When you think of Reader’s Digest, a feel-good publication your grandmother reads might come to mind. But in its early days, this American legacy had a more hard-nosed edge. In 1937, optometry was in its crosshairs.
In August of that year, Reader’s Digest published an investigative report, “Optometry on Trial,” that purportedly “revealed grave abuses in the field.”1 The firestorm of responses it elicited amongst the optometry profession and the medical community played out in the pages of both that magazine and this one, then known as The Optical Journal and Review of Optometry (Optical Journal-Review or OJRO for short).
The two-part Reader’s Digest series was written as a nationwide, behind-the-scenes investigative report. Over a 10-month period, six individuals went “undercover” to optometric practices across the United States, and their experiences were recorded. The results? After visiting numerous offices, each of these undercover patients essentially received a different diagnosis from each practitioner. Worse, the patients would then be charged for a new set of glasses, since they were told the prescription sold to them by the previous optometrist was incorrect.
The tone of the first article implied that optometrists were unskilled hucksters, trying to make a buck from unwitting patients. In other words, optometrists were untrained at best and unscrupulous at worst, selling their patients glasses whether they needed them or not.
The first article in the series, published in August 1937, shared this grim assessment: “There are many conscientious and skilled optometrists; men who will frankly admit their limitations when they see that the eye conditions of their visitors are behind their abilities and training,” the author of the series, Roger William Riis, wrote. “But there are many optometrists—far too many—who blithely undertake problems beyond their training. To consult one of these, when you have serious eye trouble, may be worse than useless.”1
One of the patients, a 13-year-old girl, visited optometrists at practices from Boston to the Rockies, and at each location she was given a different diagnosis. One practice said she was far-sighted. Another claimed she was near-sighted. Yet another said she had astigmatism.
Another decoy patient, an attorney who suffered from glaucoma and strabismus, saw three top “oculists” (i.e., ophthalmologists) in New York before going undercover. After visiting 41 different optometrists, “he got not one single correct diagnosis of his eye trouble!” the article states.1 Thirteen optometrists gave the attorney no response when he told them about his condition, while five “nodded amiably” but then proceeded as if it made no difference. Yet others stated the attorney’s eye problems were due to “shadows” on the patient’s lenses or a “tired cranial nerve.” One even attributed his glaucoma and strabismus to abnormal brain patterns and “immoral thinking.”1 In total, 24 of the 41 new glasses prescribed to him by optometrists were deemed incorrect by oculists.
“If the eye were merely a refracting apparatus—something that properly-fitted glasses could correct—the optometrists would fit far better into the scheme of things,” Riis wrote with evident disdain. “But this complicated and delicate organ is more than an arrangement of lenses existing apart from the rest of the body.” Rather, it’s “a subtle barometer of general health” that can reveal systemic diseases. “Competent eye examination may give you notice of some such condition in time to permit early treatment. An optometrist’s examination may, as our survey shows, equip you merely with a pair of futile glasses and leave you ignorant of a serious menace to your health.”1
Riis demonstrated his point by bringing along an ophthalmologist—his profession kept mum—to pose as a patient for one visit and pretend to have a brain tumor, syphilis and glaucoma. The optometrist told him he had eyestrain, sold him a new pair of glasses and “gave him a bottle of eyewash to dispel one of the most dangerous afflictions that can beset human life!”1
Unfortunate though these missed calls surely were, many in optometry felt this was no mere investigation. It was a sting operation.
Condemnation was swift. Just a week after the issue hit the newsstands, The Optical Journal-Review informed its readers about the article and helped to put it in perspective. “The article contains some truth, but it also contains some half-truths, a good deal of exaggeration and generalization, some statements that are manifestly unfair and some that are positively silly,” OJRO editor Maurice Cox wrote in the August 1, 1937 issue.2 He also opined that the author had stacked the deck by comparing the work of department store optometrists to that of a few preeminent ophthalmologists. “These three men top their profession,” Riis wrote of his experts.1 “We venture to say,” Cox retorted, “that the findings of any 41 oculists would very likely differ from the prescription worked out by the three top-rung oculists.”2
|Maurice Cox’s editorial, going toe-to-toe with Reader’s Digest. |
Still, Cox and other leaders in optometry did admit that some of the criticism was warranted. “Optometry knows there are abuses in her field. She knows she has her share of incompetents, just as has medicine, dentistry, law and the other professions,” Cox wrote in his editorial. “Optometry is cleaning house—it has been doing it, steadily, gradually, for a long time. Educational standards have been raised and will probably go higher; stress has been placed on the recognition of ocular and systemic pathology; the aid of medical men has been enlisted for both undergraduate and graduate study; State Optometry Boards, in many instances, have set up minimums of equipment and examination routine.”2
Those advancements were already well underway when Reader’s Digest turned its investigators loose. Like an adolescent in the midst of an awkward and unflattering puberty, optometry was embarrassed to have its maturation exposed to public scrutiny. While the publicity may have come at an inopportune time, Cox exhorted the optometric field to “look upon the Reader’s Digest article as a spur, cruelly applied, which will accelerate her own movement for complete professionalization.”2
The second half of the exposé was supposed to run the next month, in September, but due to a flood of telegrams, long-distance calls, pamphlets on optometry and letters by the hundreds that were sent to Reader’s Digest about the article from physicians, oculists, optometrists, opticians, state officials and even the Better Business Bureau, the magazine held off on publishing the second story until further investigation could be done.
