Opternative is a Chicago-based startup that launched in 2012 and now offers the first online refractive eye exam. With $40 and no trip to the doctor, patients aged 18-40 can get a signed prescription for glasses or contacts. While Opternative is convenient and cheap, the concept has received criticism from providers and industry groups.

The test takes about 30 minutes using your smartphone and a computer. Opternative asks some basic health questions to make sure you’re eligible before instructing you to stand the correct distance from your computer screen based on your shoe size. Using a smartphone browser, the test has you answers questions about letters, shapes and lines that appear on the screen.

Opternative CEO Aaron Dallek says 65,000 patients have signed up for the eye exam. The test is free, but it costs $40 to have a doctor in your home state review the online results and email a prescription.

While Opternative is available in 34 states, it has not been approved by the FDA. The company works directly with ophthalmologists in each state to review exams and write prescriptions. Opternative has also been criticized by provider organizations who worry that consumers might substitute Opternative for a comprehensive exam, which looks for glaucoma and cataracts and can check for health problems like diabetes.

Opternative’s online eye exam is making waves in the eye care industry
Opternative’s online eye exam is making waves in the eye care industry

The American Optometric Association filed a complaint with the FDA in April, saying the vision test poses significant health risks to the public and should be taken off the market. The FDA hasn’t taken action, but legislators in Indiana recently passed a law that prohibits the startup from continuing to make prescriptions and other states are threatening to follow suit.

Despite these concerns, the American Academy of Opthomology says that online eye exams “may be appropriate for people 18-39 years of age with non-severe corrective eyeglass prescriptions and no symptoms of eye disease.” The organization said it supports the use of new technologies to improve efficiency and widen access to eye care services.

“As long as it’s not interfering with patient safety, we really felt it was not appropriate to limit technology,” said Dr. Dan Briceland, senior secretary for advocacy at the Academy.

Opternative recommends that patients get a comprehensive eye health exam every two years. As CEO Dallek told NPR, “Some people may choose to get it less often, but that’s their choice. That’s part of the free market, for patients to be able to kind of choose what’s best for them.”

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