Protecting patients or the bottom line: Buying prescription glasses online


(WSPA) – A new prescription for eyeglasses won’t have all the information a patient needs to improve vision. The doctor can determine how near or farsighted a patient is but won’t give patients the critical measurements needed to get glasses that fit.

In South Carolina, the optician who measures pupillary distance and other critical information is not required to share it with patients. Patients who want to shop around and save money by shopping online may be forced to take less precise measurements themselves.

There are literally thousands of options for a new pair of prescription glasses. Frames are made for every face, from dozens of brands in hundreds of styles. None of them will work properly without pupillary distance.

“Pupillary distance is basically where your center of vision is going to be in that lens, where the center of the pupil is,” said paraoptomitrist Terra Mathews. “Your glasses will not be correct without that pupillary distance.”

In most cases, it’s someone like Mathews and not a doctor who takes a pupillary distance measurement.

“That is the last measurement that I take and I do it twice just to make sure,” she said.

The problem for patients and customers is that a new pair of glasses can be expensive, even for those who have vision insurance and unlike many prescriptions that can be easily filled online, eyewear prescriptions need that secondary information before a sale.

Many online retailers offer instructional videos that teach patients to take the PD measurement themselves. But because pupillary distance is so precise, measured to the nearest millimeter, self measurements are rarely as precise as those done by a professional.

Scott Ligon, an optician at Jervey Eye Group in Greenville, says he sees patients who want to buy glasses online about once a day. He says Jervey will provide the information for $25 and a signed waiver that says a patient won’t hold them responsible for the quality of glasses bought elsewhere.

“I always start out with, let me tell you why that’s a bad idea,” Ligon said, “the best price may be online but you’re not getting the best quality.”

Many Upstate opticians will simply refuse to release the PD measurement at all and will only take it before making a sale. The South Carolina Board of Opticianry won’t provide much clarity.

When the issue of pupillary distance came before the board last May, board members met with lawyers behind closed doors. When they emerged, they decided they had “no opinion at this time”.

Board members were even less willing to provide answers when contacted by 7News for this story. The board chairman and most other members referred questions to a spokesperson for the state board who simply provided a copy of the minutes from the board meeting. One member who did agree to an interview later cancelled when his employer, Prisma Health, declined to make him available for an interview after learning about the nature of this story.

Prisma Health – Upstate did provide a written statement about PD policy: 

“Like most health care providers, Prisma Health–Upstate follows recommendations of the several national organizations representing opticians. Many opticians are hesitant to provide adjunct information such as pupillary distance because they’re concerned about possible harm that could be caused by glasses that are improperly fabricated. Improperly fit and/or incorrectly processed glasses can cause eye strain, blurred vision, headaches, nausea and dizziness.”

“It seems intuitive, if you didn’t know the reasons it’s a risk, you think why not?” said Dr. Anthony Johnson, a pediatric ophthalmologist at Jervey Eye. “Especially if you can save 50, 60, even 70 percent.”

Doctor Johnson said the eye profession’s reluctance to share pupillary distance is not about money or trying to make a sale. He says, while online retailers usually only require a prescription and the PD measurement, there are several other important measurements that only an optician can provide. Some of those additional measurements, he said, are critically important to good vision.

“The horizontal measurement is at least 10 times less important or 10 times less sensitive than a vertical measurement and the vertical measurement (of online sellers) is a complete guess,” Johnson said, “you’re trying to fit the optical center of this lens you’re custom making for each eye into the specific frame for that specific face.”

Ligon claims as many as 90% of the patients who pay him for a PD measurement and then buy glasses online will later return to him for adjustments because their new lenses are flawed. “They almost never get it right. The pupillary distance may be right, the prescription may be right, but that vertical measurement is wrong or they have a prescription that doesn’t work for the frame.”

Meanwhile, Mathews and Spartanburg Vision remain something of a rarity. She said she strongly urges patients not to shop for glasses online but will provide the PD measurement if a patient requests it.

“Because ultimately, that is their choice,” she said, “that is their prescription.”

Online retailer Zenni Optical said they are aware there are issues in making proper glasses beyond the prescription and the PD measurement. The company said it was investing in technology and algorithms to estimate things like segment height for progressive lenses. A spokesman for the company said that because the average pair at Zenni costs about $40, patients are able to make multiple selections for the same price as most frames purchased in person.

Another online seller, Warby Parker sent this comment about getting a proper fit, “Warby Parker measures ocular center height in stores for orders where the specificity of this particular measurement is required. A common misconception is that this measurement is required for all orders, when in fact it’s not.”

Copyright 2021 Nexstar Inc. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed.

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