by Sally Greenberg
Consumer milestones that make the marketplace fairer and transparent and promote better health are worthy of celebration. I count among those milestones the Fairness to Contact Lens Consumers Act.
Signed into law in 2004, the Fairness to Contact Lens Consumers Act (FCLCA) gave more than 45 million contact lens-wearing patients better information and more choices and evened the playing field between contact lens providers and eye care professionals.
Today, a consumer can walk into an eye doctor’s office and receive a prescription for contact lenses that treat astigmatism, accommodate near and far sightedness at once, and receive daily disposable lenses or lenses that can be cleaned and worn again. Patients can then take their prescription and buy their lenses from a multitude of online sellers for the same price as their doctor’s office. FCLCA is largely responsible for this robust competition.
However, as this law has matured, the National Consumers League (NCL) has some concerns that perhaps the pendulum has swung too far in the direction of online sellers who are aggressive marketers of their products.
Contact lenses are Class II and Class III medical devices, which means they have a moderate to high risk to patients. Contact lenses can cause infections – to the tune of 1 million each year. I should know. I, myself, had a lens-induced infection. It was difficult to treat and extremely painful. I could have lost sight in my left eye without a doctor’s intervention and strong medication.
With so many lens-related infections, it is alarming that several online sellers have lobbied state legislatures to allow for contact lenses to be sold multiple years at a time without receiving an annual eye exam (Carson).
NCL thinks this type of effort is harmful to consumers and supports the requirement of a yearly eye exam because eyes are a window into overall health. An annual eye exam can detect more than vision problems. Diseases like glaucoma and age-related macular degeneration, which cause many older Americans to go blind each year, can be detected through an annual eye exam. In total, an eye exam can detect more than 276 different medical conditions, including brain cancer, and is currently the only noninvasive way to detect diabetes.
This is where NCL believes that the pendulum swing comes in.
The FTC is charged with implementing the FCLCA and has worked to oversee the implementation of the law, but we believe that too many online contact lens sellers are gaming the system. Over the last several years, the use of robocalls by online contact lens sellers to verify contact lens prescriptions has increased. Online sellers know they can make robocalls to a doctors’ office to “verify” the contact lens prescription and actively avoid talking with the consumer’s doctor. Once the 8-hour passive verification window set by the FCLCA has passed, online sellers then fill the prescription, which all too often might be the wrong prescription or a lens other than what was prescribed, ultimately selling a lens that isn’t ideal for the patient. The consumer receives lenses unaware that there may be something wrong. This intentional avoidance of talking with the consumer’s doctor places consumers at a greater risk.
NCL supports the FCLCA, and we commend the FTC for its efforts to update the rules related to the FCLCA. The FTC has done an admirable job with limited resources. However, NCL also believes increased enforcement and oversight of online sellers who actively avoid consumer protections under the FCLCA. Online sellers should follow the spirit of the law in confirming a patient’s prescription and not simply employ robocalling.
The FCLCA has indeed opened up the market to consumers and made the purchase of contact lenses far more competitive. That said, NCL believes the FTC should tighten up the robocall loophole by requiring online lens retailers to use live telephone calls or, even better, secured emails and patient portals to verify prescriptions and close the robocall loophole.
In so many ways, the marketplace has improved for consumers of contact lenses. Closing this loophole would be a welcome first step in modernizing and protecting the eyes and overall health of patients. When it comes to your eyes, you don’t want to fool around!
Carson C. Arizona contact lens wearers could see eye doctors less. KTAR News. Posted February 17, 2016. Accessed May 15, 2019.
Deloitte. Consumer Priorities in Health Care Survey. 2016. Accessed May 15, 2019.
For more information:
Sally Greenberg is executive director for the National Consumers League in Washington.