The American Optometric Association (AOA) has called upon the Federal Trade Commission (FTC) to strengthen its Contact Lens Rule to prevent its manipulation by contact lens retailers for their own financial benefits, causing potential harm to patients.
In anticipation of the FTC’s 10-year review of its Contact Lens Rule
, the AOA called for its members to submit comments on changes they would like to see and any incidences of abuse they’ve experienced with contact lens retailers.
The AOA is asking the FTC to mandate a quantity limit on contact lens Rxs, require retailers verify Rx expiration date, and halt the sale of contact lenses without a valid Rx.
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AOA President Steve Loomis calls the submission of comments the first step in a lengthy process. The FTC will use the comments submitted from consumers, the eyecare industry, doctors, and the AOA to make changes to the Rule. Then the FTC will call for comments on the changes, which it will take into consideration before finalizing the Rule. The process will likely take months.
Dr. Loomis told Optometry Times
the organization received dozens of personal testimonies from its members and used the responses to craft its letter to the FTC.
“We looked at the concerns that were brought forth by our members,” says Dr. Loomis. “We were aware that the passive verification system was being abused, robocalls were being used, expired prescriptions are being filled.”
The letter addresses a number of common problems doctors have noted with contact lens retailers, including selling lenses based on expired prescriptions and encouraging bulk purchases.
Jeff Walline, OD, PhD, FAAO, chair of the Contact Lens and Cornea Section of the AOA, says the AOA’s comments are helping to protect patients from companies that are exploiting them to make a quick buck.
“There are a lot of ways that these companies are skirting the intent of the law, and the AOA is trying to close up some of those loopholes,” says Dr. Walline. “I hope the FTC starts to not only look at the loopholes that have been exposed, but that it also starts to enforce the laws that are already on the books because there’s not been much enforcement at all.”
Next: Quantity limits on prescriptions
Quantity limits on prescriptions
In its letter to the FTC, the AOA explained that through online contact lens retailers like 1-800 CONTACTS, consumers can purchase bulk quantities of contact lenses, which would far exceed the legal expiration of their prescriptions. For example, the letter states that a patient can purchase up to eight boxes of 1-Day Acuvue TruEye 90-day packs for each eye, which would total 720 lenses per eye.
“Retailers who are able to sell nearly a two-year supply or more of lenses for a prescription that is likely valid for only one year can put the patient at risk,” the letter states, “as many patients may experience a change in eye health and/or vision, develop complications that go untreated, or may have been counseled to stop wearing contact lenses.”
In the development of the Contact Lens Rule, the FTC debated whether there should be a quantity limit noted on prescriptions, but ultimately decided against it. The AOA, however, is now requesting that a quantity limit be included in order to protect the patients’ health and safety.
“More and more frequently retailers are encouraging consumers to use mobile technology to submit copies of prescriptions via email or by text message, bypassing the prescription verification process,” it writes. “The checks and balances the FTC anticipated when the Rule was first written do not function in many instances, to the detriment of consumers.”
Next: Respecting prescription expiration
Respecting prescription expiration
Along the same lines, the AOA also asked the FTC to prevent contact lens retailers from marketing to specific customers to reorder their lenses after their prescription has expired. In the letter, the AOA cites a study that found a large percentage of consumers reorder their contact lenses with an expired prescription.1
The AOA also notes that the prescription verification system created by the Fairness to Contact Lens Consumers Act (FCLCA) allows retailers to request verification of an otherwise expired prescription, and they can ship the lenses if the prescriber does not respond within eight business hours that the expiration date has passed and inform the seller.
“Allowing repurchases based on long-expired prescriptions may be, at the time, convenient for the patient and profitable for the seller, but increases the risk of patient harm,” the AOA writes. “Patients might not have seen the prescriber in years, depriving them of a professional assessment of their eye health and the opportunity for education to reinforce proper lens wear and care habits, which have been shown to mitigate many potential adverse health effects.”
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The AOA is asking the FTC to require the expiration date or issue date to be provided in prescription verification, which it says would incentivize sellers to make sure patients know their expirations when placing orders.
“The prescription verification scheme should not be abused by sellers to knowingly push contact lenses to consumers with expired prescriptions, hoping the error is not noticed by whichever prescriber receives the verification request,” the AOA writes.
The AOA also highlights a number of companies—including 1-800 CONTACTS and Coastal.com—that use phrases that appear to blame eyecare providers when a patient cannot purchase new lenses after his prescription is expired. For example, 1-800 CONTACTS states, “We’d like to send your lenses out to you with free overnight delivery once your prescription is up-to-date but your eye doctor won’t allow us to do that until you have an exam,” in their message to their customers.
“This type of communication pits consumers against their physicians and does not accurately describe anti-competitive impact when an order is denied based on an expired prescription,” the AOA writes.
Next: Stop the illegal sale of contact lenses
Stop the illegal sale of contact lenses
In its letter to the FTC, the AOA says it has identified 41 online contact lens retailers that it believes are illegally allowing consumers to purchase contact lenses—both corrective and plano, costume-style—without a prescription. The AOA states that it has reported many of the retailers to the FTC over the last year, but the retailers are still selling lenses.
The AOA also raised concerns over a growing trend of patients using social media sites to sell contact lenses. Social media usage has exploded since the FCLCA was passed, the AOA says, and the organization and its members have seen individuals using sites like Facebook to resell their extra lenses or sell costume contact lenses.
“The AOA has engaged Facebook on this issue, citing Facebook's own policy of not allowing the sale of regulated goods through their website,” the AOA writes, “but to date we have received no response from the company and individuals continue to attempt to use Facebook as a safe haven to sell lenses without a prescription.”
1. Fogel J, Zidile C. Contact lenses purchased over the Internet place individuals potentially at risk for harmful eye care practices. Optometry
. 2008 Jan;79(1):23-35.