8 ms·

Contact lenses next? It's amazingly stupid that I, as a tourist, who knows exactly what types of contacts I need, may need to get a US prescription for contact

Contact lenses next? It's amazingly stupid that I, as a tourist, who knows exactly what types of contacts I need, may need to get a US prescription for contacts.

bastardoperator 5y ago
How are optometrists supposed to make money if they don't sell you services and glasses from their showroom?
- DaveExeter 5y ago
  They charge for the eye exam.
  - bastardoperator 5y ago
    That's the break even, those optometrist tools aren't cheap and that's to get you in the door. The real money comes from frames and contact sales.
    - RHSeeger 5y ago
      Then their business model is broken and they need to charge more for exam.
- adam_arthur 5y ago
  How are people supposed to make money when we have machines producing all these goods! Maybe your post was sarcasm though :) That's the economic progress of humanity. We automate, and jobs that were once valued are no longer needed. Easy to look at a specific instance and fight against the change, but in the long run it's better for everybody. Glasses/Vision in particular costs hundreds more than it needs to. Glasses could be produced and sold at $10-20 bucks if regulations were eased. What is the material cost to produce these? You can get reading glasses in grocery stores for a few dollars. I'm fairly well off and even I feel bad paying over a hundred dollars for some of this stuff. Imagine all the lower earners/poor that pay hundreds of dollars for glasses for no reason other than protectionism. The entire eye exam can be automated very easily (and I believe already has). Would be easy to have machine learning algorithms that can diagnose problems from the image of your retina scan. I really don't think it'd be that difficult, if it doesn't exist already.
kevin_thibedeau 5y ago
Then the doctor leaves their signature off the prescription so that it is effectively useless.
- Turing_Machine 5y ago
  I've had no trouble ordering from online retailers such as Zenni Optical just by typing in the numbers from the prescription. No signature needed. They do ask for a prescription date, and require that to have been within the last two (I think it is) years, but as far as I can remember it's all on the honor system. They don't even ask for the doctor's name. Edit: it occurs to me that this may very well be one of those things that's dependent on state laws, so your mileage may vary. Worth a try, in any event. Edit 2: and yeah, this is for old-school glasses. The requirements for contacts may be more stringent.
  - kevin_thibedeau 5y ago
    1800contacts definitely rejects unsigned prescriptions. You have to upload a scan and they have manual review.
- dqv 5y ago
  This is just a general thing I've learned from working adjacent to US healthcare... It's annoying to work with and there are all kinds of little rules because of how inefficient the system is. First, always have a list of all relevant phone numbers (at a minimum, but other information is helpful too) to any healthcare entity you need to work with. Your primary care doctor, your pharmacy, your hospital, your preferred lab, any specialists. Also have all your insurance information on that same list - especially the different numbers for different departments (e.g. provider lines, authorization lines, etc). Just assume they don't have any of your information on file or their information is inaccurate and needs to be updated. Always get a paper copy if possible (I think some things have to be electronic in certain states, but just strongly emphasize getting a paper copy for anything else). Pharmacies, labs, other offices always say whatever you need wasn't sent (even if you watch them send the request and it says it successfully went through). And yes make sure it has the doctor's signature on it! I'm not sure if it's specific to insurance companies or just certain medications, but they sometimes require diagnosis codes in some states. Find out prescribing rules in your state... I think it has to do with narcotics, so make sure you know the rules in your state for narcotic prescription. Always know, ahead of time, the exact lab you're going to and hound the doctor's office about using the right paper work and ensuring diagnosis codes are present (there is apparently no universal lab paper work, so knowing ahead of time is important). Get a paper version of the signed referral. It needs to have the diagnosis codes and whatever other codes are required for billing (honestly not sure why medical offices aren't doing this by default, but whatever). Make sure one of "with contrast" or "without contrast" is selected if you see those options on the request sheet for radiology. Assume you won't be able to contact the doctor after this visit to have the lab order sent again. Also assume that even if you can reach the doctor, that the lab won't accept the order without a written copy. Always get confirmation from the doctor if the prescription is covered by insurance. There are apps like Coverage Search[0] that can give you some information about whether it will be covered or not. And of course there are a bunch of other annoying little rules that I just haven't encountered yet. On top of the ridiculous costs, it's your responsibility to make sure things go smoothly ;) gotta love US healthcare [0]: https://apps.apple.com/us/app/coverage-search/id834992816 https://apps.apple.com/us/app/coverage-search/id834992816
