It’s been over a decade since the Federal Trade Commission mandated the Contact Lens Rule. Its intent is to allow patients the right to purchase contact lenses from the seller of their choice, whether a health care provider or other source, including online.¹ The intentions are worthy. 

However, most of us would agree that it just doesn’t work in its current form. Most likely, you can easily cite abuses that have resulted from the Contact Lens Rule. At best, the current system of verification is onerous. Eye care providers must verify the patient’s prescription through a “passive” process—and within eight regular business hours after a seller requests it. Should the prescriber’s office not respond in time, the seller can (and will) consider the prescription verified (even though it has not been) and sell the patient lenses. 

A 2015 survey found that approximately 25% of consumers who bought their lenses from a big-box or other retailer were given a different brand than was prescribed. The survey also found that nearly a third of consumers could order lenses with an expired prescription (often beyond one year).² Many consumers in the survey noted they were advised to purchase a non-prescribed product.

Hitting Close to Home
Let me share a recent first-hand experience with a close relative as an example. My relative called me up, saying: “I just got these lenses in the mail that were distributed from Taiwan—30 days’ worth for free. Can I wear them? Apparently, I can order more if I like them!”

My response? “No, you can’t, and how did they get the right prescription since no one has ever evaluated those lenses on you?” 

He said, “I provided my prescription numbers online and they claim to have verified the accuracy with your office.”

I called the company’s “medical hotline,” got a recorded message and left my number. While I have yet to hear back, my staff tracked down a different contact and I spoke to a very cordial person who stated that our office received a fax on a Sunday evening at 9:30pm to verify the prescription that doesn’t exist; I don’t have a fitting set to evaluate their lenses. My staff swears they didn’t receive the fax. It’s possible there was human error, but I don’t think so. The important question remains: how can this company fill a prescription they know doesn’t exist through this verification process? They know who has their fitting set and who doesn’t. 

This is beyond troubling for me. 

Rules, or Suggestions?
Just for reference, here is a section from the Contact Lens Rule:¹

“No alteration of prescription. A seller may not alter a contact lens prescription. Notwithstanding the preceding sentence, a seller may substitute for private label contact lenses specified on a prescription identical contact lenses that the same company manufactures and sells under different labels.”

Beyond a disregard for the verification process, this company apparently assumes their product is a generic equivalent to almost anything a patient might be wearing. 

I will concede that the material this company used, methafilcon A, is available in many different lens types and generally works well for most patients. Nevertheless, an on-the-eye assessment by a health care professional is required before a prescription is valid. 

I know my outrage may appear self-serving to some. But, the experience with my relative would make any eye care practitioner tremble at the potential for disaster. Taking a patient’s request for trials without proper evaluation, dispensing a month’s worth of the trial lenses and ultimately prescribing lenses for the next full year with an extended delivery system is reckless. When would we see the patient to evaluate the lenses on the eye and the eye’s response? A year later? 

Let’s work on a better system of verification for contact lens prescriptions. Short of that, we are living in a world of generic equivalents, and in my humble opinion, that’s dangerous. After all, contact lenses are a medical device, the last time I checked. And for those who might be wondering: That close relative receiving lenses from a rogue source? My son.

Some of you have likely already received similar requests—if you haven’t, get ready!  

1. Contact lens rule. Federal Trade Commission. July 2, 2004. www.ftc.gov/enforcement/rules/rulemaking-regulatory-reform-proceedings/contact-lens-rule. Accessed March 27, 2017. 

2. Loopholes in today’s contact lens online marketplace. Johnson & Johnson Vision Care. 2015. http://jnjvisioncareinfo.com/sites/default/files/Loopholes%20link.pdf. Accessed March 27, 2017.