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Ever since online eyeglass sales began, optical industry observers have wondered when online refraction would follow. But although eyewear e-tailers now offer simple technology that lets people measure their own PD, being able to accurately measure one’s own visual acuity using an online test is more technically challenging.

The first company to attempt it is Opternative, a Chicago-based start-up founded by Steven Lee, OD and Aaron Dallek, an entrepreneur who has co-founded a printer cartridge sales and recycling company and a carbon information management software company. The two partners have created a test, also called Opternative, which they describe as “the world’s first online refractive eye exam to deliver a valid prescription.” They plan to launch it this summer.

Dallek and Lee would not reveal the details of how the exam works, in part because they are still fine tuning it based on feedback from a study they are currently conducting with 500 to 1,000 users. However, they said the test has “a sophisticated algorithm on the back end that is based on very sound optics and science.”

The test is monocular, according to Dallek, who presented Opternative at VM’s 2014 Global Leadership Summit. “We specify how far the user should be from their computer, and we have ways of verifying that. For each part of the prescription we are able to identify axis, sphere, cylinder.”

Opternative is also developing a clinical study to determine the efficacy of the Opternative exam versus a traditional refraction. The study is registered with the National Institute of Health and will be reviewed by the International Review Board, Dallek said.

   
  Opternative founders Aaron Dallek (l) and Steven Lee, OD.
To ensure that performing online refractions works within the laws of each state, Opternative plans to use its web-based technology along with authorization from a licensed ophthalmologist to provide customers with a prescription within 24 hours. However, some optometrists are alarmed at the prospect of online refraction. On March 17, the American Optometric Association 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.

“We believe that claiming to have performed an eye exam without physically examining a patient is offering misleading information and may contribute to a patient believing—incorrectly—that his or her eye health needs have been met,” AOA president Mitchell T. Munson, OD said in the organization’s statement.

Dallek and Lee claim that their intent is not to eliminate an in-person exam, but simply to provide a convenient way for people to get a refraction in between regular visits to either their optometrist or ophthalmologist.

Although Opternative’s initial vehicle is online, Dallek and Lee said they are also developing a professional version of their exam. “It’s designed in a way to help improve access for their population, and improve the overall experience for the patient. Our goal is to help them make their practice more efficient, which would save them time and money. The most important thing is engaging their patients. The average eye exam is every 2.2 years. How do you engage these people? Is there a way you can ping them, and say ‘Hey, take your refraction at home but come in for a comprehensive eye exam.’”

On a broader scale, Opternative’s goal is to improve the overall experience of providing eyecare to an underserved population both in the U.S. and around the world. “There are more than 50 million people in the U.S. who have never gotten an eye exam,” Dallek noted.