Are Those Online Eye Exams Legit?

photographed by Erin Yamagata.
If you're anything like me and all of your free time is spent listening to strangers on a podcast, then there are probably dozens of advertisements that have washed over your ears. But unlike the many ads for electric toothbrushes or polycarbonate suitcases that I fast-forward through, one advertisement for an online eye exam called Simple Contacts has me intrigued. According to the ad, you can renew your contact lens prescription online for $20, and skip a trip to the eye doctor altogether.
As someone with horrendous eyesight (-9 in the right eye, -8 in the left) who recently cried during a vision test because I couldn't read the fuzzy letters, taking an eye test in the comfort of my own home sounds super-appealing. But then again, as someone who's generally skeptical of direct-to-consumer health trends, I had to ask an expert's opinion on this.
According to Mary Anne Murphy, OD, an optometrist and board member for the eye care insurance company VSP, when it comes to truly defining someone's prescription, these online tests just aren't totally there yet. "Maybe at some point when the technology is up to snuff it could be used to augment what happens in a traditional office," she says. "But now I think it's incomplete." After all, a vision check is really just one part of a comprehensive eye exam, Dr. Murphy says. When you physically go to an eye doctor, they're also taking in your whole health history and checking to make sure you don't have any health conditions that could affect your prescription (like diabetes, glaucoma, allergies, or hypertension), which an app can't totally do right now.
That said, if you're in a bind and need new contacts ASAP — and you don't have a history of eye conditions, don't have health conditions that affect your vision, and you do have a stable prescription already — then a service like Simple Contacts sounds pretty stunning. For everyone else, an online eye exam wouldn't be an option, because most have a pre-screening questionnaire that will weed out any patients who would be considered at-risk.
So, how does an online eye exam work anyways? I took a Simple Contacts test in the middle of watching Real Housewives of Orange County and it took 10 minutes tops. You start by answering questions about when your last eye doctor appointment was, whether you have any pain, and what health conditions (like any inflammatory disease or condition, for example) you have. Then you have to say that you understand that this is not a substitute for an in-person eye health exam, which I did.
Then the fun part starts. The website prompts you to position your face a "dollar bill-length" away from your computer or phone screen, and tilt your head, then only move your eyes up, down, left, and right. (Yes, it is ironic that getting your eyes tested involves staring into a computer screen, which is bad for your eyes.) For the vision test, you stand 10 feet away from your screen, and it records you reading off the letters one eye at a time. Standing in my kitchen reading aloud to no one, I thought, Couldn't you just cheat? Technically, yes, but this video gets sent to an ophthalmologist who reviews the results and gets back to you in 24 hours. At the end of the test, you manually input the prescription that you wear and order your boxes of contact lenses.
At the end of the day, the big difference between an online test and an IRL test is that the online ones are just checking that your prescription works, whereas an actual eye doctor would be adjusting and perfecting it over time, based on your lifestyle, Dr. Murphy says. For example, an eye doctor might have different suggestions for someone who stares at a computer all day versus someone who drives a bus. As for the irresistible price, Dr. Murphy points out that "the consequences of making poor choices are astronomical when it comes to cost."
TL;DR If you want to take an online eye exam to renew your contact lenses, that's cool, but make sure you also see an eye doctor every couple years to rule out any other conditions. Would I use it again? Yes, but I also want to get Lasik at some point, and an app definitely can't do that — yet.

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