Long considered a disruptive threat to traditional modes of eye care, first with online eyeglass sales and more recently in online vision testing, Warby Parker recently expanded its virtual eye exam reach with the launch of an app called Virtual Vision Test that allow users to renew their glasses or contact lens prescriptions remotely through their iPhone. The updated app pivots the company into the telehealth contact lens realm, as its previous vision test—Prescription Check, launched in 2017—limited users to spectacle lens Rxs only.
Besides the convenience of a remote vision test that the company says will take only 10 minutes, Warby Parker is also appealing to customers by charging only a nominal fee for the service: just $15, and that only if the user’s prescription is renewed. If the patient is still seeing well with their current prescription, deemed by a Warby Parker doctor, they will receive a renewal Rx within 48 hours.
The company says the test is for individuals between the ages of 18 and 65 who have no ocular health issues, a single-vision distance prescription and can see well in their current spectacle lenses or contacts.
Here’s how the new app works: From their phone, users answer a series of questions, including the last time they visited an eye doctor, presence or absence of symptoms (e.g., ocular redness, headache, eye pain, new floaters and light sensitivity) and any relevant history of dry eye, keratoconus, glaucoma, high IOP, macular degeneration, cataracts or diabetes. Based on the responses, users will either be given the green light for the virtual eye exam or will receive a recommendation to get an in-person appointment.
Optometrist Brian Chou of San Diego test drove the Virtual Vision Test app, compared it to his previous review of Prescription Check, and found the newer version is more user-friendly.
Virtual Vision Test makes use of the iPhone or iPad to automatically detect and guide the user to stand 10 feet away, while Prescription Check was relatively cumbersome and required one digital device to serve as a screen and another as a remote control, Dr. Chou explains. Prescription Check also required the user to hold a credit card against a screen for letter size calibration, he adds. Those additional steps are gone with Virtual Vision Test, allowing the user to verbally read out loud the letters seen on the eye chart.
Additionally, Vision Test is less ambitious because it only seeks to renew an existing eyeglass of disposable contact lens prescription, abandoning its prior efforts to measure refractive error with a fan dial and duochrome test, Dr. Chou explains.
“Like other online vendors, Warby Parker is driving the market for prescription renewal for glasses and contact lenses,” Dr. Chou says. “COVID-19 has served as a tail wind. Many optometrists themselves have gone from denouncing telemedicine technologies to embracing it. This shift has greased the rails for the online companies to introduce online sight testing services to a more receptive industry.”
The online companies have identified prescription renewal as the low-hanging fruit vs. the more challenging de novo refraction, he adds.
“We can all expect continued development in this space, making it easier and easier for consumers to renew their eyeglass and disposable contact lens prescriptions,” Dr. Chou says. “As a result, it is logical to believe that more consumers will forego and delay in-person examination.”
The downstream effect is that in-person exams will increasingly lean toward the evaluation of more severe and involved problems, and the routine and high-volume procedures, which lend themselves susceptible to automation and prescription renewal, will continue to gain traction, he suggests.
“Despite this impending shake-up, I believe optometrists that position themselves to use social intelligence, complex critical thinking and creative problem solving— all of which are the highest and best use of a doctor’s time—should do fine,” Dr. Chou says.
Grudging Acceptance of the ODs’ role
Dr. Chou says he finds it noteworthy that Warby Parker’s corporate stance has seemingly changed from being hellbent on disintermediating optometrists altogether from prescription fulfillment to the current recognition that ODs are important for patient care.
Case in point: The Virtual Vision test has multiple touchpoints where the app makes clear that it doesn’t replace comprehensive exams and recommends visiting an eye doctor for traditional exams, albeit in a self-dealing manner since it directs users to their own corporate sublease ODs, Dr. Chou explains.
“Still, this is a welcome change in direction. Many ODs still harbor negative sentiments toward Warby Parker. Yet, I feel that it is time to accept that they have an important role in the eyecare market and their contribution to new ways of delivering eye care,” Dr. Chou says.
Still No Substitute for In-Person Exams
Optometrist Vince Zingaro of Malvern, PA, calls the new app a “slippery slope.”
The introduction on the company’s website states the app is not a substitute for a comprehensive eye exam, but it’s clear that no one is going to get one if they qualify for new glasses through the app, Dr. Zingaro says.
This creates the potential for, at best, a poor-quality eye exam, and at worst, detrimental vision loss, Dr. Zingaro suggests.
For example, it’s not uncommon for a patient in the 18-to-65 range to have no complaints with their vision, as these individuals often think they see well, yet they may have dry eye, retinal holes/tears, allergies, risk factors for glaucoma or other ocular conditions.
“It seems very possible that these findings may be hidden on the screening from this app,” Dr. Zingaro says.
At his practice, Dr. Zingaro says he’s helped patients without CL complaints and improved their wearing experience by switching them to another lens with the latest technology based on their lifestyle and ocular surface findings.
Another problem with the app: It’s hard enough to convince the general public about the importance of an annual eye exam, he adds.
“The app is a bit confusing and misleading by blurring the lines between a comprehensive exam and a refraction,” Dr. Zingaro says.
If a patient can pass a physical during a primary care exam, feels like they are in “good shape,” and can do 45 push-ups in a minute, Dr. Zingaro asks, should the doctor just skip the bloodwork, blood pressure readings, and other vitals?
“I don’t think most primary care providers would be willing to sign off on this, and I don’t think eye care providers should be comfortable doing this for patients’ eye health,” Dr. Zingaro says.