By joining forces, Wal-Mart Stores, Inc. and 1-800 CONTACTS say they will save contact lens wearers $400 million over the next three years and improve eye health.

But, some O.D.s question whether patient compliance will improve. And, they worry about the impact on private practice.

On January 17, the two companies announced a long-term agreement in which Wal-Mart, Sams Club and 1-800 CONTACTS will combine their call centers, Web sites and purchasing/distribution efforts this fall. This alliance allows for greater access to contact lenses as well as affordable options to improve our customers and patients eye health, says Jeff McAllister, senior vice president of Wal-Marts Optical Division.

So, where will the projected $400 million in consumer savings come from? Based on third-party research, we estimated savings based on the size of our two businesses today and the savings we offer contact lens wearers relative to the average price paid at other optical retailers, says Deisha Galberth, Wal-Mart spokesperson.

Lowering costs and increasing convenience will make it easier for patients to follow their doctors advice and replace their lenses as recommended, adds John Agwunobi, M.D., M.P.H., M.B.A., senior vice president and president of Wal-Marts professional service division.

The companies cite a McKinsey & Company survey in which 57% of consumers said they would replace their lenses more frequently if the lenses cost less.1 Also, 30% identified cost savings as the reason they over-wear their lenses, and 22% cited inconvenience as the reason they do not replace their lenses as often as recommended.

But, not everyone believes that the cost savings and convenience touted by Wal-Mart and 1-800 CONTACTS will necessarily result in greater patient compliance.

What we do know, and what research has shown, is that contact lens wearers who purchase their lenses from an online retailer, optical chain or wholesale club, rather than from an eye care practice, are less likely to follow their doctors recommended healthy eye care practices, says Louise Sclafani, O.D., chair of the American Optometric Associations Cornea and Contact Lens Section. This is especially concerning because patients become complacent and forget that contact lenses and the solutions used with them are medical devices.

A new study in the January issue of Optometry found that individuals who purchased their contact lenses from an online site or store, rather than from an optometrist, are less likely to adhere to healthy eye care practices, as recommended by their eye doctor.2 In a survey of 151 college students, researchers Johsua Fogel, Ph.D., and Chaya Zidile of Brooklyn College found that:

Fifty-seven percent of individuals who purchased lenses from an eye doctor went for a follow-up appointment vs. 29% from online purchasers.

Nearly 77% of patients who purchased their lenses via the Internet saw an eye doctor annually vs. 86% of individuals who purchased their lenses from an eye care provider.

Thirty-five percent of online purchasers did not check if the Rx was correct.

When patients dont use lenses as directed, the consequences may be dangerous, Dr. Sclafani says.

Meanwhile, some O.D.s worry that the alignment between the two companies will be dangerous for private-practice optometry as well. This creates a situation for private-practice O.D.s who do not have an e-commerce alternative in their practicesin short, to immediately lose their contact lens replacement business to a less expensive, more convenient competitor, says Paul Farkas, O.D., administrator of Over the long-term, once [patients] are part of the Wal-Mart mailing list, marketing these patients to get their general eye care from Wal-Mart becomes a far easier proposition. So, the danger becomes not only short-term contact lens replacement lost revenue, but also potential loss of the patient and possibly their entire family to Wal-Mart Vision.

To avoid losing patients to Wal-Mart, one O.D. says, private-practice O.D.s will need to make patient access to contact lenses just as simple and fast as Wal-Mart/1-800 CONTACTS.

Also, we must continue to stress the overwhelming importance of proper care and compliance with our patients, and maintain friendly and personalized doctor/patient relationships, he says. We have to make sure our patients know and respect the fact that contact lenses are medical implements.

Meanwhile, major contact lens companies have declined to comment. As a matter of policy, we do not comment on the activities of other companies, says Gary Esterow, director of public relations for Vistakon, a division of Johnson & Johnson Vision Care Inc. Vistakons biggest customers are Wal-Mart and 1-800 CONTACTS.

Representatives from CIBA Vision and Bausch & Lomb declined to comment while waiting for further specifics. 1-800 CONTACTS did not respond to repeated inquiries as of press time.

1. Federal Trade Commission March 2004 Report. Possible Anticompetitive Barriers to E-Commerce: Contact Lenses. Available at: (Accessed January 30, 2008).
2. Fogel J, Zidile C. Contact lenses purchased over the Internet place individuals potentially at risk for harmful eye care practices. Optometry 2008 Jan;79(1):23-35.

Vol. No: 145:02Issue: 2/15/2008