The way social media is changing healthcare is well-established: If users (who are essentially prospective patients) can acquire needed medical attention without the hassle, time constraints, and exorbitant fees usually related to doctor’s visits, the better – and an eye exam is no exception. You can’t simply order a pair of eyeglasses or contacts online – you need a prescription from a doctor first, no ifs, ands, or buts. And that means logging off, leaving work, and making it to an appointment in the flesh. Until now, that is.
Solving the in-person appointment problem is just one of the issues Opternative wants to fix. Opternative is a brand-new service that employs a one-of-a-kind computer algorithm designed to simulate the refraction portion of an eye examination, only it’s accessible via any computer or tablet with a camera wired or built into it. That’s right: It’s the first online eye exam.
The technology
Here’s how it works: Opternative guides the user to walk a few steps away from the device in order to initiate the refractive portion of the algorithm. Once the user is at an appropriate distance, he or she will be instructed to answer various questions based on images the service will be projecting. After the examination, the user will be asked to answer a series of questions to establish a thorough case history. If the software detects a need for further treatment at any point during the exam or the questionnaire, Opternative will direct the user to the company’s satellite clinics to ensure that they receive immediate and proper care. The Opternative eye exam is very easy to do and anyone can redo the examination if they desire to. Unlike in an eye doctor’s office, where many doctors are in the rush to examine the next patient to make more profit, the Opternative test allows individuals to go at a pace they are comfortable with.
Opternative will work with any Web cam made in 2000 or more recently. The webcam will primarily be used for directional instructions and recording the eye exam to ensure it is being done properly.
Why instant eye care?
Opternative is the brainchild of Dr. Steven Lee – a seasoned eye care specialist with particular strengths in the areas of difficult contact lens fittings, ocular disease treatment, and dry eye management – and Aaron Dallek, a well accomplished entrepreneur. Together, they hope to change the way eye care is provided to patients. “There’s too much corporate greed in the marketplace, where business owners would charge insane amounts of money for things like writing out a prescription for contact lenses,” says Lee of their decision to build Opternative. “We didn’t like the fact that eye care facilities would force people to re-examine their eyes when they had prescriptions that were going to expire in two weeks, but were still legally valid. Eye care in general has always been associated with extreme markups, and we wish to bring down the cost of the actual examination so that everyone can attain glasses and contact lens prescriptions for prices that are reasonable and won’t break the bank.”
Anyone can sign up for the Opternative examination provided that they can read and understand English, but Lee says international versions will be added soon after the company’s official launch, scheduled sometime before the year ends. A typical exam would cost about $20 for an eyeglasses and/or contact lens prescription – quite affordable compared to the usual price of $75 for an exam and an additional $75 for the prescription. Lee guarantees that at some point after the service becomes fully available to the public, they will be offering a package to do a full health check plus their refraction system once they have a comprehensive database of partner clinics around the country.
“In the US you need to have an exam every 1-2 years to renew your prescription but we’ve determined, through consulting with ophthalmologists and optometrists from around the world, that the yearly eye exam health check is not necessary for everyone. It is only essential for high-risk patients,” reveals Lee. “[Opternative] allows people to get their prescription renewed every year at a nominal cost and then allows them to get their eye health check-up at intervals more suitable for their age and risk profile.”
According to a study done by a group of ophthalmologists in Canada, the intervals between eye health checks for key individuals can be reduced in order to decrease the cost of health care for not only the government, but also its citizens. It can also spare valuable time. “By forcing everyone to get eye health checks yearly, it only drives up the cost of health care for no reason, other than corporate profit to the eye care facility owners,” explains Lee. “Our solution is that we offer an online refractive exam annually to be taken between health checkups.”
The limitations (for now)
Of course, you can’t expect perfect and infallible health care, especially one sourced from the Web, but Lee guarantees that Opternative’s current tests show that the service’s margin of error is only 0.25D, which he says is the smallest unit of a prescription that you can change. “This is very accurate, and most doctors will agree that because refraction is best done ‘subjectively,’ there is always a little error based on how each doctor does their examination, and this is also based on how the patient is feeling,” says Lee. With Opternative, patients are not forced to take the first eye prescription they’ve been given – they are allowed to redo the test if they want to be more certain.