jtwaleson 5y ago
Do you mean contacts or glasses?
- 0des 5y ago
  Surely it's not glasses, I just go to the website and punch in my measurements, pick frames and they arrive shortly after.
  - jtwaleson 5y ago
    Afaik you need a valid prescription by law in the US. This might not be strictly enforced or verified by the retailers.
    - 0des 5y ago
      I'm curious which law that might be. Is this something you've run into legal issues with in the past?
      - jtwaleson 5y ago
        I'm CTO of easee, an online eye exam and have been involved in some US market research. It's a rapidly developing field and a lot of regulations are a gray area or different per state. E.g. it might be mandatory to have a valid prescription, but it might not be mandatory for the seller to verify this before selling glasses online. I've just learned some new things about the eyeglass rule from a sibling in this thread.
        0des 5y ago
        I'm trying to visualize or recall any complications that could arise or have passed from shipping or receiving 'unsanctioned' glasses. I can't even imagine which regulating body would give orders to which enforcement organization that could make anything happen. To live by these rules is enabling my own abuse. Just curious, since you mention that you're soon to be in the business of eye exams, do you think at some point your business is going to have to maintain this status quo in order to 'play ball' legislatively during your growth phase? If yes, how do you feel about that? If no, can you explain why you'd be exempt? Are these laws something that articulates with your business model or is this only in adjacent businesses like providing lenses?
deleted 5y ago
[deleted]
tshaddox 5y ago
Is this really a problem in practice? I've always had a valid prescription when I buy glasses, but at the glasses store I just flash them the prescription on my phone for a few seconds. It's a PDF on official looking letterhead, but I don't think there's any verification. I suppose it's probably not the best idea to fake an eyeglass prescription, but it certainly seems like it would be very easy to do.
- bckygldstn 5y ago
  * I had an optometrist only give me a prescription for glasses, even though I indicated I wear contact lenses on my intake form and was wearing them at the appointment! When I realised a few days later after being denied trying to buy contacts with a glasses prescription, the optometrist said I would have to come in again and pay for a full consultation (out of pocket as my insurance only covers one per year). * I've tried to buy contacts online in the US with an expired prescription, the retailers say their hands are tied, they need a current dated one. I now just buy contacts online from Europe or New Zealand. No BS, same price, the EU company I buy from includes a mini bag of haribo gummies :)
  - weaksauce 5y ago
    i'm pretty sure us based online don't require a formal verification... i only have experience with coastal though and only for glasses.
    - bckygldstn 5y ago
      The law only applies to contact lenses, not glasses.
      - weaksauce 5y ago
        i see... any clue why it's only contacts? edit thinking about it a little bit i could see it being harmful to not have someone go through the "you don't want to do this or else you could potentially lose your eyesight" talk at least once.
treeman79 5y ago
I ordered an optometry kit from Amazon as my prescription changes by the hour most days. Was very interesting to play around and helped me isolate the 2 prescriptions that my eyes drift back and forth from. Something that eye doctors had given up on trying to help me.
- jtwaleson 5y ago
  Cool, that's a great hacker approach! Fine-tuning like this isn't economical for eye doctors, and 99.5% of the population isn't interested but it will give you the best results. Just checking because it looks like you're from '79 and talk about drifting vision: you know about presbyopia and accommodation? You might need multi-focals.
  - treeman79 5y ago
    It’s cranial pressure and sixth nerve palsy. As my cranial pressure goes up my horizontal eye nerves weaken causes vision to go double. Prism glasses fixes this. But it’s a completely different power. +3 goes to -1 or anything in between. As pressure goes down it reverts. Medication or activity can drop or raise it in an hour or less.
