Online Refraction Systems: Test Them Out, Then Define Your Value Proposition

By Ken Krivacic, OD, MBA

Sept. 28, 2016

There has been a lot in the news lately about Opternative, an emerging technology that facilitates the consumer self-refracting. So, my practice decided to test it out ourselves. We wanted to see how, if at all, we needed to adjust the patient experience we offered.
Opternative is a company that enables individuals to perform an online refraction on themselves, have their results reviewed by an ophthalmologist,then receive a prescription for eyeglasses or contact lenses that can be filled anywhere.

It just recently launched at the end of July and charges $40 for a refraction and $60 for both the refraction and a contact lens prescription. Opternative is attempting to partner with large online retailers such as Warby Parker and 1-800 CONTACTS to fill prescriptions.

Optimize the Technology Currently Available to Add Convenience

We currently do not have the capabilities on our web site for patients to obtain a refraction. I still believe that is best done in the office face-to-face. Yet we cannot ignore technology, it is only going to get better. It may not be too farfetched in the future to perform remote eye exams from either your office or home.
For now, our practice makes the most of the technology currently available to us, speeding up the check-in and patient registration process by having patients provide us with their history online, which is then uploaded into our EHR system, so our techs do not have to spend as much time with the patient in the office conducting a case history.

The appeal of online refraction is convenience.Dr. Krivacic advises ODs to take note of this and to use technology to increase convenience. Enable patients to register for appointments online, fill outforms, ordercontact lenses online. Feature patient reviews and let patients share their own thoughts in an online survey.

See What You’re Up Against

Set Up Your Test

Upon hearing about this new technology we decided to test the process.

One of our contact lens technicians volunteered to sign up for and take the test to obtain a refraction and also a contact lens prescription. Before the test was taken you need to sign up on the Opternative web site and answer a few questions to make sure you are eligible to take the test.

The Opternative web site advertises that you will receive your written prescription within 24 hours. In the case of our technician, it took closer to five days as there were some questions from the approving doctor about her previous prescription history.

The initial test indicated that she did not need a prescription. After she e-mailed her current prescription to Opternative, (she is a low hyperope – approx. +1.00 OU) and retook the test, she was provided a prescription that was very similar to her current prescription.
From a contact lens perspective, the patient will only be re-fit into the same brand they are currently wearing. The site also does not apply to a patient who is currently not wearing contact lenses.

Gauge Strengths & Weaknesses of Platform

Opternative requires internet access, a smartphone and a computer. You answer questions using your smartphone as to what you see on a computer monitor. From a practical standpoint, our tech who took the test reported that it was cumbersome having to cover her eye with one hand and operate her smartphone with the other. It took her longer than the advertised 25 minutes to take the test. She also felt apprehension performing the test without any feedback from a doctor or technician as to how she was doing.

The experience Opternative provides is not ideal, but some prospective patients may respond to the convenience of getting an eye exam for new glasses or contact lenses without leaving their home.Opternative is streamlining the process for those patients who find the act of going to the doctor a burden. Even our tech commented that it was convenient to be able to perform the test anytime and at home.

Online Refraction: Check it Out

Opternative has an informative video on its homepage promoting the convenience of conducting an online refraction.

Take note of the criticisms of the OD practice: time spent waiting to make an appointment, time off for work, etc.
“Results are reviewed by an ophthalmologist.”

Observe How Online Refraction Competitors Are Marketing Themselves

Opternative is marketing the online exam as a way to have a refraction performed without having to see a doctor, and it is currently approved in 27 states.

It is marketing to the individual who finds it inconvenient to go to a doctor’s office. It harps on the fact that the online exam is every bit as accurate as an in-office refraction. Their site even has a claim of a 99.6 percent satisfaction rating.
To its credit, Opternative also claims that it is not a replacement for a comprehensive eye exam. The site states “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. After taking the Opternative exam, we’ll help you locate an ophthalmologist or optometrist in your area. Learn more in our FAQ section.”

Create Action Plan to Compete

Educate Patients: One-on-One, In-Person Eyecare is Best

How does a conventional brick-and-mortar optometrist compete with an online refraction? Education, education, education. We need to do so by continually educating our patients on the benefit of the one-on-one experience. We need to educate the patient of the benefit of being able to provide that patient feedback during the refraction process. More importantly, we need to educate the patient that a refraction is not a comprehensive eye exam. They need to be constantly reminded that we are doing more than just evaluating the visual system with a refraction. The health of the eye should be evaluated yearly.
We also need to provide a better experience for the patient when they come to our office. That includes a physically attractive environment, prompt service, modern equipment and convenient hours.

Offer Specialty Services

The other approach to compete with online options is to become more specialized. That would include areas such as contact lenses, including specialty contact lenses, medical eyecare, pediatric eyecare and sports vision. These areas will be more difficult to replace by technology – at least for now.

The bottom line: Online refraction is here. See how it works, and understand the convenience-driven appeal of it,then fashion a strategy to emphasize the value you provide with a comprehensive eye exam.

Have you tried online refraction yet yourself? Have any of your staff or friends? What can you tell your patients about why it’s still worthwhile for them to visit your office for an in-person refraction (and comprehensive eye exam)?

Ken Krivacic, OD, is the owner of Las Colinas Vision Center in Irving, Texas. To contact him:






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