Opternative Online Eye Exam Service Sparks Criticism from Optometrists

The concept has ignited a firestorm among optometrists.

ByABC News
August 5, 2016, 8:12 AM

— -- Getting a prescription for eyeglasses and contact lenses usually means scheduling a trip to the eye doctor, but Chicago-based start-up Opternative says consumers can skip the step with its 20-minute do-it-yourself online eye test that delivers prescriptions by email in 24 hours or less. The program is raising eyebrows among some eye care professionals across the country.

Optometrist Steven Lee described coming up with the concept.

“When I was practicing in a clinical practice, I came across a patient that asked me 'why we can’t do this at home?'” Lee said. “That question sparked a ‘eureka’ moment in my mind.”

Lee partnered with Aaron Dallek to develop the program which is now available to users aged 18 to 50 in 38 states. The company says data from their online tests are reviewed by an ophthalmologist before a prescription can be issued.

“Opternative is very simple, all you need is a computer and a smartphone,” said Dallek. “The computer is like a digital eye chart, and the smart phone is a remote control, kind of like a video game. And there are audio instructions that walk you through it every step of the way.”

The concept has ignited a firestorm among optometrists, who view themselves as primary eye care givers and have complained to the FDA that the app is potentially unsafe for consumers.

“It would be analogous to taking a picture of your teeth and sending it to someone and having a filling sent to you,” said optometrist Andrea Thau, president of the St. Louis-based American Optometric Association, which represents 39,000 members across the country.

“This is really foolhardy and really dangerous," she said. "It is taking a risk because you’re doing one small fraction of the whole eye exam with a potential for missing things that can be very significant to your eye health and your systemic health.”

Laws that limit telemedicine in 11 states have not stopped Opternative from practicing in some of these states.

“We have a 99.6 percent satisfaction rate with our prescriptions,” said Dallek. “We are clinically validated to be accurate.”

“GMA" Investigates decided to take a closer look and recruited eight volunteers between 21 to 39 years old to take the Opternative eye exam, and then made appointments for them to have their eyes checked by Dr. Lisa Park, an associate professor of ophthalmology at the NYU Langone Medical Center in New York City.

Out of the eight "GMA" volunteers, three were exact matches to their current prescriptions, three were slightly different but not significant, according to Park, and two did not get a prescription -– instead they were encouraged by Opternative to see an eye doctor.

“For those who got prescriptions, they were relatively good,” said Park said, adding: "Anybody who has a risk factor for disease should be screened out and probably not given a prescription online.”

Park would not recommend Opternative for someone like Dexter Hills, one of our volunteers. Although the 35-year-old had no history of eye disease, his vision was 20/20 and his prescription exactly matched his Opternative script, Park observed elevated pressure in his eyes, a risk factor for glaucoma.

In Hills case the risk factor was not detected by Opternative.

“I’m not saying he has glaucoma,” said Dr. Park. “But he should keep it on his radar.”

Patients may not know they have glaucoma until they start experiencing vision loss. The disease is treatable if it's caught early enough, which is why experts say it’s important that people get their eyes checked by an eye doctor.

Opternative’s website and prescriptions also recommend that users get a comprehensive eye exam every two years. Dr. Park recommends that those over 40 get eye exams every year.

Editor’s Note: This story was updated to reflect the number of states where Opternative is available to consumers.