Opternative currently has no plans to accept insurance, but Lee believes that with the low cost of their technology and the services they plan to offer, individuals will be better off not having eye insurance since their overall cost will be less.
Lee and Dallek have launched an Indiegogo campaign to hasten the process of making Opternative a reality. Funds will be used to fine-tine the already-existing software that has gone through initial testing and improve its complete accuracy and ease of use. Their fundraising goal is set at $15,000 (they already have 20 percent raised as of this writing) and their project will be running until the end of July.
As previously mentioned, Lee estimates to have a full working version of Opternative by the end of this year, but in case they are not able to reach their fundraising goal, they are open to angel investment opportunities they have denied at the beginning of the project in an attempt to try crowdfunding first. Whether they reach their target or not though, Lee says they will still build and launch Opternative.
Gray areas and online eye exams
“The old way is outdated [when it comes to conventional eye exams] and is denoted by a constant flurry of lens changes in front of the patients’ eyes,” says Lee. “This sometimes confuses patients by all the choices. In addition, the constant ‘1 or 2’ question becomes very tedious for both patients and the doctors, and we wanted to get away from that completely. With our technology, you no longer have to worry about lenses [changing] in front of your eyes – you only need to look ahead at a screen, and answer questions.”
The “old way” may be outdated, but there are those who still think it’s the best way, especially since there are currently legal restrictions about doctors practicing outside of their home state. In an interview with NPR, Dr. Ray Dorsey, director of the Movement Disorders Division and Neurology Telemedicine at Johns Hopkins, mentioned that one setback to broadening the horizons for telemedicine is the requirement for doctors to be licensed in the state where patients are physically located at the time health care services are provided. Gary Capistrant, senior director of public policy at the American Telemedicine Association (ATA), verified this and said that gray areas in the laws are only likely to grow as technology progresses and becomes more highly-developed.
In anticipation of this, Opternative will have doctors hired in each state to sign off on prescriptions for local patients. Lee also brings up a common scenario: When a patient calls their general practitioner over the phone due to not feeling well or a need for common drug refills (like birth control pills), the doctor simply renews the patient’s prescription and calls it into the pharmacy without the need for an in-person consult. “With those cases, that is severe in my opinion – drugs like that affect the entire body. Our system actually has checks and balances, and does not rely on guesswork over a call,” says Lee.
Lee believes eye doctors are still very essential to the overall service of eye care patients, but he thinks Opternative will provide a very valuable service that is currently lacking in today’s environment: The ability to renew your glasses and contact lens prescription from the privacy and comfort of your own home or office, as long as you have had your regular eye health checks done within certain specified time intervals. “With our service we provide huge advantages,” promises Lee. “Time savings, so you don’t need to travel to a brick and mortar store; cost savings, [since] we will charge only a fraction of what eye doctors would normally charge; pressure-free, because we will not force you to buy a year supply of our store branded contact lenses or glasses, and overall convenience.
Those who are hesitant to believe in online health care for fear of a service’s lack of medical approval can temporarily put their doubts on hold – according to the U.S. Food and Drug Administration, the phoropter or refractor that determines a person’s prescription used by Opternative is classified as a Class 1 device and doesn’t need FDA pre-market approval. “Class 1 devices are not intended to help support or sustain life or be substantially important in preventing impairment to human health, and may not present an unreasonable risk of illness or injury,” assures Lee. “Examples of other Class 1 devices include elastic bandages or examination gloves.”
Opternative is also in the midst of forging a partnership deal with BonLook, an online store for prescription eyewear willing to provide a special promotion on their frames. Interested individuals may visit Opternative’s Indiegogo campaign page to learn more about the product, to contribute, and to receive updates regarding the service’s development.
