The Federal Trade Commission (FTC) has triggered a major lobbying battle with a proposal that would make it easier for people to purchase contacts over the internet.
Eye doctors say patients who buy contacts online put their vision at risk, but internet retailers such as 1-800-CONTACTS and Lens.com claim they offer more affordable prices for the same lenses without compromising safety.
The FTC’s revision of the contact lens rule threatens to shake up the $4.6 billion industry.
“The public has no idea you can buy contact lenses online,” said Cary Samourkachian, founder of Lens.com. “Sometimes patients ask me if it’s legal. They think the only place they can buy contacts is from their eye doctor.”
Eye doctors hold all the power, Samourkachian said, because they write the prescriptions their patients need to purchase contact lenses.
“They are one of the only healthcare providers who sell what they prescribe,” Samourkachian said. “If you go to a regular doctor, they don’t walk you out into the lobby and sell you medicine.”
“That’s an inherent conflict of interest,” he said.
The FTC is aiming to level the playing field so the nearly 41 million Americans who wear contact lenses can choose whether to buy from their eye doctor or online. The commission is combing through more than 4,000 comments on the rule.
But it is unclear what impact the transition to the Trump administration will have on the regulatory push, given that President Trump is set to appoint three new commissioners who will take control of the independent agency.
Since 2004, the FTC has required eye doctors to provide patients with a copy of their prescription, even if they don’t request it, so they can shop online for better prices.
But critics question just how closely optometrists follow the rule. A survey from -1-800-CONTACTS found that one-third of people who wear contact lenses never received a copy of their prescription.
Ken McEldowney, executive director of Consumer Action, called them “captive customers.”
“They don’t have any choice whatsoever to seek out cheaper contact lenses,” he said.
To address that, the FTC is proposing that eye doctors obtain signed consent from their patients confirming that they received a copy of their prescription.
The FTC says this small tweak will encourage consumers to shop for better prices and more convenience. But it could have major ramifications for the contact lens industry, driving sales from eye doctors to online retailers, which currently account for less than 20 percent of the market.
Eye doctors warn that buying contacts online could discourage patients from coming in for their annual eye exams. Without consistent reminders from their optometrists, they say, patients are more likely to fall into bad habits and mistreat their contact lenses. This increases the risk that patients will contract an eye disease without being diagnosed.
“When you have that regular interaction with your eye doctor, you’re more likely to take better care of your eyes, because you’re better informed,” said Deirdre Middleton, spokeswoman for the American Optometric Association, which represents eye doctors.
The FTC said it found no evidence that buying contacts online increases health risks, suggesting these warnings from eye doctors are “more anecdotal than empirical.”
“It doesn’t matter so much where you purchase your contact lenses, as long as you take care of them,” said Cindy Williams, general counsel at 1-800-CONTACTS.
“Sleeping in your contact lenses, wearing them for longer than the recommended period of time, not washing your hands before you touch them, topping off the solution instead of replacing it each day, or storing them in water are bad habits that increase the risk of developing eye infections.”
Others suggest the health concerns are overblown.
Samourkachian called the warnings a “scare tactic” employed by eye doctors to protect their bottom line.
“It is still important for people to go to an eye doctor,” Samourkachian said, “but they should not be profiting from what they prescribe.”
“I’ve been in business for 21 years, and the one issue that’s very bothersome is that the consumers are getting ripped off by their eye doctors,” he added. “That’s what keeps me going every day.”
The American Optometric Association pushed back.
“We’re talking about a company accusing doctors of trying to make more money,” Middleton said.
“The top priority for an eye doctor is the patient’s health, so they will choose the right contacts for them,” she added. “The other side isn’t responsible for the patient’s health. Their sole responsibility is to their shareholders.”
The FTC says it is trying to referee the fight by empowering consumers to choose where to get their lenses themselves.
“We think the rule strikes a good balance,” said FTC spokeswoman Elizabeth Delaney.
The FTC’s contact lens rule mandates prescriptions must last for at least one year, but several states, including Utah, Washington, Minnesota, New Mexico, Florida and Maryland, extend the minimum length of a prescription to two years.
1-800-CONTACTS and Lens.com are pushing for the FTC to adopt a two-year prescription minimum across the country.
Eye doctors may write longer prescriptions, but they have little incentive to do so.
The FTC prohibits internet retailers from selling contacts to patients based on expired prescriptions. To get around this requirement, the American Optometric Association accused online retailers of selling multiple years’ worth of contacts before the patient’s one-year prescription expires.
But Samourkachian pressed the FTC to loosen these prescription requirements.
“Globally, there are many countries like Germany where contact lenses don’t require prescriptions,” Samourkachian said. “They’re sold over the counter. I don’t see any Germans walking around with eye patches because they’re going blind.”