    - jtwaleson 5y ago
      Wow, that's more serious than what I was expecting and beyond my limited ophthalmology knowledge. Glad that you managed to find a solution.
- MandieD 5y ago
  OMG. You may end up having changed my life - it had never occurred to me that a) this was a thing I could just up and buy, and b) it really isn’t that expensive. No more worrying that I’m about to stick myself with the wrong prescription because the optician (yes, that’s who measures you for glasses in Germany) or I lost patience trying to find the boundary between spherical and cylindrical correction, or doing this at the wrong time of day, all for less than a pair of glasses costs. Any brand recommendations?
jedimastert 5y ago
Is that true? I've ordered all of my glasses online for the past few years, and they've never asked for anything other than a form to fill out.
- TedDoesntTalk 5y ago
  I don’t buy online because I want to see how they look on my face first. Many shops won’t sell you glasses unless your prescription is under 1 year old. This allows them to charge you for an exam when you don’t necessarily need it.
  - Turing_Machine 5y ago
    Some of the online shops now actually allow you to upload a selfie, and they'll composite your chosen frames onto your face. Probably not quite as good as a live view, but not bad.
    - TedDoesntTalk 5y ago
      What about the privacy issues of sending them my face for them to keep in a database forever?
      - Turing_Machine 5y ago
        I'm pretty sure that ship has sailed. Unless you stay indoors all the time, or maybe you live in Bush Alaska or something, your face is likely being captured and stuck in a database tens of times every single day.
  - bckygldstn 5y ago
    Sites like Warby Parker will send you a bunch of frames to try on for free so you can see how they look. And I find sites like Zenni are so cheap that it's worth taking the risk: an ugly pair can go in the car /gym bag / work desk for if I lose a contact lens.
weaksauce 5y ago
if you have an address for any length of time you could use a service like coastal.com as when I bought mine I am pretty sure they didn't ask for a formal prescription. I only have experience with them but maybe others like warby parker or the like are similar?
bckygldstn 5y ago
For the commenters asking: this applies to contact lenses, not eye glasses. From the Contact Lens Rule [1]: "a contact lens seller cannot provide contact lenses to its customer unless the seller either obtains a copy of the prescription or verifies the prescription information with the prescriber" The Eyeglass Rule [2] doesn't contain this stipulation. https://www.ftc.gov/enforcement/rules/rulemaking-regulatory-reform-proceedings/contact-lens-rule https://www.ftc.gov/enforcement/rules/rulemaking-regulatory-... https://www.ftc.gov/enforcement/rules/rulemaking-regulatory-reform-proceedings/eyeglass-rule https://www.ftc.gov/enforcement/rules/rulemaking-regulatory-...
- nostromo 5y ago
  Many states have that rule though. In California, for example, you can't buy prescription glasses without an active prescription. I found this out when my glasses broke on the weekend and couldn't get replacements before talking to a doctor -- none of which had availability for several days. So I suffered from headaches and poor vision for several days thanks to this ridiculous regulation.
  - bckygldstn 5y ago
    Interesting, I thought I had bought glasses in a CA Warby Parker store without a prescription. Maybe it's a Tesla-style showroom thing where you look at the frames in store but technically buy the glasses online.
  - jsmith45 5y ago
    Sure states may have that rule, but it is totally legal to go to a state that does not have the rule, buy some glasses and bring them back. (Or to buy online from a state that does not have the rule). Neither the FDA nor FTC at the federal level technically require prescriptions for glasses. Indeed, most online glasses shops will simply take you at your word that you have a prescription, presumably because they are located in a state that nominally requires a prescription, but places no requirement on the shops to verify that the customer really does have one. This is totally different from contacts, where at the federal level, sellers must verify the prescription with the prescriber, except that if 8 business hours have passed since they started trying to contact the prescriber, without hearing back, the prescription is considered verified. (That last is to prevent the prescriber from trying to prevent customer from getting lenses elsewhere by refusing to verify).
skizm 5y ago
Visiondirect.co.uk sells contacts to US customers without a prescription FYI
max-ibel 5y ago
You need to know your prescription, but not present it if you order on Zenni for instance. Parker Warby is probably the same.
comrh 5y ago
Blood work too, let me just test my own cholesterol please.

