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For glasses, sure. For contacts, maybe not. That is a medical device that is in contact with a highly sensitive organ for extended periods of time, and is ofte

For glasses, sure. For contacts, maybe not. That is a medical device that is in contact with a highly sensitive organ for extended periods of time, and is often re-used by design. A yearly contact lens eye exam is annoying but seems reasonable to ensure nothing changed in the last year to suggest the wearer should stop wearing contacts, or use a different brand or type

A_D_E_P_T 3y ago
You can buy cosmetic contact lenses freely, without a prescription. So carving out an exception for contact lenses -- based on the notion that they are in contact with the eye -- is unprincipled. The vast majority of people who use contact lenses suffer no complications. What's more, in foreign countries eye exams are frequently done by technicians who are not doctors. It's not that complicated to press the "start" button on an autorefractor. So even if eye exams are required, they can be done far more quickly and easily than at present. In many countries in Asia and Europe, prescriptions aren't _required_ for hardly anything. You can buy drugs and glasses at will, including antibiotics. (Typical exceptions only for most stimulants and some -- but not all -- opioids.) In the US, where you can't get anything without seeing a doctor, including a box of contact lenses, one feels infantilized.
- zen_1 3y ago
  Also worth noting is that in many countries Pharmacists can prescribe certain classes of medicines, again excluding most stimulants and opioids. But need some ciprofloxacin? Just rock up to your pharmacy and ask.
- clarionbell 3y ago
  I can speak for some parts of Europe when I say that most antibiotics and majority of drugs definitely need prescription. There are several good reasons for it. 1. Antibiotic overuse is a serious issue. If people could just get them without prescription they would use them for flu etc. Because they wouldn't be able to tell that it's a viral infection. Over time this would lead to even more antibiotic resistant pathogens than we have now. Plus there is the whole "kills your gut biome" thing. 2. Our healthcare is heavily subsidized and practically universal. The antibiotics and many other medications are, indirectly, payed for by government, with prices negotiated and set trough complicated process involving semi-state insurance companies and government. Letting people buy drugs without prescription could lead to abuse, like exporting them to third countries. Causing shortages etc.
  - JPLeRouzic 3y ago
    Some antibiotics are authorized in Europe for veterinary use: https://www.ema.europa.eu/en/documents/report/infographic-categorisation-antibiotics-use-animals-prudent-responsible-use_en.pdf https://www.ema.europa.eu/en/documents/report/infographic-ca...
    - seszett 3y ago
      They are generally only available for professionals, and those that can easily be bought as a private person are much more expensive than the human version. I haven't heard of anyone doing that (why would anyone do that, actually?) instead of just going to a human doctor to get a prescription for human drugs.
    - samus 3y ago
      Which is indeed one of the strongest arguments against industrialized meat production.
  - A_D_E_P_T 3y ago
    I suppose it depends where in Europe. I spend most of my time in the south and east -- where, e.g., Serbia doesn't even have a prescription system. You can literally buy whatever you want, and doctors won't write you a formal prescription -- they'll give you some product names to pass along to the pharmacist. Bulgaria and other Balkan countries are similar, which is why they're so popular with steroid users and dealers. (I can confirm that you can buy testosterone and other bodybuilding drugs without a prescription, and without any fuss.) In the Czech Republic, Slovakia, and Hungary, it's mixed, but generally _much_ more relaxed than the US. In many cases, even if a prescription is "required," pharmacists won't stand on principle. I realize that one can't generalize across the entire continent, but there are certainly regions where things are more like Thailand or China than they're like the USA. And it's really no big deal.
