How AOA advocacy keeps contact lens wearers fright free

Each October, the 31 in 31 annual advocacy campaign connects with online retailers, brick-and-mortar shops and other sellers who distribute contact lenses without valid prescriptions, in violation of federal law. 

The campaign has identified more than 150 retailers the AOA has directly contacted to inform them of the law regarding the sale of contact lenses. Doctors of optometry are central to identifying these companies—especially during this time of year when people are purchasing Halloween costumes, including decorative contact lenses. 

Renee Reeder, O.D., chair of the AOA’s Contact Lens & Cornea Section (CLCS), points out that while many of the retailers identified in the 31 in 31 campaign are flagged for selling lenses without a prescription, there also are companies identified as not being properly registered or Food and Drug Administration (FDA) -cleared for U.S. sales. 

“If we have an illegal lens that isn’t sterile or not manufactured properly, it could be as minor as an uncomfortable fit but as severe as an infection, so we really do need to catch these incidents early,” Dr. Reeder says. “The more and more these companies get away with it, the more chance there is for someone to get hurt, so keep reporting potential violations.” 

The AOA sends a letter to companies that may be in violation of these federal laws, in part saying that “all contact lenses, even those that are only intended to change the appearance of the eye, require a prescription. The AOA would like for your company to be aware that the Food and Drug Administration (FDA) regulates contacts as medical devices. The improper wear and care of contact lenses can cause eye infections that can lead to serious, long-term damage, including vision loss. As such, we believe it is dangerous to consumers to sell such devices to individuals within the United States without appropriate prescriber supervision.” 

Copies of those letters are also sent to federal agencies, such as the FDA. 

AOA’s contact lens safety advocacy

Ensuring that contact lenses are used safely by the public—and urging a robust response by federal and state authorities to illegal and improper contact lens sales—is a top priority for the AOA. In addition to efforts to educate consumers, the AOA regularly meets with federal agency officials to urge that more be done to crack down on dishonest internet and unconventional direct sellers, and these efforts are always informed and bolstered by reports the AOA receives from individual doctors from across the country. 

Last year, H.R. 2748, the Contact Lens Prescription Modernization Act, was introduced—an effort to close a potential loophole on automated robocalls for contact lens prescription verifications. And this spring, a companion bill, named the Contact Lens Prescription Verification Modernization Act (S. 4083), was introduced into the United States Senate with bipartisan support and jointly backed by the AOA and Health Care Alliance for Patient Safety.   

Advocates say a drastic and immediate change is needed to the current FTC rule allowing online retailers to leverage robocall verification for online orders. With poor call quality, timing and delivery, among others, robocalls do not effectively protect consumers’ vision while ensuring their preferred access to prescriptions. H.R. 2748 and S.4083 work to strengthen the process, ensuring consumers receive the correct contacts lenses and prescription when they order online by establishing a paper trail by requiring retailers to use direct communication, such as email, live phone calls or fax, to confirm prescription accuracy. Further, the bill requires retailers to offer a HIPAA-compliant method for allowing patients to upload an electronic copy of their prescription thereby deprioritizing the use of verification robocalls. 

Passing this bill is critical in increasing the safety of the more than 45 million Americans who rely on contact lenses, FDA Class II and Class III regulated medical devices, for safe and effective vision correction. Improper lens usage, which can result from the substitution of lenses not prescribed by the patient’s doctor or using an outdated prescription, can lead to serious health complications, including infections and other sight-threatening conditions, such as microbial keratitis, corneal edema, ulcers and neovascularization. 

Report suspicious sales and resources for practices

Eye care practitioners should report all violations of the FCLCA, including instances in which contact lens sellers fail to comply with the prescription verification provisions of the law.  

Here's how doctors of optometry can help the AOA serve as a resource to the public for reliable and current information related to safe management of contact lenses: 

• Report a website illegally selling contact lenses. 
• Report an adverse event related to contact lenses. 
• Report problems with decorative contact lenses. 
• Report suspected violations to the AOA or direct questions to stopIllegalcls@aoa.org. 

The AOA provides patient- and public-oriented resources on decorative contact lenses (videos, social media posts, a press release and more) and information on the risk of buying decorative lenses online during Halloween.