A couple of months ago, Yascha Mounk, a contributing writer for The Atlantic wrote an article criticizing the process of getting eyewear in America versus other parts of the world. The story, published by the author in the publication’s opinions section, detailed his personal struggle to find eyewear after losing his glasses in a rafting mishap. His story highlights the difference in time between needed glasses or contact lenses and receiving them in America versus other countries, such as Peru, where the author recalls being able to tell a clerk their prescription and then get a pair of contact lenses ten minutes later. The article was a scathing review of how optometry in America is antiquated and inefficient. It was, however, an opinion-based piece that was almost immediately met with responses from the AOA and optometrists like Arthur B. Epstein, OD, FAAO, Chief Medical Editor of Optometric Physician.
Dr. Epstein’s thoughts on the issue are that Mr. Mounk was writing more from an emotional standpoint, rather than factual. Certainly, he can sympathize with Yascha’s struggle, as we all can. However, Dr. Epstein notes in his response that one doesn’t have to jump through hoops to get proper eye care in America. “Oddly, had Mounk invested a bit more effort or asked a few more questions, he would have found that both glasses and contact lenses are as easy to get in the US without a professional exam as in Bangkok. From my perspective, that’s not usually a good thing,” Dr. Epstein details.
As anyone who has lost their glasses knows, walking around in a blind state is trying and challenging. The four-eyed world can sympathize with Yascha in this way. However, it is our duty as scientists and doctors to provide the facts as they are, and explain why getting a new pair of glasses in America isn’t any more difficult than any other country.
First, to understand the process of getting glasses in America, you have to look at the systems that administer it. Here, all things medical and edible are governed by the U.S. Food & Drug Administration (FDA). Everything on your dinner plate, in your pillbox, or resting on the bridge of your nose, goes through the FDA before it comes to your local eyewear shop. The FDA is responsible for classifying eyeglasses and contacts as medical devices, which means there needs to be a medical reason for getting such a device. This is your prescription!
Along with the FDA, you have the Federal Trade Commission (FTC) overlooking the business practices of eye care offices, and the American Optometry Association (AOA), which works on behalf of optometrists. One of Yascha’s complaints was of the bureaucratic process. While the acronyms can pile on, these organizations are necessary to make sure the item you are receiving is accurate and safe.
Think back to online glasses or costume contacts, for example. Both are easily attainable, but both can raise major dangers to your eyes. The FDA, FTC, AOA, and other organizations put processes in place to make sure that glasses, contacts, and any medical device in general, are all available in a safe manner. Think quality over quantity. On the anecdote of getting glasses at a street vendor, Dr. Epstein explained, “Yes, you can buy glasses without a prescription in Tangiers, but people with scarred blind eyes are a disturbingly common condition in Morocco. Likewise, you can self-prescribe contact lenses and get them from a stall in Hong Kong or purchase drugs without a prescription in Mexico; however, none of this is an acceptable rationale for adopting such indiscriminate and dangerous standards in the US.”
On a state level, there are some legal matters to consider. Another one of Yascha’s complaints was on the process of getting one’s prescription. Yascha’s story described a difficult time trying to contact his optometrist and get a copy of his prescription, only to be rejected. In most states, like Nevada, optometrists are required to give you a copy of your contact lens prescription, once it is finalized, upon oral or written request from the patient. This also goes for a copy of your eyeglass prescription; if a copy wasn’t given to you at the conclusion of your exam, all you need to do is ask. This requirement was originally put into action by the FTC in 1978 and is generally called the Eyeglass Rule.
The AOA has always been for sharing that information on the principle of it. Even before the legal requirement, the AOA recommended optometrists to be transparent with giving patients their prescriptions. As Yascha pointed out in his article, the AOA was against the FTC’s modification to the Fairness in Contact Lens Act and Eyeglass Rule, but from the standpoint of wanting to prevent patients from ordering glasses and contacts online that might be inaccurate or dangerous. Aside from that, the only difference between what the AOA has been doing and what the AOA would be doing is the formality! The legislation Yascha talks about formalizes the process, which can actually make it more difficult for both you and for us to navigate the system and respect HIPAA. All the same, we at Downtown Vision have worked hard to streamline the process and give you your prescription as quickly and concisely as possible.
In the event you break or lose your glasses, there are processes set in place here in Nevada and all across the country to make it as easy to get a new replacement pair of glasses. During this past legislative session in Nevada, a bill was put in motion to require a simple eye test in order to get replacement eyeglasses. This would simply add an extra safety measure to an already easy process. At present, if you have a broken pair of glasses, you can take them into any optometry office and have them recreate them by reading the prescription. If you lose your glasses, a full eye examination would be required; unless you have a valid (non-expired) copy of your prescription, then you could bypass the need for an exam (meaning you are up to date).
