An Ultra Marathoner’s Wake-Up Call: How an Online Exam Almost Cost Him His Vision

"What I love most about ultramarathons is the depths people have to take themselves to achieve these things," Austin Gaydosh says. "My vision plays a huge role in running. The last thing you want is an injury."

Thirty-year-old ultramarathoner Austin never imagined that his routine contact lens habits could put his vision at risk. But after years without seeing an optometrist in person and relying on an online vision check for prescription renewal, Austin noticed that something was wrong with his vision.

For three years, Austin had worn two-week replacement contact lenses and frequently slept in them for up to a week at a time. When his prescription expired, he used an online vision service to renew it and ordered lenses from a major online retailer.

"I was renewing my contact prescription online for three years without seeing a doctor. I thought it was completely fine," he reflects.

Everything was fine – until it wasn’t. At first, Austin thought it might be an allergic reaction but 24 hours later, the symptoms became so severe that Austin went to the emergency department in Knoxville, Tennessee. In his right eye, he was diagnosed with a corneal ulcer—a painful and potentially sight-threatening condition. The emergency physician prescribed antibiotics and instructed him to follow up with an optometrist.

Austin visited Jeffrey Sonsino, O.D., in Nashville. His uncorrected vision was 20/200 in the affected eye, and even with correction, it only improved to 20/25 compared to his original 20/20 vision. Dr. Sonsino found a central corneal scar in the upper part of Austin’s visual axis—a scar that will affect his vision permanently.

"Austin first came to us in crisis. He had never been to our practice before. Even though he came to us with a major problem, we were so glad that he decided to come in and seek our help," says Dr. Sonsino. "A corneal ulcer is when bacteria from some source invades the top layer of the eye and can actually eat through the cornea."

In addition to anti-inflammatory eye drops, Dr. Sonsino began an experimental treatment to help limit scar formation in the healing process.

"The problem with corneal ulcers is that they almost always turn into a scar," Dr. Sonsino explains. "So, we immediately put him on a steroid eye drop to try to prevent scar formation the best we possibly could."

The Food and Drug Administration (FDA) classifies contact lenses as Class II and III medical devices—the same category as cardiac stents—because of their potential to cause harm when not managed appropriately. Annual in-person exams with a doctor of optometry are vital for catching early warning signs like redness, swelling, or lens-related irritation that could lead to complications.

Online vision tests, while marketed as convenient, are no replacement for in-person care. They fail to fully cover any of the 12 essential exam components and can lead to inaccurate prescriptions or missed diagnoses of serious conditions like glaucoma, diabetes, hypertension cataracts and macular degeneration. The American Optometric Association (AOA) has long warned of their risks. In fact, the AOA issued a public health alert in 2022 outlining how these services can mislead consumers and delay critical care.

"By getting my contacts online, I knew I was taking a shortcut. I wouldn’t have suffered the ulcer if I had seen a doctor of optometry," Austin says.

His story is a cautionary tale for the millions of contact lens wearers who may be tempted to skip annual eye exams in favor of convenience.

AOA urges patients to:

• Schedule annual, in-person eye exams with an AOA doctor of optometry
• Follow safe wear and care instructions for contact lenses
• Avoid online vision services that bypass professional evaluation
• Call your optometrist if you’re experiencing an eye-related emergency during business hours

Convenience should never come at the cost of your sight. Protect your eye health—book your next eye exam with a doctor of optometry today.

Dr. Jeffrey Sonsino

Jeffrey Sonsino, O.D., FAAO, is a distinguished specialist in cornea and contact lenses based in Nashville, Tennessee. He currently practices at Optique Eyecare and Eyewear and is the director of the Contact Lens Center, where he designs advanced contact lens solutions for patients with complex corneal conditions, dry eye, and post-surgical needs. He completed his optometry degree at the New England College of Optometry in Boston, followed by a cornea and contact lens residency at the Illinois Eye Institute.  

Dr. Sonsino is internationally recognized for his expertise and has served in leadership roles with the American Optometric Association and other notable optometric organizations, holds multiple patents in vision-related medical devices, and frequently lectures and publishes on contact lens advancements.