- Al-Khwarizmi 3y ago
  Glasses, certainly, but regarding drugs, I don't think Europe is generally less restrictive than the US, in fact I thought it was the opposite (see e.g. the phentanyl problem). In Spain not only you can't buy antibiotics at will, but you can't even buy 1 g paracetamol pills (you can buy 500 mg pills, though - I guess the government wants to protect people who can't add 500+500!). Some pharmacists will turn a blind eye with silly restrictions like paracetamol, though - but not all, because they might be fined if they get caught.
  - seszett 3y ago
    > you can buy 500 mg pills, though - I guess the government wants to protect people who can't add 500+500! I know it sounds a bit absurd at first thought, but restricting the amount that can be bought at a time actually works for preventing overdosing. People are just less likely to swallow 12 500 mg tablets in one time than 6 1g tablets.
dr_dshiv 3y ago
You must be in on the scam. The idea that you aren’t allowed to see unless you pay for a yearly exam is ridiculous. So much theater to it, too. In europe, you can just buy them ongoingly.
- jtwaleson 3y ago
  Not everywhere in Europe. It varies by country. Also please drop the ad-hominem. Contact lenses are a high risk medical device. Contamination or mis-use can cause serious permanent damage. Wanting to prevent permanent damage is a good thing. Now as different countries had different policies for decades now, we can compare the health outcomes of these policies. My personal opinion is that the rules can be relaxed in the US, but I don’t have all the data and am not a policy expert.
  - dr_dshiv 3y ago
    Ad hominem attack is different from suspecting that you or a family member are in the industry. Characterizing contact lenses as “high risk medical device” is completely ridiculous. Pencils can cause serious permanent damage. There is no evidence that expensive yearly exams are necessary. The fact is that technology almost completely replaced the need for these people and so they built themselves into the medical system.
    - jtwaleson 3y ago
      No need for a witch hunt. There is a risk classification system for medical devices. Most regulatory bodies have put contact lenses in the moderate to high risk category. E.g. the FDA classifies contact lenses as Class 2 out of 3. You don’t put pencils in your eye for hours every day. The fact that most people use contacts just fine does not mean that there are no risks. If you want to know about them, talk to an eye doctor, they all have horror stories about contact lenses.
    - syndicatedjelly 3y ago
      Yep I've worked in med tech. I'm more skeptical of our entire healthcare system than you are, trust me. But there is a reason regulation is in place, similar to why the airline industry is highly regulated. > Characterizing contact lenses as “high risk medical device” is completely ridiculous. Pencils can cause serious permanent damage. No, it's not. That's a terrible slippery-slope argument and you know it. Contact lenses are an FDA Class II medical device. They are *designed* by the manufacturer for contact with the eyeball. A pencil is not. > There is no evidence that expensive yearly exams are necessary. There is a mountain of evidence suggesting that contact lenses can cause permanent blindness when used incorrectly. Feel free to search for it.
miggol 3y ago
In the Netherlands, you would likely get your first contacts from the same optician's that just gave you your free eye test. They famously don't let you leave with them until they've seen you put them in correctly yourself. A friend of mine had to embarrassingly come back another day and try again, after his eyes had gotten too irritated from the failed attempts. You can still buy disposables over the counter, though.
- raverbashing 3y ago
  Yeah, I wouldn't want to buy contacts before being shown how to use them. Really It's not hard, but at the first time, the guidance is really useful
- NavinF 3y ago
  > They famously don't let you leave with them until they've seen you put them in correctly yourself It's the same in the US. (Well I'm sure if you insisted they'd let you, but standard practice is to try again the next day. I know people who had to go several times before buying contacts)

