AOA warns public about online eye exams

March 13, 2014
An online exam has the potential to miss critical, underlying health problems that can be detected through an in-person, comprehensive eye exam from a doctor of optometry.

The AOA is 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 cautions. In a statement, AOA President Mitchell T. Munson, O.D., says the association has received an increasing number of questions about the safety and validity of this type of online test.

The AOA contends that such tests are no substitute for an in-person comprehensive eye exam by a doctor of optometry 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," Dr. Munson says.

The value of in-person exams

One such website says its online refraction test is only available to those between the ages of 18 and 40 who are in good health—meaning people with no history of conditions such as hypertension, cataracts, glaucoma or diabetes.

But what if patients don't know they have these diseases?

Diabetes, for example, affects more than 8% of the U.S. population, but roughly 7 million people are unaware that they have this condition, according to estimates from the Centers for Disease Control and Prevention.

Like diabetes, most systemic conditions are asymptomatic in their earliest and most treatable stages.

These are precisely the types of chronic conditions an OD can diagnose and manage during a comprehensive eye exam, the AOA maintains.

An online exam has the potential to miss critical, underlying health problems, says Beth Kneib, O.D., director of the AOA Clinical Resources Group.

"If you look at refraction only, you're not personally looking in the patient's eye, you're not examining their eye health, you're not looking at their history or observing medical conditions firsthand," she says.

Perhaps a patient is having a shift in vision because of cataracts and isn't aware of it. "And they could be getting better treatment by having the cataract addressed. Maybe they have diabetes and they have fluctuating vision, and they don't know their glucose is causing their decreased vision if they're just getting lens prescriptions over the Internet," Dr. Kneib says.

Dr. Munson cautions that any delay in intervention in such cases could result in progressive vision damage and more costly and intensive treatments down the road.

"Consumers with chronic conditions such as diabetes or hypertension may be at significant risk regarding proper diagnosis and treatment of potentially sight-threatening diseases if they are not properly evaluated by an eye doctor," Dr. Munson says.

The AOA is calling for a thorough evaluation of online eye-testing sites, and how they might affect patient health. The AOA also plans to monitor these sites and play an active role in fact-checking their claims.

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