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Why An Online Eye Test Can't Replace Your Eye Doctor

For many people, the notion of being able to get an eyeglass prescription and buy glasses without a trip to the eye doctor sounds appealing. But is this really a good idea?


Here's what you need to know about online eye "exams" and vision tests before thinking about saying goodbye to your eye doctor.

Online Eye Tests

First of all, it's important to understand that an online eye test — even if it's called an "online eye exam" — does not evaluate the health of your eyes.

Eye doctor and patient discuss during an eye exam
Online eye tests let you check your vision between regular exams by your eye doctor.

Usually, an online eye test (more accurately, an "online vision test") only measures your visual acuity and refractive error. In some cases, other vision tests, such as contrast sensitivity and color blindness, are included.

But these measurements tell you little or nothing about the health of your eyes and whether you have conditions such as cataracts, glaucoma or macular degeneration.

Even if you choose to try an online vision test, be aware that you should still have routine eye exams as frequently as your eye doctor recommends. A comprehensive eye exam is the only way to insure your eyes are healthy and free from sight-threatening conditions.

Online eye tests, however, do have value.

For example, an online vision test can enable you to quickly obtain a valid eyeglass prescription so you can replace your glasses. This can be very useful if you break or lose your eyewear when vacationing away from home or you cannot schedule an appointment with your eye doctor for some other reason.

Also, in some cases, an online vision test can help you monitor your eyesight and refractive error between routine eye exams. But be aware that though the results of some online eye tests have been validated with limited studies, this is still relatively new technology.

More research is needed to guarantee that the accuracy of an eyeglass or contact lens prescription generated by an online vision test is comparable to a prescription determined in person by your eye doctor.

Opternative

One "online eye exam" company is Opternative, which was established in 2012 and currently is at the center of the controversy about online vision tests (see sidebar).

To begin an Opternative online eye exam, you calibrate the test on your computer screen by measuring a credit card.

You are then shown a series of tests to determine your nearsightedness, farsightedness, and/or astigmatism.

The Opternative online eye exam takes less than 25 minutes and provides a prescription for glasses or a contact lens prescription for $40 (or both prescriptions for $60). The prescription is delivered via e-mail within 24 hours, according to the company.


Though Opternative does not sell eyeglasses or contact lenses, the prescription(s) will enable you to purchase new glasses or buy contact lenses online.

Opternative also says a clinical study has shown its online eye exam was as accurate as a traditional refractive exam performed by an optometrist or ophthalmologist using a phoropter.

Certain limitations apply concerning who is an acceptable candidate for the Opternative online eye test. For example, the company says its technology is suited and intended for only people between the ages of 18 and 40 who are in good health.

Opternative Controversy
Opternative online eye exam.
Eye chart on an Opternative vision test.

AOA Files Complaint Concerning Opternative

September 2016 — The American Optometric Association (AOA) submitted a formal complaint to the U.S. Food and Drug Administration (FDA) in April 2016, contending that Opternative's online vision test poses significant health risks to the public.

The AOA argues that Opternative's continued marketing of its vision test to consumers without federal approval is in violation of the Food, Drug and Cosmetic Act (FDCA) and that the product should be taken off the market until the FDA has thoroughly reviewed the product's claims, safety and efficacy.

Risks Of Online Eye Exams

It's worth repeating: If you choose to replace a comprehensive eye exam by your eye doctor with a self-administered online eye "exam," it's important to know that there are a number of risks you are taking on.

First and foremost, there is no trained eye care professional present to carefully examine the health of your eyes. As previously mentioned, online eye exams cannot determine if you have cataracts, glaucoma, diabetic eye disease and other eye or general health problems that your eye doctor can detect during a comprehensive eye exam. Early detection of these problems can improve treatment outcomes, potentially preventing vision loss and even legal blindness.

Even if your eyes are perfectly healthy, there is a greater risk of getting an incorrect prescription for eyeglasses or contact lenses with self-administered online vision tests. Even if the results of your online "exam" are reviewed by an eye care provider before your eyewear order is filled, there is no eye care professional present when you are actually taking the vision test to insure the testing is performed properly.

If you don't take the online vision tests correctly, it's possible you won't be seeing as clearly as you should for driving, or you may experience problems such as headaches and eyestrain with your new glasses or contacts.

And what do you do if you think your prescription might be incorrect? Do you have to retake the online vision test again? Do you have to pay for the second test, with no guarantee the new results will be any better?

Online Eye Exam Cost: Not Necessarily A Money-Saver

You might think an online eye test or some other way to have your vision tested will save you time and money compared with the cost of a comprehensive eye exam performed by an optometrist or ophthalmologist.

But remember — you are only receiving a small part of the services provided by your eye doctor during a complete exam.

Also, the cost of online vision tests typically are not covered by health insurance or vision insurance. Therefore, if you have a vision benefits plan, your co-pay cost for a comprehensive eye exam might be less than the cost of an online eye test.

If you are employed, be sure to ask your employer what type of coverage you have for eye care. Many people are unaware that they have vision benefits and fail to use them.

Understand The Services Provided

When using an online eye test, online eye exam, or other types of mobile eye care services, the key is to understand what the service does and does not provide. Keep in mind that testing your vision, measuring your refractive error and obtaining a prescription for eyeglasses and/or contact lenses does not insure your eyes are healthy.

It is essential for you to have a live, face-to-face comprehensive eye exam with your eye doctor on a routine basis to safeguard the health of your eyes and enjoy a lifetime of good vision.

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Amy HellemAbout the Author: Amy Hellem is a writer, editor and researcher who specializes in eye care and other medical fields. She is a past editor-in-chief of the professional ophthalmic journals Review of Optometry and Review of Cornea & Contact Lenses and currently is president of Hellem Consulting, LLC.

Dr. Gary HeitingAbout the Author: Gary Heiting, OD, is senior editor of AllAboutVision.com. Dr. Heiting has more than 25 years of experience as an eye care provider, health educator and consultant to the eyewear industry. His special interests include contact lenses, nutrition and preventive vision care.

Page updated September 2016