Instead, an “editorial interlude” ran in the September issue, summarizing the controversy and sharing several responses the magazine had received from both supporters and detractors. “Mr. Riis’s article oversteps all limits of decency and good taste. A more biased, a more slanderous article I have never as yet read,” one Pennsylvania optometrist wrote. “I classify it as nothing more than pure, unadulterated propaganda for a group of starving oculists who have steadily throughout the last few years been waging a losing battle to hold the goodwill of the public in competition with the growing profession of optometry.”3
The Digest concluded its interlude by quoting three full paragraphs of Cox’s Aug. 1 editorial in OJRO—in which he laid bare optometry’s ongoing evolution—before teasing readers to look for the sequel next month.
As heated correspondence flashed across the pages of The Optical Journal-Review, some, like the Pennsylvania optometrist, viewed the Reader’s Digest story as a hit piece on optometry, while others saw it as an opportunity to rein in the unscrupulous part of the profession. “Tightening up of optometry laws throughout the nation, in efforts to purge the profession of racketeers, is seen as the beneficial result of ‘Optometry on Trial,’ the article in the Reader’s Digest that has caused an uproar among optometrists,” an editorial in the OJRO summarized.4
Such was the opinion of optometrist Earle Sterzer, secretary of the Ohio State Optometric Association. “We have been waging a fight in Ohio for the past five years to eliminate the so-called racketeer. We have had numerous cases brought into court and they have been successfully prosecuted,” Dr. Sterzer wrote. “The article in Reader’s Digest was unfair, inasmuch as it was biased and made no differentiation between the racketeer and the legitimate optometrists. It indicated that an oculist is above reproach and an optometrist is not. However, the article has awakened the legitimate optometrist to the real situation, and we should see a wave of legislation throughout the country in efforts to tighten up the optometry laws.”4
That September 1937 issue of The Optical Journal-Review was filled with more articles, letters to the editor and editorials also calling out the Reader’s Digest article. “We believe that the intended effect of the first article is largely lost on the public that the editorial interlude tends to nullify it,” one editorial suggested. “The fact that there was a ‘storm of controversial correspondence’ indicates to the public that there are two sides to the story and the public will continue to make its choice as it has been doing actually these many years.”5
The issue became so heated that the AOA stepped in. The AOA president at the time, Harry E. Pine, immediately sprang into action and requested a meeting with Reader’s Digest, and it was granted. Dr. Pine met for seven hours with the associate editor in charge of the article, and when the second part of the series came out in October, the anti-optometry tone had softened a bit.
“While the author sticks to the thesis that he set up in the first article and gives a strong appearance of holding his ground, a careful reading of the sequel will show that a modified note is struck,” an editorial in the October issue of The Optical Journal-Review said.4
Riis conceded in the second piece that “optometrists who use blatant advertising, who fill their shop windows with show words and scare copy about your sight and health; who flaunt neon signs, who offer free examinations, bargain prices, easy terms. Who tempt you with ‘the latest and smartest frames;’ who work in shops or large stores selling all sorts of merchandise—these are condemned by their own ethical and competent colleagues in optometry. The latter deserve your supports.”5
The second story in the “Optometry on Trial” series concluded with a call to action: that “the optometrists raise their standards and drive out all commercialism from their ranks; that they and the oculists try to settle their differences, stop quarreling about jurisdiction over the human eye, and seek to cooperate in working out a program primarily for the public’s good.”5
Still, in the pages of this magazine, all wasn’t forgiven. In a series of detailed letters and editorials that ran in the October issue, a common consensus was that optometry was already cognizant of its challenges and was well on the way to working them out.
“Above all, the greatest unfairness lies in the fact that Mr. Riis has undertaken to expose the weaknesses of an infant profession that is gradually working its way to maturity,” said an editorial in the October OJRO. “A further fact is that optometry is fully aware of its own shortcomings and has been steadily working to correct them, pulling itself up by its own bootstraps, so to speak, with no thanks to the medical profession, and little support from the public. Whenever Mr. Riis quotes from optometric sources to prove his point, he proves also that optometry is fully aware of the evils that need correction.”6
Cox may have summed it up best: “As we see it, Mr. Riis and the Reader’s Digest have erred in that they have tried to pillory a profession that is diligently trying to work out its own destiny,” he wrote. “Optometry has been smarting under the lash, but no doubt she will soon forgive. But if she is wise, she will not forget the lesson that Mr. Riis has brought. If optometry’s house is to be in good order, she will withstand the strongest blasts come what may.”
1. Riis RW. Optometry on trial. Reader’s Digest. Aug. 1937;31(184):77-85.
2. Cox ME. Yes, optometry is on trial. Optical Journal-Review. Aug. 1, 1937:22.
3. Optometry on trial—an editorial interlude. Reader’s Digest. Sept. 1937;31(185):100-102.
4. Optical Journal-Review. Sept. 1, 1937:11, 21.
5. Riis RW. Optometry on trial—II. Reader’s Digest. Oct. 1937;31(186):96.6. Optical Journal-Review. Oct. 1, 1937:24-25, 28.