Online vision tests from companies like Opternative are not accurate for diagnosing typical eye health problems. But they also fail to detect functional vision problems, which can impact a person’s ability to learn and work. Let’s look at the proper alternative to companies like Opternative.
Any online search for “vision test” or “eye exam” will unearth a number of apps or websites that promise Internet-based exams. One particular company, Opternative, has sparked a complaint from the American Optometric Association (AOA) to the Food and Drug Administration (FDA).
The AOA contends Opternative’s online eye exams should be withdrawn from the market until they meet FDA approval. We agree, not only because they fail to accurately assess eye health, but because they are also unable to properly diagnose functional vision problems.
“Corporate Equivalents of Snake Oil Salesmen”
In a release on the AOA’s website, Steven A. Loomis, OD and currently AOA immediate past-president, believes organizations like Opternative are the “corporate equivalents of snake oil salesmen promoting unproven products and shortcuts that lower the bar on quality care standards and put patients at risk.”
Opternative’s website encourages visitors to sign up for free, and then take an exam using a smartphone and a computer. The exam will be reviewed by an ophthalmologist, and you will be issued a prescription within 24 hours that can be used anywhere. Even though you don’t actually see a doctor, the cost is still $40.
The site also notes “Opternative is not a comprehensive eye health examination. It’s important that you visit an eye care professional’s office for a comprehensive eye health exam at least once every two years.” They also promise to help you locate an ophthalmologist or optometrist in your area.
Cheap Tests, Yes. Proper Testing Methodologies, NO.
The driving force behind Opternative’s offer is price, which is $40 a visit, and convenience. But as is typically the case with low-cost alternatives, you are going to get what you pay for. Which, in this case, is an incomplete evaluation using suspect methods.
According to the AOA, Opernative’s position seems to be that their app is substantially equivalent to a visual acuity chart, color vision test and medical device data.
The AOA’s assessment of the application determined that these tests were used differently than commonly accepted use, and some of the methods and calculations described by the patient application “weren’t established or customary practices.”
Worse, the app is “administered without the involvement of a knowledgeable eye doctor who can detect vision disorders and other diseases in the patient.”
The AOA put out a release of the issues with Opternative. Here is a summation:
- Opternative’s online vision app does not fully cover any one of the twelve components of a comprehensive eye exam and cannot detect eye health and vision conditions, such as glaucoma, diabetes or neurological issues.
- Because Opternative only performs a refractive test to determine a prescription, its customers may end up delaying essential, sight-saving treatment. Only an in-person comprehensive eye examination with your doctor of optometry can properly diagnose issues and offer personalized expertise that an app cannot.
- Opternative’s online vision app is not approved by the Federal Drug Administration; it is simply registered, something any company or tool can accomplish. In April 2016, the AOA submitted a complaint to the FDA to take action on Opternative’s online vision app, which has not been submitted to the type of testing and pre-market approvals frequently required of new medical device technology. Additionally, twelve states have put into place legislation to safeguard public health and safety by regulating the usage of unproven technologies which provide a prescription or claim to provide care.
Why These Tests Miss the “Undetected” Vision Problems, Too
Beyond falling short of a comprehensive vision exam typically administered by a licensed optometrist, the prospect of people relying on Opternative for a vision assessment has sent shivers through the staff at The Vision Therapy Center.
Why? Because as developmental optometrists, we specialize in treating functional vision problems.
Functional vision problems are different than issues with eyesight. 20/20 is a measurement of your eyesight, or ability to see clearly at distance. Functional vision is your ability to move, team and focus your eyes to gather information from the world around you.
Even if you have 20/20 vision, you may have difficulty with skills like tracking words on a page and processing information. Your depth perception may be impaired. You may complain of eyestrain, headaches, and sore or watery eyes. An Opternative exam cannot detect the cause of these problems.
These problems require a specific set of tests to determine if they exist. For example, convergence insufficiency, a condition to which the eyes don’t properly converge, requires a cover test, nearpoint of convergence assessment and vergence testing. None of these are part of an Opernative exam.
Typically, when we’re testing for functional vision problems, we have to run a wide range of tests to hone in on a specific issue like convergence insufficiency. Opternative and similar programs, at their very best, test only for visual acuity and refraction. But those are just two of many potential issues.
Do Online “Exams” Have a Role? No, but Symptom Detectors can Help.
There simply is no substitute for an in-person exam from a licensed optometrist, and those visits should occur at least once a year.
However, online symptom detectors do present opportunities to help detect symptoms of vision problems -- even functional ones. Our Vision Quiz, for example, includes a list of symptoms indicative of a functional vision problem.
These questionnaires can confirm you have symptoms of a problem, but they in no way offer a diagnosis, a prescription or a treatment plan.
The AOA’s filing with the FDA occurred back in April. Around that date, the state of Michigan issued a cease and desist order against Opternative for violating provisions of the state’s Eye Care Consumer Protection Law.
In November, nine representatives from the AOA and the FDA met face-to-face. The AOA walked through the details of the complaint, “underscoring how the Operternative medical device has not delivered any credible scientific evidence that it works.”
It included a new concern that Opternative is aggressively marketing itself to high-risk populations. We’ll keep you posted on new developments.
Visit Your Optometrist for an Exam. Please.
As the AOA’s Loomis said, “There are simply too many questions about the accuracy of this so-called eye exam.”
We agree. But Opternative’s exams are missing more than just eye health problems. They’re also not testing for functional vision problems, which can dramatically affect a person’s ability to perform in school and work.
Instead of Opternative, visit your optometrist for an exam every year. And if you feel like you or your child is struggling because of a functional vision problem, click below to take our Vision Quiz to determine if you have some of the typical symptoms.