In-person eye exams vs. online eye tests


What is an online eye test?

A refraction determines the lens power you need to compensate for any refractive error (nearsightedness, farsightedness or astigmatism), as well as the curvature of the eye to prescribe glasses or contact lenses. Online eye tests attempt to replace one element of an eye examination, the refraction, in order to yield a prescription for glasses or contacts. It is not unlike taking a blood pressure reading at a kiosk and expecting a prescription; the reading does not provide sufficient information to determine a patient's needed course of therapy. The refraction performed by online eye tests is only one of many tests performed during an eye examination, and taken by itself, does not provide sufficient information regarding the treatment of a patient, including the prescription of glasses or contact lenses.

To find a doctor of optometry near you to schedule a comprehensive eye exam, please visit the American Optometric Association doctor locator.

Are online eye tests accurate?

Online vision tests often give inaccurate or misleading information, and can misinform consumers that can delay essential, sight-saving treatment. Comprehensive eye exams with your doctor of optometry 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.

Why should you have a comprehensive eye examination by a doctor of optometry?

Personalized comprehensive eye examinations by a doctor of optometry are an important part of general preventive health care. In addition, changes in refractive status can be an underlying symptom of a number of eye or systemic conditions. Systemic diseases can also be detected through comprehensive eye exams. In fact, 240,000 cases of diabetes were first detected by an eye doctor in 2014.

What tests are performed during an in-person comprehensive eye exam?

If serious conditions are left undiagnosed for long periods of time and a patient skips office visits with an eye care professional, the chance for identifying an effective treatment lessens and could lead to irreversible vision loss or worsening of a systemic disease. That is why a comprehensive adult eye and vision examination may include, but is not limited to, the following tests:

Patient and family health history, visual acuity measurement, preliminary tests, refractive status, eye health examination and dilation and additional tests as needed that may include digital retinal imaging tests, ultrasounds of the eye and automated visual field technology may also be used to detect and diagnose serious eye and health problems. Click here for more information about comprehensive eye exams.

Does the American Optometric Association (AOA) recommend the use of online vision testing apps?

Medical technology can be a powerful tool when used properly by a licensed professional.

The AOA and doctors of optometry are supportive of technology that helps patients, but there stands a growing concern over the claims that a vision screening conducted through an app can replace an in-person, comprehensive eye exam. Eye exams uncover vision issues as well as a multitude of health problems like diabetes. Telemedicine cannot be held to the same standards as an in-person visit.

"The AOA's primary concern is that patient health and safety is at risk due to lack of understanding as to what services an online vision test company actually offers and can deliver to consumers," said Steven A. Loomis, O.D., AOA past president. "When a patient comes in to the office for an examination we do so much more than just update a prescription for glasses or contacts. Our tests are specialized for the needs of each individual and allow us to check the overall health of our patients. By analyzing images of the back of the eye, for example, we can see how a patient's blood vessels are functioning which can signify serious conditions like hypertension that often go undetected. The eyes are the window to your well-being and their care cannot be left to a computer and a smart phone."

The AOA has voiced its health and safety concerns to the Food and Drug Administration (FDA) requesting legal action against an online vision test being marketed by Opternative, Inc. without the type of testing and pre-market approvals frequently required of new medical device technology. In a detailed complaint submitted to the FDA in April, the AOA challenges claims made by Opternative about its product's capabilities, and calls for enforcement action to remove it from the market until it can be shown to meet all appropriate Federal requirements for medical devices under the Food, Drug and Cosmetic Act, including those for safety and effectiveness, as determined by Federal officials. 

Eye chart reflection

Are online vision screening test available in all states?

Ten states including South Carolina,  Alabama, GeorgiaIndiana, Maine, Michigan, Mississippi, Nebraska, Ohio and West Virginia have enacted critical patient protection safeguards that reinforce the benefits of in-person, comprehensive eye examinations.

Patients who've been harmed or received erroneous prescriptions from an online vision test are urged to file a claim/report with FDA Med Watch at http://www.fda.gov/Safety/MedWatch.

More information:
A closer look at online eye exams, questions of legality
Test It: Opternative, the online eye exam
Online vision test receives failing grade from optometrist

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