This month, EB provided an update on online refractions and both the controversy surrounding them and the lobbying efforts against them. Plus, we asked two optometrists to try out the online service to see how it fared (hint: not well).
One of those optometrists, Christopher Wolfe, expanded on his experiences with Opternative and provided some strategies that practices can use to stay popular, relevant, and successful in the face of potential “disruptive” online technologies.
 
Like many optometrists, Dr. Wolfe, who is a partner at Exclusively Eyecare in Omaha, NE, says he is not against the advancement of technology, and believes it does indeed have a place in the future of optometry.
 
“As technology advances I think there is opportunity to extend the doctor/patient relationship beyond the borders of a physical office,” he says. “This makes sense when the standard of care is still being served.”
 
But he thinks the services like Opternative are giving the public the wrong idea about what they are, and could pose a risk to consumers’ eye health.
“The real challenge is that even an informed writer mistakes a remote subjective monocular refraction as an ‘online eye exam,’ he notes. “The public believes that from a marketing perspective they are getting an online eye exam, when in fact, they are at best getting about 1/4 of 1/12 of a comprehensive eye examination. Since there is no objective data gathered and there is no binocular assessment of a patients visual system, they are getting about 1/4 of a refraction and a refraction is 1/12 of a comprehensive eye examination.”
 
So what can ECPs do to face the challenges of “disruptive technologies” that are giving patients other avenues toward getting refractions without going to an optometrist?
 
“In our practice, we have always thought it was important to educate patients on everything that I am looking for and focusing on during the entire examination,” Dr. Wolfe says. “We show them what I am seeing with photography and scanning devices so they know that what I do is much more than prescribe glasses and contact lenses.  We also focus on patient complaints and provide specific solutions to specific problems not just limited to those that can be corrected with glasses and contacts, so when they try an unproven technology like Opternative they understand that there is a difference.”
 
Dr. Wolfe also points out that the use of the term "disruptive technologies" assumes that the technology is going to change the way that a service will be provided. He doesn’t believe online refractions belong in that group.
 
“I think that is true about some technologies but I would not lump Opternative into this category. I think of the way that OCTs have become so critical to managing eye diseases. The first OCTs were introduced in the 90's (primarily for research) and with significant technological advancements and thousands and thousands of scholarly articles to evaluate how to interpret and when to utilize this technology, OCT has become a standard of care for managing many eye diseases. That is a disruptive technology,” he says.