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New Law Means Hoosiers Can't Use Online Eye Exam


More business is conducted online all the time. One of the latest startups is an online eye exam. It’s called Opternative and it allows people to test their vision without having to step foot in a doctor’s office.

But soon it won’t be an option for Hoosiers. A telemedicine law going into effect next month means the company is prohibited from operating in Indiana.

How The Technology Works

We use them for just about everything. With just the touch of a few buttons, you can order pizza, look up directions, even deposit a check into your bank account. And now a Chicago startup says you can use your phone and computer to help test your vision.

Opternative tests for refractive error and provides people with a prescription within 24 hours.

"Opternative is an easy-to-use way to get a prescription for glasses and contacts that is issued by a doctor, an ophthalmologist licensed in your state," says Opternative CEO Aaron Dallek.

Optometrists feel that technology is a threat to their business.

Here’s how it works: after you log onto the website and answer a few questions, you use your computer and smart phone to complete a series of tests. The computer acts as a screen where letters or numbers will pop up that are similar to what you might see during a traditional eye exam. Your phone acts as a remote, allowing you to answer prompts that come up during the test.

Not everyone can use the service. Opternative is only offered in 33 states, with plans to expand. At least three states have passed legislation banning the company.

In Indiana, a telemedicine law going into effect July 1 bans Opternative from offering its services to Hoosiers.While the bill allows doctors to write some prescriptions without seeing a patient in-person, it prohibits the prescription of contacts, glasses or low-vision devices through telemedicine.

Dallek calls the law anti-consumer.

"Optometrists feel that technology is a threat to their business," he says. " And they held the Indiana telehealth bill hostage and threatened to kill it if prescribing glasses and contacts wasn’t banned in the new law."

Optometrists Say Online Exam Poses Public Health Risk

Neil Pence disputes Dallek's claims. Pence is the Associate Dean for clinics and all-care patient services at Indiana University’s School of Optometry and says the telemedicine bill didn't target Opternative.

"Telemedicine is to have a patient interview, to have a doctor, physician, physician’s assistant, nurse, nurse practitioner actually interview the patient, actually be able to see the patient, so with live video," Pence says. "So there are various restrictions that define what a telemedicine encounter would be. Theirs does not fall anywhere close to what would be allowed."

Opternative touts a more than 99 percent customer satisfaction rate, but Pence says there’s no evidence their vision screenings are as effective as traditional exams.

The American Optometric Association filed a complaint with the Food and Drug Administration earlier this year, claiming Opternative poses a risk to public health and is in violation of federal law because it didn’t go through the pre-market approval process.

Dr. Christopher Browning says no online technology can duplicate the benefits of an in-person visit to an optometrist. At his Greenwood office, there are about a dozen instruments used to gather various information about people’s eyes – and the screenings go well beyond testing vision.

You can't put a price on how much your eyes are worth or how much your eyesight's worth.

"Many times in our office we’re detecting diabetes for the first time," Browning says. "A lot of patients that have diabetes don’t know that they do and it’s detected by their optometrist or ophthalmologist first."

Optometrists can also detect neurological problems during routine exams. And while they may be more expensive than using a service like Opternative, Browning says patients get much more for their money.

"There’s more to value than just how much something costs," he says. "So you can’t put a price on how much your eyes or worth or how much your eyesight’s worth. It’s the most important sense for sure."

But the founders of Opternative insist they’re just trying to increase access to eye exams for under-served populations.

"There’s no reason we can’t help an Indiana farmer that is 40 to 50 miles away from the nearest optometrist to get a prescription for glasses or contacts," Dallek says. "That’s’ the whole point of making telehealth available in Indiana."

Opternative’s CEO says he plans to challenge Indiana’s law.

Want to contact your legislators about an issue that matters to you? Find out how to contact your senators and member of Congress here.

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