AOA urges Federal Trade Commission to investigate

AOA to FTC: Marketing of online vision test by 1-800 Contacts misleads, confuses consumers

On behalf of patients, the AOA is asking the Federal Trade Commission (FTC) to investigate whether the marketing of an online vision test offered by 1-800 Contacts' website potentially confuses consumers about the service they are receiving. On 1-800 Contacts' website, it states that the online vision test, called ExpressExam, relies on technology provided by Visibly, the company formerly known as Opternative. The AOA argues in a March letter to the FTC that the ExpressExam name and 1-800 Contacts' website leave the public with the wrong impression about the content of the service, which could potentially threaten eye health and vision if an incorrect perception leads to individuals foregoing regular, comprehensive eye exams.

"Now, more than ever, there is a risk that certain practices associated with online services can undermine the foundations of quality care and the doctor-patient relationship, and AOA will expose and seek to have these practices held accountable at every turn," AOA President Samuel D. Pierce, O.D., says.

Marketing creates consumer confusion

Words matter. To illustrate the potential for confusion in this specific instance, the AOA cited an online health care terminology survey it commissioned in February among a nationally representative sample of 1,000 consumers that found:

  • 56 percent thought an "ExpressExam" was the same exam/test that a doctor would provide during an in-person office visit, but in less time.
  • Nearly half (49 percent) thought that an ExpressExam would afford them the opportunity to talk about their eye issues with a doctor. That opportunity doesn't exist through ExpressExam, the AOA says.

"We believe that the use of the term 'exam' by 1-800 Contacts is a material misrepresentation that could affect a consumer's choice to obtain an in-person, comprehensive eye examination or to obtain another company's online vision test," Dr. Pierce wrote in a letter to Andrew Smith, director of the FTC's Bureau of Consumer Protection.

Online vision tests "can delay essential, eye-saving treatment," Dr. Pierce wrote. "Comprehensive eye exams are one of the most important, preventive ways to preserve vision, and the only way to accurately assess eye health, diagnose an eye disorder or disease, and determine the need for corrective lenses."

Questions about the FTC Act

In its letter, the AOA acknowledges that Visibly states that its test is somewhat limited and not a substitute for a comprehensive eye exam. Even Visibly's founder has stated that, "We're definitely not a comprehensive eye exam, and we're not a replacement for optometrists."

AOA's letter asks the FTC to investigate whether 1-800 Contacts' practices may be in violation of two sections of the FTC Act:

  • Section 5, which declares unlawful acts or practices that are unfair or deceptive.
  • Section 12, which prohibits false ads likely to induce the purchase of food, drugs, devices or cosmetics.

"We believe that the use of the term 'exam' in the ExpressExam branding and throughout the 1-800 Contacts website is misleading in a material respect, especially when one considers that other companies offering the same services take steps to ensure that the term 'exam' is not used to describe the service provided."

There is no substitute for an in-person, comprehensive eye exam, Dr. Pierce says, citing from the AOA's clinical practice guideline, Comprehensive Adult Eye and Vision Examination. Doctors of optometry continue to be trusted sources. A 2018 American Eye-Q® Survey found that 75 percent of Americans trust them to safeguard their eye health.

AOA's advocacy on behalf of patients

The AOA has long championed patient safety and public health priorities. In recent years it has repeatedly pressed federal agency officials and Congress to crack down on illegal internet contact lens sellers who the AOA believes put health and vision at risk, as in its 31 in 31 campaign.

Separately, in 2016, the AOA lodged a complaint with the Food and Drug Administration over Opternative's noncompliance with federal medical device and patient safety laws. In its complaint then, the AOA raised concerns about product safety and efficacy regarding its mobile app. Following intense pressure by the AOA, Opternative (now Visibly) began taking steps to correct its online messaging.

And last year, the FDA validated the AOA's concerns by ruling the company had violated federal law by illegally marketing its app-based vision test without prior government approval.

The AOA will continue to ask regulators to hold online vision test companies accountable when it believes that consumers' vision is potentially in jeopardy.

These efforts are supported by the public. The AOA-commissioned survey found that more than half (55 percent) of respondents support laws or regulations that prohibit online vision tests that do not comply with existing standards for in-person eye care.

April 4, 2019

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