Nevada specifically has rules that define the procedure to replace glasses and contacts if they get lost or broken. Here’s a quick overview of how the Silver State helps streamline the process of getting replacement eyewear:
- Breaking your glasses - The specs can be neutralized by an optician and remade as was even without a valid prescription in the state of Nevada. No vision check is required. The Nevada Optometric Association would have liked to change the law so that the old prescription was appropriate and the patient was seeing well out of the new glasses, but that portion of the law was removed because of opposition from the Nevada Board of Opticianry. This change, put simply, would have required a mere vision screening to verify if DMV vision requirements were still being met with their current glasses.
- Lost glasses, with valid prescription - they can be remade without having to see a doctor.
- Lost glasses, without valid prescription - Requires a visit to an optometrist for as little as $50 for a refraction and exam and depending on your location the glasses can be made in less than one hour.
Need new contacts, with valid prescription - Most optometry offices will dispense a trial pair for a nominal fee on the spot or sell you a box of contact lenses if they have them in stock.
Need new contacts, without valid prescription - we can contact your previous doctor to attain the Rx otherwise you need an exam and a contact lens fitting for as little as $100 total which includes a pair of contacts when applicable and many of the optical chains will have evening and weekend appointments available.
Granted, the process can seem intimidating and confusing. A lot of legalities and a lot of safety measures, all to ensure the replacement glasses you get are the right ones for you. But how does that affect you? How easy is it to get a new pair of glasses on the fly?
As it turns out: really, really easy.
We’ll start with our own office. We can give you same-day service for a majority of the things we provide. We can give you a full eye examination, evaluate and fit you for contacts, help you find frames or hand you a year’s supply of contacts, and can give you a copy of your prescription, all in the same visit. Replacement contacts can be ready at a moment’s notice, we have trial contacts that can fit about 95% of our patients. Glasses can be ready in 24 hrs, if ordered by 3 pm. And with or without vision benefits, we try to make this as affordable as possible, too. If Yascha was rafting the Truckee River and been here from out of town, he’d be in luck with us! We have openings every day and we would have been able to see him, check the health of the eyes, get him a prescription for glasses and a pair of or even year supply of contacts. That day.
Dr. Troy Ogden says, “If this had been a patient of mine and he was out of town, all he would have to do is call our office, and we will get his prescription information for him, and send it anywhere. Even if he was planning to buy online, I will gladly give him his prescription so he could order the new glasses or contact lenses immediately.”
If you have vision benefits, you can use them towards contacts or glasses. The only exception to this is for most Medicaid plans, who can use their benefits for glasses only. We also give you a discount if you pay with cash. We also have discount glasses with standard lenses for $60 and lighter, thinner lens for close to $100. When everything is said and done, a good pair of glasses can be as little as $200. But it gets better! With benefits, your copay for the exam is $10, and the frames can vary. Some frames will be almost completely covered by insurance and may cost you another $10 to $20 dollars, while other frames can be partially covered by insurance. With most Americans having coverage, we don’t see too many cash-based patients. Less than 20%, in fact! And of course, we ship. So if you have your examination today and are leaving town tomorrow or if you live out of town, we can ship your glasses or contact lens to wherever you’re going or live and they’ll meet you there.
But maybe waiting a day isn’t your thing or maybe you can’t make it to our office. Thankfully, we live in the land of quick-service industries, and this includes eye care! At almost every mall, you can find a Vision Works or an equivalent, capable of giving you an eye exam and glasses in about an hour. At most Wal-Mart stores, you can get an eye exam for about $59 without vision benefits helping to alleviate much of the financial burden of not having vision coverage. So even if you are on the other side of the country, you can still call us to get your prescription, go to your local Vision Works or mall, and get a new pair of glasses or contacts, all on the same day! It might not be a streetside glasses stand, but it’s not too shabby of a system.
At the end of the day, we’re not here just to debunk myths or say someone is flat out wrong. We’ve all been in a similar situation as Yascha, and we want to not just provide the facts, but provide solutions if you ever find yourself in a similar situation. With that, we leave you some parting advice from Dr. Ogden: “Remember to request and take a picture of your prescription and save it on your phone. That’s all you need to show to get your glasses or contacts and get the correct prescription. A large number of patients won’t remember their prescriptions. Keeping it on your phone or as a note keeps it nearby and handy if you ever need replacement glasses or contact lenses. Also, remember you don’t have to just go to one place. If a local optometrist can’t fit you into their schedule, go to the nearest mall or Wal-Mart that offers eye care services. They can help you.”