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Eyecare community raises red flags over Opternative


Online refraction is officially here with the last week’s launch of Opternative, a company offering its online vision test to the public for the first time.

Chicago-Online refraction is officially here with the last week’s launch of Opternative, a company offering its online vision test to the public for the first time.

How it works

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

The company offers an online vision test through its website, Opternative.com. The test takes about 25 minutes, and the patient 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. The patient can receive a prescription for glasses or contact lenses for $40 or for both for $60.

Related: Blink in-home vision test worries ODs

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

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

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

Next: From development to launch


From development to launch

Optometry Times spoke with Dallek in early 2014, when the company was still in its early stages of developing its technology. The company has spent the last year and a half testing its technology on 1,500 patients to prove it works and it is safe, Dallek says.

Related: Are you ready for online refraction?

“We’ve been focusing on perfecting our technology as we concluded a clinical trial that showed the Opternative refractive vision exam is statistically equivalent to an in-office refractive exam. We finished the clinical trial earlier this year,” he says.

Although the company officially launched just a few days ago, Dallek says the reaction from the public has been positive.

“Consumers are very enthusiastic,” he says. “They recognize we offer a service that saves them time and money. They also appreciate the freedom to shop anywhere they want for glasses or contacts. Consumers understand the value of what we offer.” 

Next: Eyecare community raises concerns


Eyecare community raises concerns

But not everybody is feeling the love for Opternative. Several members of the eyecare community have expressed concerns that patients will choose the online Opternative vision test and neglect getting a full ocular health exam.

“The rollout of this online vision test is a troubling development in the eyecare industry,” says 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,” says 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.”

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AOA President Steven Loomis, OD, spoke out recently to raise awareness among consumers about the 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 says. "Consumers can be lulled into a false sense of security."

Dallek says Opternative is aware of the controversy surrounding the company within the eyecare community.

“We are familiar with ODs’ concerns, and we take them seriously,” the CEO says. “We make it clear to patients that the Opternative eye exam is a refractive exam meant to provide a prescription for glasses and contact lenses.”

Dallek says 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 five-year period without getting an eye health exam, in accordance with the American Academy of Ophthalmology’s recommendations.

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

“We think we can help optometrists improve their patient efficiency so they can focus on eye health concerns,” he says.

Next: Opternative's approach is 'infuriating, deeply troublesome'


Opternative’s approach is ‘infuriating, deeply troublesome’

Optometry Times Editorial Advisory Board member Justin Bazan, OD, says he found this promotional video from Opternative to be “infuriating and deeply troublesome.” The video’s inspiration is taken from the usual line of questioning during a refraction-“Which is better: one or two?”

“You've run out of contacts, and your glasses are ancient. It's time to get an eye exam. Which is better: one or two? One, putting that silly appointment card to use or two, enjoying your morning coffee?” the video’s narrator asks. “Three, listening to the doctor's on hold music, or four, sharing your morning photo of Rufus? Excellent! Five, figuring when you can take time off work for your appointment, or six, taking your eye exam from the comfort of home? Good choice!”

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The video then goes on to explain Opternative’s services.

“I applaud Opternative for bringing patient-driven subjective refractions online. I'm excited about the possibilities it brings,” says Dr. Bazan. “I do feel that Opternative has very promising technology that I'm sure will lead to the development of other technology that will have a positive benefit to both patients and doctors.

“However, I feel the company leaders are taking some very misguided steps-one of them being to encourage the public to enjoy their morning coffee and ignore that silly appointment card from their eye doctor,” he says. “They have chosen to throw shade at eyecare providers by downplaying the importance of scheduled comprehensive eye care with the patient’s eye doctor. As evident by this video from their homepage, they are purposefully misleading the public. The powerful and purposeful messaging it contains certainly overshadows any info about the limitations of their testing and the need for scheduled eye care.”

ODs on Facebook founder Alan Glazier, OD, agrees with Dr. Bazan, saying that spinning the technology as “disruptive” doesn’t hide the fact that it can’t diagnose eye disease. 

“Their use of the phrase ‘eye exam’ to sell their service screams that the founders of the company don’t care about the overall wellness and safety of netizens,” Dr. Glazier says. But he says that, in general, he’s not worried. “For more than a co-pay people can spend a half hour on an incomplete eye exam that might miss eye disease-good luck with that!”

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