Finding the right combination of ocular health screening and patient convenience is the name of the game in contact lens fits—now more than ever with COVID-19 disrupting the traditional care model. But focusing too much on convenience at the expense of ocular and systemic health is not in the best interest of patients.1
Unfortunately, the recent Federal Trade Commission (FTC) ruling may have shifted the balance in the wrong direction, potentially preventing the timely diagnosis of ocular and systemic disease.
The FTC’s decision places a significant burden squarely on a law-abiding profession. Now, optometrists must document every contact lens prescription by obtaining signed acknowledgment forms, whether it’s a separate confirmation statement, a prescriber-retained copy of the prescription or a prescriber-retained copy of the sales receipt for the exam that contains a statement confirming the patient received the prescription. Clinicians must maintain these records for three years. If a patient or their designated agent requests an additional copy of the prescription, optometrists must comply within 40 business hours.
Hundreds of members of Congress have expressed concerns over this red tape, and the American Optometric Association (AOA), led by Bill Reynolds, OD, is doing all it can to encourage the FTC to reconsider and reverse the ruling.
Ultimately, this update—designed to facilitate contact lens shopping by “requiring prescribers to automatically provide a copy of a patient’s prescription to the patient and to verify or provide prescriptions to third-party sellers,”—harms the American citizens the FTC is designed to protect.2
We know that the business models for certain online contact lens sellers are based solely on convenience. These new burdensome FTC rules that punish optometry can only push these companies’ agendas of patient convenience with little to no regard for ocular health. (To be fair, Hubble has recently expressed sincere interest in working with optometry to better serve patients by promoting yearly exams. The company is working to educate patients on the importance of the yearly eye exam to ensure ocular and systemic health, and it has plans to push 10,000 to 25,000 patients that visit their site daily into optometric offices.)
If patients are foregoing their annual eye exams because they can get their contact lenses online, optometrists lose the opportunity to ensure each patient’s ocular health and catch any early signs of disease—especially asymptomatic blinding conditions such as glaucoma.
Not only that, contact lens wearers require more frequent monitoring of their corneal health to help avoid infectious and inflammatory events; and we’ve all seen examples of patients who eventually require corneal transplants due to poorly fit contact lenses and lens wear and care non-compliance, resulting in microbial keratitis.
We also know the eye is the window to the body. Each year thousands of patients see their eye doctor and their ocular findings lead to a diagnosis of diabetes, hypertension, brain tumors or even choroidal malignancies, to name a few. Although convenience is a necessity in the COVID era, the increase in morbidity, blindness and undiagnosed systemic diseases is the last thing we need at this time.
The balance of ocular health and convenience has tipped in a troublesome direction. While providing convenience is important, especially today, but balance is necessary. The most recent FTC ruling appears to have tipped that balance in a direction where the ramifications on ocular and systemic health are serious. The AOA has done a great job of immediately acting on the need to protect the public and the eye care professions, but each of us must step up and contact our representatives. Our patients’ health and our livelihood depend on it.
Note: Dr. Karpecki consults for companies with products and services relevant to this topic.
1. The interchange of health and convenience. Personal communication with Thomas Swinnen, North American President of Johnson & Johnson.
2. FTC Announces Final Amendments to the Agency’s Contact Lens Rule. www.ftc.gov/news-events/press-releases/2020/06/ftc-announces-final-amendments-agencys-contact-lens-rule. Federal Trade Commission. June 23, 2020.