We check in with two O.D. experts to break down the key reasons online refractions simply can’t replace a comprehensive exam with an eyecare professional

as online refractions receive more buzz, patients may benefit from key education points as to why an in-person, O.D.-delivered comprehensive eye exam is critical to their vision health. Here, two O.D.s deliver five intel points for patients.

Point 1:
THERE IS NO MAGIC NUMBER.

Christopher Wolfe, O.D., of Exclusively Eyecare in Omaha, NE, is quick to note how online refractions can oversimplify, in the minds of patients, a prescription—causing them to see their prescription as simply a magic number.

“When I come up with a prescription, I have a patient that I’ve talked to. I understand their lifestyle. I understand how they use their eyes,” says Dr. Wolfe. “So I’m going to make recommendations for that prescription and how we’re going to apply that prescription and how the patient’s going to use that prescription based on all of their visual demands—not simply just what the numbers are.”

Point 2:
THE DANGER OF DISEASE.

According to American Optometric Association (AOA) President Christopher Quinn, O.D., “Optometrists ensure precise and healthy vision; identify and treat numerous eye diseases, including glaucoma, and serious infections; and frequently identify other conditions related to overall health, including hypertension, stroke, and diabetes, which may have no obvious signs or symptoms.”

No online refraction will pinpoint these problems. “In 2016 alone,” states Dr. Quinn, “doctors of optometry identified diabetes-related manifestations in more than 320,000 patients who were unaware they had diabetes, leading to prompt diagnosis and care, minimizing the risk of complications.”

Point 3:
CONDITIONS VARY.

The lighting in one’s own home is likely significantly different from the lighting in a controlled eye doctor’s office setting. According to the AOA’s Health Policy Institute (HPI) statement on the online service Opternative, “…ambient light in the patient’s environment, the backlighting of the patient’s computer screen and smart phone display, and other characteristics of the computer and smart phone are not controlled for, all of which, individually or collectively, affect utility of the test results.”

Point 4:
COMMUNICATION IS KEY.

An optometrist’s step-by-step, in-person communication is a valuable tool—one that Dr. Wolfe advises O.D.s emphasize during the examination.

“If I sit and tell a patient all the things I’m looking at while I’m doing their comprehensive examination, they come out of that understanding that it’s not just a prescription for glasses or contacts,” he says. “I encourage [optometrists] to just try the online [refraction]. [Optometrists] will see how drastically different it is.”

Point 5:
ACCURACY IS CRITICAL.

Make a point that when it comes to accuracy, and catching even the slightest discrepancy from a previous examination, in-person trumps all. Speaking specifically on Opternative, the AOA’s HPI states, “Without adequate data demonstrating accuracy with respect to all components of an eyeglass or contact lens prescription, the AOA cannot support a claim that the Opternative device is indeed as accurate as an eye exam conducted face-to-face, by an eye doctor.”

—Kerri Ann Raimo