Contact lenses next? It's amazingly stupid that I, as a tourist, who knows exactly what types of contacts I need, may need to get a US prescription for contacts.

bastardoperator 5y ago

How are optometrists supposed to make money if they don't sell you services and glasses from their showroom?

DaveExeter 5y ago
They charge for the eye exam.
- bastardoperator 5y ago
  That's the break even, those optometrist tools aren't cheap and that's to get you in the door. The real money comes from frames and contact sales.
  - RHSeeger 5y ago
    Then their business model is broken and they need to charge more for exam.
adam_arthur 5y ago
How are people supposed to make money when we have machines producing all these goods! Maybe your post was sarcasm though :) That's the economic progress of humanity. We automate, and jobs that were once valued are no longer needed. Easy to look at a specific instance and fight against the change, but in the long run it's better for everybody. Glasses/Vision in particular costs hundreds more than it needs to. Glasses could be produced and sold at $10-20 bucks if regulations were eased. What is the material cost to produce these? You can get reading glasses in grocery stores for a few dollars. I'm fairly well off and even I feel bad paying over a hundred dollars for some of this stuff. Imagine all the lower earners/poor that pay hundreds of dollars for glasses for no reason other than protectionism. The entire eye exam can be automated very easily (and I believe already has). Would be easy to have machine learning algorithms that can diagnose problems from the image of your retina scan. I really don't think it'd be that difficult, if it doesn't exist already.

kevin_thibedeau 5y ago

Then the doctor leaves their signature off the prescription so that it is effectively useless.

Turing_Machine 5y ago
I've had no trouble ordering from online retailers such as Zenni Optical just by typing in the numbers from the prescription. No signature needed. They do ask for a prescription date, and require that to have been within the last two (I think it is) years, but as far as I can remember it's all on the honor system. They don't even ask for the doctor's name. Edit: it occurs to me that this may very well be one of those things that's dependent on state laws, so your mileage may vary. Worth a try, in any event. Edit 2: and yeah, this is for old-school glasses. The requirements for contacts may be more stringent.
- kevin_thibedeau 5y ago
  1800contacts definitely rejects unsigned prescriptions. You have to upload a scan and they have manual review.
dqv 5y ago
This is just a general thing I've learned from working adjacent to US healthcare... It's annoying to work with and there are all kinds of little rules because of how inefficient the system is. First, always have a list of all relevant phone numbers (at a minimum, but other information is helpful too) to any healthcare entity you need to work with. Your primary care doctor, your pharmacy, your hospital, your preferred lab, any specialists. Also have all your insurance information on that same list - especially the different numbers for different departments (e.g. provider lines, authorization lines, etc). Just assume they don't have any of your information on file or their information is inaccurate and needs to be updated. Always get a paper copy if possible (I think some things have to be electronic in certain states, but just strongly emphasize getting a paper copy for anything else). Pharmacies, labs, other offices always say whatever you need wasn't sent (even if you watch them send the request and it says it successfully went through). And yes make sure it has the doctor's signature on it! I'm not sure if it's specific to insurance companies or just certain medications, but they sometimes require diagnosis codes in some states. Find out prescribing rules in your state... I think it has to do with narcotics, so make sure you know the rules in your state for narcotic prescription. Always know, ahead of time, the exact lab you're going to and hound the doctor's office about using the right paper work and ensuring diagnosis codes are present (there is apparently no universal lab paper work, so knowing ahead of time is important). Get a paper version of the signed referral. It needs to have the diagnosis codes and whatever other codes are required for billing (honestly not sure why medical offices aren't doing this by default, but whatever). Make sure one of "with contrast" or "without contrast" is selected if you see those options on the request sheet for radiology. Assume you won't be able to contact the doctor after this visit to have the lab order sent again. Also assume that even if you can reach the doctor, that the lab won't accept the order without a written copy. Always get confirmation from the doctor if the prescription is covered by insurance. There are apps like Coverage Search[0] that can give you some information about whether it will be covered or not. And of course there are a bunch of other annoying little rules that I just haven't encountered yet. On top of the ridiculous costs, it's your responsibility to make sure things go smoothly ;) gotta love US healthcare [0]: https://apps.apple.com/us/app/coverage-search/id834992816 https://apps.apple.com/us/app/coverage-search/id834992816

jtwaleson 5y ago

Do you mean contacts or glasses?