A_D_E_P_T 3y ago

You can buy cosmetic contact lenses freely, without a prescription. So carving out an exception for contact lenses -- based on the notion that they are in contact with the eye -- is unprincipled. The vast majority of people who use contact lenses suffer no complications. What's more, in foreign countries eye exams are frequently done by technicians who are not doctors. It's not that complicated to press the "start" button on an autorefractor. So even if eye exams are required, they can be done far more quickly and easily than at present. In many countries in Asia and Europe, prescriptions aren't _required_ for hardly anything. You can buy drugs and glasses at will, including antibiotics. (Typical exceptions only for most stimulants and some -- but not all -- opioids.) In the US, where you can't get anything without seeing a doctor, including a box of contact lenses, one feels infantilized.

zen_1 3y ago
Also worth noting is that in many countries Pharmacists can prescribe certain classes of medicines, again excluding most stimulants and opioids. But need some ciprofloxacin? Just rock up to your pharmacy and ask.
clarionbell 3y ago
I can speak for some parts of Europe when I say that most antibiotics and majority of drugs definitely need prescription. There are several good reasons for it. 1. Antibiotic overuse is a serious issue. If people could just get them without prescription they would use them for flu etc. Because they wouldn't be able to tell that it's a viral infection. Over time this would lead to even more antibiotic resistant pathogens than we have now. Plus there is the whole "kills your gut biome" thing. 2. Our healthcare is heavily subsidized and practically universal. The antibiotics and many other medications are, indirectly, payed for by government, with prices negotiated and set trough complicated process involving semi-state insurance companies and government. Letting people buy drugs without prescription could lead to abuse, like exporting them to third countries. Causing shortages etc.
- JPLeRouzic 3y ago
  Some antibiotics are authorized in Europe for veterinary use: https://www.ema.europa.eu/en/documents/report/infographic-categorisation-antibiotics-use-animals-prudent-responsible-use_en.pdf https://www.ema.europa.eu/en/documents/report/infographic-ca...
  - seszett 3y ago
    They are generally only available for professionals, and those that can easily be bought as a private person are much more expensive than the human version. I haven't heard of anyone doing that (why would anyone do that, actually?) instead of just going to a human doctor to get a prescription for human drugs.
  - samus 3y ago
    Which is indeed one of the strongest arguments against industrialized meat production.
- A_D_E_P_T 3y ago
  I suppose it depends where in Europe. I spend most of my time in the south and east -- where, e.g., Serbia doesn't even have a prescription system. You can literally buy whatever you want, and doctors won't write you a formal prescription -- they'll give you some product names to pass along to the pharmacist. Bulgaria and other Balkan countries are similar, which is why they're so popular with steroid users and dealers. (I can confirm that you can buy testosterone and other bodybuilding drugs without a prescription, and without any fuss.) In the Czech Republic, Slovakia, and Hungary, it's mixed, but generally _much_ more relaxed than the US. In many cases, even if a prescription is "required," pharmacists won't stand on principle. I realize that one can't generalize across the entire continent, but there are certainly regions where things are more like Thailand or China than they're like the USA. And it's really no big deal.
Al-Khwarizmi 3y ago
Glasses, certainly, but regarding drugs, I don't think Europe is generally less restrictive than the US, in fact I thought it was the opposite (see e.g. the phentanyl problem). In Spain not only you can't buy antibiotics at will, but you can't even buy 1 g paracetamol pills (you can buy 500 mg pills, though - I guess the government wants to protect people who can't add 500+500!). Some pharmacists will turn a blind eye with silly restrictions like paracetamol, though - but not all, because they might be fined if they get caught.
- seszett 3y ago
  > you can buy 500 mg pills, though - I guess the government wants to protect people who can't add 500+500! I know it sounds a bit absurd at first thought, but restricting the amount that can be bought at a time actually works for preventing overdosing. People are just less likely to swallow 12 500 mg tablets in one time than 6 1g tablets.

dr_dshiv 3y ago

You must be in on the scam. The idea that you aren’t allowed to see unless you pay for a yearly exam is ridiculous. So much theater to it, too. In europe, you can just buy them ongoingly.

jtwaleson 3y ago
Not everywhere in Europe. It varies by country. Also please drop the ad-hominem. Contact lenses are a high risk medical device. Contamination or mis-use can cause serious permanent damage. Wanting to prevent permanent damage is a good thing. Now as different countries had different policies for decades now, we can compare the health outcomes of these policies. My personal opinion is that the rules can be relaxed in the US, but I don’t have all the data and am not a policy expert.
- dr_dshiv 3y ago
  Ad hominem attack is different from suspecting that you or a family member are in the industry. Characterizing contact lenses as “high risk medical device” is completely ridiculous. Pencils can cause serious permanent damage. There is no evidence that expensive yearly exams are necessary. The fact is that technology almost completely replaced the need for these people and so they built themselves into the medical system.
  - jtwaleson 3y ago
    No need for a witch hunt. There is a risk classification system for medical devices. Most regulatory bodies have put contact lenses in the moderate to high risk category. E.g. the FDA classifies contact lenses as Class 2 out of 3. You don’t put pencils in your eye for hours every day. The fact that most people use contacts just fine does not mean that there are no risks. If you want to know about them, talk to an eye doctor, they all have horror stories about contact lenses.
  - syndicatedjelly 3y ago
    Yep I've worked in med tech. I'm more skeptical of our entire healthcare system than you are, trust me. But there is a reason regulation is in place, similar to why the airline industry is highly regulated. > Characterizing contact lenses as “high risk medical device” is completely ridiculous. Pencils can cause serious permanent damage. No, it's not. That's a terrible slippery-slope argument and you know it. Contact lenses are an FDA Class II medical device. They are *designed* by the manufacturer for contact with the eyeball. A pencil is not. > There is no evidence that expensive yearly exams are necessary. There is a mountain of evidence suggesting that contact lenses can cause permanent blindness when used incorrectly. Feel free to search for it.

miggol 3y ago

In the Netherlands, you would likely get your first contacts from the same optician's that just gave you your free eye test. They famously don't let you leave with them until they've seen you put them in correctly yourself. A friend of mine had to embarrassingly come back another day and try again, after his eyes had gotten too irritated from the failed attempts. You can still buy disposables over the counter, though.

raverbashing 3y ago
Yeah, I wouldn't want to buy contacts before being shown how to use them. Really It's not hard, but at the first time, the guidance is really useful
NavinF 3y ago
> They famously don't let you leave with them until they've seen you put them in correctly yourself It's the same in the US. (Well I'm sure if you insisted they'd let you, but standard practice is to try again the next day. I know people who had to go several times before buying contacts)