I’ve just taken an eye exam — not in a spiffy doctor’s office with fancy contraptions, but in my living room with my smartphone and laptop.  A new site called Opternative promises the high-tech, hands-off equivalent of a refraction test — one of the exams performed by an eye doctor to measure a prescription for eyeglasses or contact lenses — in the comfort of your own home.  To do the test, you need to have smartphone, a computer and at least 12 feet of space. You also have to be between the ages of 18 and 40. Unfortunately, I don’t make the cut, but for the purpose of experiencing this service first hand, I shaved an even 10 years off of my real age and did the test anyway. What’s a little white lie for science?  The actual exam is simple. You start by stepping 10 feet away from your computer — which Opternative calibrates and walks you through using a credit card and your own shoe size. Once you are set up, it’s an easy dive into the D.I.Y. exam. The test includes a series of visual tests, some with one eye covered, looking at various shapes, patterns, numbers and letters on the screen. You’re guided through the process with audio and video prompts, and respond to questions by clicking through multiple-choice questions using your smartphone as a remote control for the test.  At the end of the test, it asks you to fill out your medical and eye history, choose glasses or contacts ($40), or both ($60), and then wait for an ophthalmologist licensed in your state to review the exam and issue a prescription. Easy right? You’ll have a digital eye prescription within 24 hours.  Except, that’s not what happened to me.  Shortly after finishing the exam, I received a series of emails from someone at Opternative support, advising me to go see an eye doctor in person. The company promptly refunded my $40 and offered to help me find a trusted doctor in my area. They also helpfully recommended that I pick up a pair of +1.50 reading glasses.  With my permission, Aaron Dallek, the company’s co-founder, spoke with the California-based ophthalmologist who reviewed my exam to find out why he chose not to issue a prescription. There were apparently a few red flags from my medical history that kept me from fooling the system.  First, I hadn’t ever seen an eye doctor in person, other than doing regular eye checks with my family physician. Second, I had mentioned some fuzziness around lights while driving at night, and some reading issues when my eyes are tired. While those symptoms are perfectly common for a 44-year-old (my real age), they are cause for concern for someone who reports their age as 34, which is what I did.  Even though I fooled no one, in my quest to test Opternative, I still found the process to be straightforward and relatively hassle-free. Opternative is best suited for the person who finds themselves between eye exams and simply needs a new pair of glasses or wants to try a new brand of contact lenses. And the firm says it plans to expand its test to the over-40 crowd next year.  Now some bad news. You’ll need 25 uninterrupted minutes to take the test. Unfortunately, it’s also not covered by insurance, and it’s only available in 30 states so far. Most important, it’s not a comprehensive eye exam so it’s not a good option for people who have an unusual symptom or are worried about their eye health, including diseases such as glaucoma, cataracts and diabetes.  Even so, for people who are candidates for the service, the company says the results are statistically equivalent to a traditional in-person exam. The firm says data from a clinical trial showed that participants achieved at least 20/25 vision with the prescription generated by the Opternative self-test. Those results are statistically equivalent to a traditional in-person exam.  Opternative does have a disclaimer at the bottom of its homepage: “Opternative’s service does not include any type of eye health exam. Our service only provides patients with a refractive eye exam, which measures a person’s prescription for glasses or contact lenses.”  Even so, the American Optometric Association does not support online eye exams. The A.O.A. president, Dr. Steven Loomis, has said he’s concerned that eye patients may try to skip in-person appointments entirely once they get a taste of digital convenience.  “Opternative knows it’s not offering anyone an eye exam, yet they claim that they are,” Dr. Loomis said in an email. “We actively oppose inferior and outright bad patient care, and instances when technology can be abused in a way that leaves patients misled, misinformed or confused about the state of their own health.”  Adding to the criticism from the optometry community is a lawsuit alleging one of Opternative’s co-founders used proprietary information from the National Board of Examiners in Optometry for a different website business. The complaint, which isn’t related to Opternative’s online eye exams and has been settled, does seem to have created a public relations challenge for the firm.  What does all of that have to do with the convenience of getting a prescription for glasses or contacts? Nothing for me. Heeding Opternative’s advice, I made an appointment with an eye doctor, and spent two hours in his office and more than $500 to end up back where I started: With a pair of reading glasses and the knowledge that my eyesight just isn’t what it used to be.  I personally did not feel misled by my online eye exam experience, but I am not surprised that eye doctors are wary about online services. Other medical professionals have expressed similar reservations about telemedicine, but a number of new digital services are now delivering online consultations anyway. It was only a matter of time before the eyes have it too.
An online eye exam taken at home is an easy alternative to the office visit, but only if your eyes are 18 to 40-years old.