16 CFR Part 456 ; Agency Information Collection Activities: Review; Comment Request Ophthalmic Practice Rule (Eyeglass Rule): FTC Project No. R511996
The Eyeglass Rule remains necessary to protect consumer rights. It allows consumers the freedom of choice in deciding which of cost, quality or service is most important to them in their eyecare. Neither consumers nor businesses are currently harmed by the rule, but changes are necessary. Financially, the rule has benefited consumers while causing possible detriment to the prescribing vendor while benefiting their competitors. The rule should be altered to allow a prescriber to warn patients that the accuracy of their prescription is only as good as those that are manufacturing their eyewear. A study published in Optometry (2011) 82, 549-555 by Citek, OD et al. entitled, "Safety and compliance of prescription spectacles ordered by the public via the Internet" it was found that nearly half of the eyeglasses produced by online retailers did not pass ANSI standards for prescription accuracy or safety. Patients lack the expertise necessary to assess on their own the accuracy and safety of the product received. As such, it is the duty of the prescriber to warn the patient of the potential dangers involved in purchasing eyewear that has not been properly manufactured. The definition of an eye exam needs also to be changed as it currently only describes the determination of a patient's refractive state. The American Medical Association's CPT definition of a comprehensive eye examination does not include refraction, as it is considered a separate diagnostic test. The Eyeglass Rule needs to reflect that an eye examination and a refraction are separate services and that a refraction is only a diagnostic test and by itself does not constitute an eye exam so as not to confuse the consumer. The rule need not be amended in regards to additional copies of the consumer's prescription. In the world of electronic health records and online patient portals making exam records and prescriptions easily available to patients additional rules regarding access to patient information by way of the Eyeglass rule is unnecessary. This also applies to the burden placed upon prescribers to verify prescriptions, as the patient should be able to provide a valid copy of a prescription to a third party vendor without causing disruption and additional costs in labor to the prescriber in efforts to verify a prescription. Pupillary distance (PD) should continue to remain the responsibility of the vendor providing the glasses. This measurement is not a necessary component of an eye exam. It is not the place of the Federal Trade Commission to determine what is and is not part of an eye exam as this power lies with individual state boards governing healthcare. Forcing prescriber's to perform unnecessary measurements just so that other competitors may benefit is anti-competitive and a detriment to a business that performs both eye exams and provides eyewear. It would essentially force a prescribing vendor to provide services and labor for the benefit of a competitor. Furthermore, PD measurements are but one part of creating a pair of glasses with today's technology. Additional measurements beyond PD's are now employed to properly place a lens within a frame. Requiring a measurement like PD's to be a mandatory part of a prescription allows the rule to become dated and restrictive in the future. Additionally, PD measurements have been traditionally only done should the consumer wish to purchase eyewear. The costs for the service in taking those measurements has been bundled in the purchase price of the materials. By forcing prescribers to perform this service separate from the provision of eyewear places an added cost to the prescriber. This increase in cost will be passed on to the consumer of eye examinations, a cost they will be forced to pay regardless of the consumer choosing to purchase eyewear at all, effectively increasing the cost of eyecare to all consumers.