0des 5y ago
Surely it's not glasses, I just go to the website and punch in my measurements, pick frames and they arrive shortly after.
- jtwaleson 5y ago
  Afaik you need a valid prescription by law in the US. This might not be strictly enforced or verified by the retailers.
  - 0des 5y ago
    I'm curious which law that might be. Is this something you've run into legal issues with in the past?
    - jtwaleson 5y ago
      I'm CTO of easee, an online eye exam and have been involved in some US market research. It's a rapidly developing field and a lot of regulations are a gray area or different per state. E.g. it might be mandatory to have a valid prescription, but it might not be mandatory for the seller to verify this before selling glasses online. I've just learned some new things about the eyeglass rule from a sibling in this thread.
      - 0des 5y ago
        I'm trying to visualize or recall any complications that could arise or have passed from shipping or receiving 'unsanctioned' glasses. I can't even imagine which regulating body would give orders to which enforcement organization that could make anything happen. To live by these rules is enabling my own abuse. Just curious, since you mention that you're soon to be in the business of eye exams, do you think at some point your business is going to have to maintain this status quo in order to 'play ball' legislatively during your growth phase? If yes, how do you feel about that? If no, can you explain why you'd be exempt? Are these laws something that articulates with your business model or is this only in adjacent businesses like providing lenses?

deleted 5y ago

[deleted]

tshaddox 5y ago

Is this really a problem in practice? I've always had a valid prescription when I buy glasses, but at the glasses store I just flash them the prescription on my phone for a few seconds. It's a PDF on official looking letterhead, but I don't think there's any verification. I suppose it's probably not the best idea to fake an eyeglass prescription, but it certainly seems like it would be very easy to do.

bckygldstn 5y ago
* I had an optometrist only give me a prescription for glasses, even though I indicated I wear contact lenses on my intake form and was wearing them at the appointment! When I realised a few days later after being denied trying to buy contacts with a glasses prescription, the optometrist said I would have to come in again and pay for a full consultation (out of pocket as my insurance only covers one per year). * I've tried to buy contacts online in the US with an expired prescription, the retailers say their hands are tied, they need a current dated one. I now just buy contacts online from Europe or New Zealand. No BS, same price, the EU company I buy from includes a mini bag of haribo gummies :)
- weaksauce 5y ago
  i'm pretty sure us based online don't require a formal verification... i only have experience with coastal though and only for glasses.
  - bckygldstn 5y ago
    The law only applies to contact lenses, not glasses.
    - weaksauce 5y ago
      i see... any clue why it's only contacts? edit thinking about it a little bit i could see it being harmful to not have someone go through the "you don't want to do this or else you could potentially lose your eyesight" talk at least once.

treeman79 5y ago

I ordered an optometry kit from Amazon as my prescription changes by the hour most days. Was very interesting to play around and helped me isolate the 2 prescriptions that my eyes drift back and forth from. Something that eye doctors had given up on trying to help me.

jtwaleson 5y ago
Cool, that's a great hacker approach! Fine-tuning like this isn't economical for eye doctors, and 99.5% of the population isn't interested but it will give you the best results. Just checking because it looks like you're from '79 and talk about drifting vision: you know about presbyopia and accommodation? You might need multi-focals.
- treeman79 5y ago
  It’s cranial pressure and sixth nerve palsy. As my cranial pressure goes up my horizontal eye nerves weaken causes vision to go double. Prism glasses fixes this. But it’s a completely different power. +3 goes to -1 or anything in between. As pressure goes down it reverts. Medication or activity can drop or raise it in an hour or less.
  - jtwaleson 5y ago
    Wow, that's more serious than what I was expecting and beyond my limited ophthalmology knowledge. Glad that you managed to find a solution.
MandieD 5y ago
OMG. You may end up having changed my life - it had never occurred to me that a) this was a thing I could just up and buy, and b) it really isn’t that expensive. No more worrying that I’m about to stick myself with the wrong prescription because the optician (yes, that’s who measures you for glasses in Germany) or I lost patience trying to find the boundary between spherical and cylindrical correction, or doing this at the wrong time of day, all for less than a pair of glasses costs. Any brand recommendations?

jedimastert 5y ago

Is that true? I've ordered all of my glasses online for the past few years, and they've never asked for anything other than a form to fill out.

