AOA’s eye health-first stance lays bare convenience messaging

Rich in firebrands, online vision tests can't match the high bar that AOA adamantly upholds for Americans' comprehensive eye health and vision care, putting these companies under scrutiny.

Americans risk their overall eye health when prioritizing convenience ahead of quality, in-person care: it's the patient safety message that AOA maintains despite negative portrayals by online vision test proponents. Undeterred, AOA continues to speak out that such tests delay patients from accessing timely, comprehensive eye care. Due to AOA's work and a general concern for the highest standard of care, 15 states have put protections in place to safeguard families from unproven technologies and business practices.

These concerns hold merit in the court of public opinion as media awareness is growing to include AOA's eye and vision health concerns in coverage of new technologies. In turn, it's pressuring companies to clarify disclaimers regarding test limitations, and Opternative is one of them. Yet patients may not necessarily pay attention to the fine print.

Months after a spate of media coverage began addressing patient safety in online vision tests, such as how Opternative's test could miss significant ocular disease markers, the company is subtly making changes to its website, in addition to seemingly pulling back on its social media marketing activities. Although Opternative is now making efforts to emphasize how its app is not a replacement for a full, comprehensive eye examination—part of its stated attempts to clarify what its app can and cannot provide—its materials still contain conflicting information, such as providing varying lengths of time to take the test.

Opternative has cited a clinical study to support its smartphone-based refractive system despite how that study repeatedly refers to the app as an "exam." In 2016, AOA filed a complaint with the U.S. Food and Drug Administration (FDA) that raises questions of the modified tests that Opternative employs as part of that app-based system, and fueled AOA concerns that the public may misconstrue using the app as similar to the treatment they would receive in a comprehensive eye exam with a doctor of optometry.

That clinical study only measured a limited number of 18-to-40-year-old subjects in good health, yet Opternative markets its age range as acceptable for 18-to-50-year-olds in good health. This discrepancy between study parameters and stated age range is not addressed by Opternative, and links to the research in question have since been removed from the website homepage. In addition, Opternative cites the American Academy of Ophthalmology's (AAO) recommendations; however, in a 2015 news release, the AAO states "these tests are not recommended for people under 18 years of age, those 40 and older and anyone at any age with a severe eyeglass prescription or those with symptoms or risk factors for eye disease."

But those aren't Opternative's only inconsistencies and subtle changes, recently. Although Opternative hangs its hat on convenience, the company isn't constant on this point either. Within the past year, Opternative has wavered among stated testing times that take "25 minutes or less" as of October 2017, to "15 minutes or less" today; however, marketing materials within the past few weeks tout 10-minute exam times.

In the midst of these changes, co-founder and entrepreneur Aaron Dallek has been quietly removed from the company website and materials.

AOA continues to advocate for patient safety

The AOA does not take patient safety concerns lightly. This includes communicating with the FDA to ensure patients' health is always paramount in development of new technologies, and aggressively countering messaging that may unintentionally mislead the public into assuming their complete eye health needs are met.

"During the past year, we have quickly engaged with more media channels than ever before, underscoring our priority messages, and positioning our profession and members as primary eye health care thought leaders," Andrea P. Thau, O.D., AOA president, said recently of AOA's media advocacy .

How to get involved

AOA members can join the AOA Federal Keyperson Network to serve as a conduit for the profession. Also, consider donating to AOA-PAC, one of the most effective ways to get involved in the advocacy process.

Visit AOA's Online Legislative Action Center to learn about key legislation and find your elected officials.