words for Opternative, as many expressed concerns that patients will choose the online test and neglect getting a full ocular health exam.

“The rollout of this online vision test is a troubling development in the eyecare industry,” said Optometry Times Chief Optometric Editor Ernie Bowling, OD, FAAO. “There is a real possibility consumers will perceive this online refraction test as a true ocular exam and subsequently ocular pathology may never be diagnosed.

“Technology is a wonderful adjunct in the right hands, but it should never be substituted or mistaken for a comprehensive ocular health evaluation,” said Dr. Bowling. “The American Optometric Association (AOA) House of Delegates resolved at the 2015 meeting that safeguards need to be in place to insure patient’s eye health and safety aren’t compromised by remote technology. I’m certain this will be watched carefully by both the AOA and state regulatory boards.”

AOA President Steven Loomis, OD, recently spoke out to raise awareness among consumers about these potential dangers.

“We are concerned consumers will mistakenly believe that a refractive eye test is a comprehensive eye health examination, which can uncover diseases such as diabetes,” he said. "Consumers can be lulled into a false sense of security."

Dallek said Opternative is aware of the controversy surrounding the company within the eyecare community, specifically optometrists.

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“We’ve had interest from optometrists who want to utilize our technology in their practice and some have asked to be a part of our doctors network,” he said. “We even have optometrists working with us to help us find the best way to utilize our technology to support the eyecare community and show them that our technology is accurate.

“Yet, while we do everything we can to embrace the optometric community, the establishment has been vocal about stopping us from helping patients get more affordable, accessible and convenient eye care,” Dallek explained. “We care about all of our patients and go to great lengths to ensure they understand that our Opternative eye exam is only a refractive eye exam and that we recommend they get an eye health exam every two years. One of our goals for the (eye exam) is to raise awareness about eye health amongst our patients, and to get them to take better care of their eyes then they would without using Opternative.”   

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Dallek said Opternative recommends patients visit an eyecare professional in person for a full ocular health exam once every two years. The company restricts patients from using the service more than four times within in a 5-year period without getting an eye health exam, in accordance with the AAO’s recommendations.

Eventually, Dallek says Opternative would like to bring its technology from online to the eyecare practice.

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‘The (eye exam) and technology platform will be able to be used by an optometrist or an ophthalmologist to complement their practice where existing state regulations allow,” he said. “However, in its current form, only ophthalmologists can prescribe through our technology. We have focused on working with ophthalmologists because regulations on optometrists in many states limit the use of innovative technologies like Opternative.”

Dallek said ophthalmologists could offer their services to Opternative patients in 45 states by becoming part of their doctors’ network.