TedDoesntTalk 5y ago
I don’t buy online because I want to see how they look on my face first. Many shops won’t sell you glasses unless your prescription is under 1 year old. This allows them to charge you for an exam when you don’t necessarily need it.
- Turing_Machine 5y ago
  Some of the online shops now actually allow you to upload a selfie, and they'll composite your chosen frames onto your face. Probably not quite as good as a live view, but not bad.
  - TedDoesntTalk 5y ago
    What about the privacy issues of sending them my face for them to keep in a database forever?
    - Turing_Machine 5y ago
      I'm pretty sure that ship has sailed. Unless you stay indoors all the time, or maybe you live in Bush Alaska or something, your face is likely being captured and stuck in a database tens of times every single day.
- bckygldstn 5y ago
  Sites like Warby Parker will send you a bunch of frames to try on for free so you can see how they look. And I find sites like Zenni are so cheap that it's worth taking the risk: an ugly pair can go in the car /gym bag / work desk for if I lose a contact lens.

weaksauce 5y ago

if you have an address for any length of time you could use a service like coastal.com as when I bought mine I am pretty sure they didn't ask for a formal prescription. I only have experience with them but maybe others like warby parker or the like are similar?

bckygldstn 5y ago

For the commenters asking: this applies to contact lenses, not eye glasses. From the Contact Lens Rule [1]: "a contact lens seller cannot provide contact lenses to its customer unless the seller either obtains a copy of the prescription or verifies the prescription information with the prescriber" The Eyeglass Rule [2] doesn't contain this stipulation. https://www.ftc.gov/enforcement/rules/rulemaking-regulatory-reform-proceedings/contact-lens-rule https://www.ftc.gov/enforcement/rules/rulemaking-regulatory-... https://www.ftc.gov/enforcement/rules/rulemaking-regulatory-reform-proceedings/eyeglass-rule https://www.ftc.gov/enforcement/rules/rulemaking-regulatory-...

nostromo 5y ago
Many states have that rule though. In California, for example, you can't buy prescription glasses without an active prescription. I found this out when my glasses broke on the weekend and couldn't get replacements before talking to a doctor -- none of which had availability for several days. So I suffered from headaches and poor vision for several days thanks to this ridiculous regulation.
- bckygldstn 5y ago
  Interesting, I thought I had bought glasses in a CA Warby Parker store without a prescription. Maybe it's a Tesla-style showroom thing where you look at the frames in store but technically buy the glasses online.
- jsmith45 5y ago
  Sure states may have that rule, but it is totally legal to go to a state that does not have the rule, buy some glasses and bring them back. (Or to buy online from a state that does not have the rule). Neither the FDA nor FTC at the federal level technically require prescriptions for glasses. Indeed, most online glasses shops will simply take you at your word that you have a prescription, presumably because they are located in a state that nominally requires a prescription, but places no requirement on the shops to verify that the customer really does have one. This is totally different from contacts, where at the federal level, sellers must verify the prescription with the prescriber, except that if 8 business hours have passed since they started trying to contact the prescriber, without hearing back, the prescription is considered verified. (That last is to prevent the prescriber from trying to prevent customer from getting lenses elsewhere by refusing to verify).

skizm 5y ago

Visiondirect.co.uk sells contacts to US customers without a prescription FYI

max-ibel 5y ago

You need to know your prescription, but not present it if you order on Zenni for instance. Parker Warby is probably the same.

comrh 5y ago

Blood work too, let me just test my own cholesterol please.