A lot of damage can happen in four years. No, I’m not talking about presidential terms. But consider the eligibility requirements for QuickRenew, the new online contact lens prescription service from CVS: “Patients must be age 18-55, have been fitted for contact lenses in the past, have had a full eye exam within the last four years and have healthy eye history.”
Excuse me? Since when is an eye exam only needed once every four years? That flies in the face of the recommendations from all corners of eye care—doctors, societies, industry—as well as the general sentiment across all of medicine that advocates for routine preventive care.
To check ocular surface health, QuickRenew instructs users to “take a couple of quick pictures of your eyes so the doctor can see if there’s any redness or other apparent irritation.” Then the patient undergoes one of the now-infamous online vision tests while wearing their current lenses. If they meet CVS’s (undisclosed) visual acuity threshold—bam! Click here to order. Will they get the same brand-name lenses, or just an equivalent Rx? Unclear.
Does any of that sound like “health care” to you? It does to the company, which notes in a press release, “This addition to our optical site gives customers a new way to fulfill an important health care need safely and confidently from the comfort of their homes.” The statement also explains that “QuickRenew requests are reviewed by a board-certified ophthalmologist, and users are prominently reminded that this service does not take the place of an in-person comprehensive eye exam.”
I took the test myself. The software does attempt to screen out problems, but the effort is entirely user-driven. The customer is asked if they have experienced infection, redness, flashes, double vision and other concerns. As long as you say no to all the above, you’re free and clear. You also tell them when your last eye exam was—again, entirely on the honor system. I had one last month but chose “four years ago” to see if it might trigger any flags. Nope.
The vision test gave me just three lines of acuity targets: one each for OD, OS and OU. I wear multifocals, but near vision testing wasn’t part of the protocol. No biggie, right? And the “eye redness check” photos were taken not with my phone’s excellent camera but my laptop’s lousy one.
What bothers me most is the service’s disingenuous use of the signifiers of health care. I intentionally failed my quickie refraction—and immediately got an email reassuring me that “the doctor recommended trying again.” Oh, “the doctor” said so, huh? At 10:30pm and within seconds? My CVS doctor then encouraged me to “take a new exam.”
If a company wants to offer a bare-bones way to buy stuff, fine, go ahead. Just don’t cloak it in the trappings of health care, with phantom doctors and dubious exams. Let customers know they’re choosing convenience over quality—and accepting a huge amount of risk in the process.
Maybe I have my dander up because this issue of Review, devoted to ocular surface health, plainly demonstrates the complexity of eye care and the value of a doctor’s expertise. I hope it helps you build up yours even more.