States and AOA persevere in fight against heightened opposition from Opternative/1-800 Contacts

Proponents of online vision tests have renewed their baseless attacks against optometry, even as the AOA and its state affiliates thwart the efforts to disrupt the doctor-patient relationship by peddling unproven online vision tests.

Indiana, for instance, is a model of a state affiliate successfully combatting these purported examinations—a model many states may need to follow as Opternative and its partners step up their tactics to suppress patient safety protections found in state laws and regulations. "As doctors of optometry, we need to remain on guard to these threats to patient safety and be prepared to fight for what is best for our patients," says Deanna Alexander, O.D., chair of the AOA's State Government Relations Committee. "If optometry sits back, we may find ourselves sitting on the sidelines and losing access to our patients."

Today, 14 states have enacted critical patient protection laws that reinforce the benefits of in-person, comprehensive eye examinations.

Indiana: As long as it takes

When then Indiana Gov. Mike Pence signed into law a comprehensive telemedicine bill last March, doctors celebrated after a hard-fought victory. Indiana's telemedicine law contains language, championed by the Indiana Optometric Association (IOA), which safeguards the vision health of thousands of families in the state. The law prohibited ophthalmic devices from being prescribed by purely electronic means. Companies utilizing these online app-based technologies, such as Opternative, are currently unable to implement their unproven technology in Indiana.

"Indiana doctors were very happy with last year's telemedicine law—the law allows doctors to treat those conditions that can properly be treated through telemedicine, but protects the ocular health of Hoosiers by banning online prescribing of ophthalmic devices," says Jim Zieba, IOA executive director.

Doctors didn't have to wait long before being forced back into action to defend the vision health of Indiana residents. When the state's General Assembly opened Jan. 3, Opternative began an effort to overturn safeguards put in last year's telemedicine law with the introduction of House Bill 1331.

IOA members rallied—again. Members of the IOA were able to convincingly make two pivotal arguments that moved legislators, according to Zieba:

• Online providers cannot replicate in-person, comprehensive eye examinations.
• Online services are not able to detect serious conditions and diseases that affect the eye—such as glaucoma, diabetes, hypertension and ocular cancer.

"HB 1331 died in the public health committee (on Feb. 20, 2017) because there were not enough votes to move the bill," Zieba says. "The bill sought to eliminate Indiana's ban on the prescribing of ophthalmic devices through telemedicine and limit the authority of the Indiana Optometry Board with regard to online prescribing."

'On guard'

Indiana's success is a prime example of the vigilance required by the AOA's state affiliates during hectic state legislative sessions, says Dr. Alexander. Especially now, she adds.

"There does seem to be an increase in activity at the state level for optometry legislation," Dr. Alexander says. "A few years ago, many doctors were satisfied with their current scope of practice in their states and did not see the need to push for advancement."

The need for increased involvement is seen now more than ever, and AOA's affiliates are stepping up. "Large corporations and insurance companies, looking out for their profits, are pushing to further their business models at the expense of patients," Dr. Alexander says.

What can doctors do?

• Monitor developments in your state and others.
• Be active with your state affiliate.
• Contribute to your local political action committee.
• Engage with your state legislators frequently.

"Opposing any unfavorable legislation at the state level requires preparation to be successful," Dr. Alexander says. "Developing h2 grassroots relationships in the states is what has carried optometry over the years, along with dedicated leadership and fundraising efforts."

Mobilizing doctors of optometry

The AOA works diligently to ensure patients are protected from misleading technologies. In April 2016, the AOA filed an expansive complaint to the U.S. Food and Drug Administration (FDA), expressing serious concerns with Opternative's online test and detailing the lack of credible evidence supporting the use of its unsupervised, self-administered vision test. Following up on the complaint, AOA President-Elect Christopher J. Quinn, O.D., and AOA staff convened an in-depth meeting with FDA officials on Nov. 4, 2016, to reinforce concerns.

Doctors of optometry can further advocate against inappropriate telehealth offerings that put patients' health at increased risk by participating in the AOA on Capitol Hill event during Optometry's Meeting^®, June 21-25, in Washington, D.C., when doctors and students will come together to advocate for the profession.