EYECARE Direct-To-Consumers: DIY Eye Tests By Andrew Karp and Mark Tosh Monday, June 22, 2020 12:33 AM RELATED CONTENT Virtual Vision Care Grows Up Special Report on Telemedicine: The Time for Optometry is Now Making the Leap into Telehealth ECP Groups Support Members’ Access to Telehealth Solutions Retailers Find Telehealth Options Improve the Patient Experience Mapping Ocular Telehealth’s Multifaceted Ecosystem Adjusting to the New Normal: How Ocular Telehealth Can Help Payers See Longer-Term Role for Telehealth in Eyecare Coming Soon: NAVCP’s Telehealth Statement Envisioning the Future of Ocular Telehealth Key Trends in Ocular Telehealth The boom in online retail sales and other direct to consumer services that began in mid-March has been one of many business success stories to result from COVID-19, and online vision testing is no exception. D2C vision care companies, including those offering online vision testing and personal vision tracking devices report that they have been doing brisk business lately, although actual sales figures can’t be confirmed. But even before COVID-19, D2C vision care companies say business was thriving. D2C vision care emerged in 2014 with the launch of Opternative (https://www.visionmonday.com/intelligent-office/exam-lane/the-rx/article/opternative-explores-the-online-option-1/), the first company to offer what its founders called “the world’s first online refractive eye exam to deliver a valid prescription.” The company’s web-based visual acuity test produced measurements that were reviewed by a licensed ophthalmologist who then, depending upon the results, provided customers with an eyeglass prescription within 24 hours. This approach brought pushback from the American Optometric Association, which promptly issued a statement warning consumers about possible risks associated with online refractive eye exams. “Such online sites tout convenience. But any alleged advantages come with risks,” the AOA cautioned, adding that online tests are no substitute for an in-person comprehensive eye exam by an optometrist or ophthalmologist.” Today, online eye testing is focused mostly on prescription renewal. Several companies provide the service, including two major online eyewear retailers. Warby Parker offers Prescription Check and 1 800-Contacts offers Express Exam. Visibly, formerly known as Opternative, was sidelined in August, 2019, following an FDA recall of its online refraction test. The company began offering a simpler type of visual acuity test in April after the FDA loosened restrictions on telehealth in response to the pandemic. EyeQue has taken a different route to engage consumers in their eye health. The company markets affordable, compact devices such as VisionCheck which lets consumers check their vision, measure their pupillary distance and order new glasses online through Zenni Optical, Glasses USA, and EyeBuy Direct. Key executives at these D2C companies commented on the impact of COVID 19 on their respective businesses, and as well as on their overall approach. Neil Blumenthal Co-Founder & Co-CEO Warby Parker We’ve seen a notable increase in Prescription Check app volume over the past few months, amidst COVID-19. We have not seen a slowdown in Prescription Check app engagement since we started reopening stores in May. As social distancing remains important, services like our Prescription Check app and Virtual Try-On tool will continue to be an important option for customers looking to limit or shorten trips outside their homes. We’ve seen a noticeable lift in new customers across Prescription Check and our website from those who would traditionally rely on in-person vision services. We expect to see this trend continue even as retail stores reopen. John Graham CEO 1-800 Contacts We’ve believed and invested in telehealth as the future of the vision industry for many years. We have seen opportunities to expand access to consumers who need vision correction through technology like ExpressExam, reducing unnecessary checkups and reserving in-person doctor visits for essential eye health checks. The implications of COVID-19 have sped up consumer adoption of telehealth tools as they’ve had a chance to experience a simpler and more convenient way to access some of the care and products they need. As we navigate this new world, we see vision related telehealth services maintaining a strong foothold and increasing in adoption with consumers. We will stay focused on providing consumers with access and choice for their vision care needs and see telehealth as an important component. Brent Rasmussen CEO Visibly We are thrilled to offer Visibly to all doctors and service providers free of charge during this global pandemic, which is making it increasingly difficult for patients and consumers to renew prescriptions for their corrective lenses and glasses. We recognize that the limitations caused by COVID-19 have created significant strain on the optical industry. We are confident that our technology will streamline the process for optometrists, ophthalmologists and patients alike, resulting in a greatly reduced lapse in service for consumers, while keeping individuals safe. The doctors are coming up with brand new use cases for our technology that we hadn’t anticipated. Some ODs are using it as a screening tool. Let’s say I have 500 patients. I send emails to them asking them to take this vision test. Those people who pass the test and see 20/20 with their glasses or contacts on get a renewed prescription. But those individuals who fail the test, alert the doctor that this person actually needs to come in and see me, let’s have a telemedicine visit via one of the platforms. So they’re using it as a safety mechanism to have less exposure during this time. People didn’t use it for that prior to this. Optometrists and ophthalmologists are also using it as post-surgery check in, to see if there’s any change in the patient’s vision. John Serri, PhD Co-Founder and President EyeQue In April, in response to COVID-19, EyeQue offered the Personal Vision Tracker (PVT) free to U.S. residents and waived annual membership fees for refraction testing in an effort to help those suddenly unable to visit their optometrist in order to check their vision. We intended to give away 1,000 PVTs but ended up delivering over 2,000 units and despite the free offer, saw record revenues for the month of April and May from sales of other devices. People are eager to self-refract and are increasingly aware that they can purchase eyeglasses online with a good outcome. EyeQue allows the consumer to test at their convenience, as frequently as they like and they can—and do—monitor their results over time. The more someone uses our devices, the better their refraction test results become. Through our screening and refraction measurement technology, EyeQue provides a new form of personal wellness information not available previously. We’ve received thousands of messages from customers appreciative of the insights into their own vision and of their ability to obtain great fitting eyeglasses, and we note that, to date, there are no reports of any harm. Telehealth is something that will greatly benefit both patients and doctors, so it is time that the eyecare community, including EyeQue, help demystify vision tests by educating consumers/patients about the components of an eye exam that can be accomplished remotely versus those that are necessary to be conducted in an office. We do have strong messaging throughout our materials and website letting people know that EyeQue does not replace the need to see an eyecare professional, nor does EyeQue perform optometric services. There are a number of specific applications that ophthalmologists and optometrists have expressed interest in using our screening and refraction devices. The ability to remotely monitor patients who have recently undergone Lasik surgery, are recovering from certain eye injuries, or are suffering from macular degeneration, for example offers a win–win for patients and ECPs. ECPs can play a crucial role when their patients use EyeQue technology to track vision at home, as an educator, to raise awareness on the importance of eye health. Eye doctors, through the use of EyeQue at-home vision monitoring tools, can reduce in office chair time by tracking vision changes the patients make while testing at home. We believe that EyeQue has great potential to serve as a referral source to ECPs as there are many persons that use our device but have never been to an eye doctor because they have normal or near normal vision. We screen for acuity and contrast sensitivity and can give the user a recommendation, without giving a specific diagnosis, to visit an eye doctor if the readings are out of the normal range. Many people skip annual visits but still are curious to know whether their vision has changed. At-home vision testing tools provide easy access for those patients and can help guide them to doctors. At-home vision monitoring tools can also help doctors save chair time on periodic follow-up visits, related to OrthoK and post-surgery (cataract and LASIK) recovery. The ability to remotely monitor patient recovery reduces the number of visits a patient has to make, thus increasing patient satisfaction and improving efficiency. The ability to detect vision changes quickly may also help doctors make better timely treatment decisions and improve long-term treatment outcomes. We are currently conducting clinical trials in the areas of visual acuity tracking for these purposes.