Prescriptions by Digital Eye Exam Banned in South Carolina

Published June 29, 2016

Residents of South Carolina will have to visit an eye doctor in person in order to buy eyeglasses or contact lenses in the state, instead of taking advantage of new services offering online eye exams.

The Eye Care Consumer Protection Law bans the use of an automated digital eye exam to obtain a prescription for corrective lenses. It went into effect immediately after South Carolina lawmakers overrode Gov. Nikki Haley’s (R) veto of the legislation.

Senate Bill 1016 prohibits providers of eyeglasses and contact lenses from issuing their products to patients who lack a “valid prescription,” the law states. To be valid, a prescription “may not be based solely on the refractive eye error of the human eye or be generated by a kiosk.” The law’s definition of a kiosk extends to do-it-yourself technology “designed to be used on a phone, computer, or Internet-based device that can be used in person or remotely to provide refractive data or information.”

The bill would stifle “competition for the benefit of a single industry,” Haley wrote in a May 16 letter informing Lt. Gov. Henry McMaster (R), in his capacity as president of the state Senate, of her veto.

“If allowed to become law, South Carolina would become the eighth state to impose such a ban, putting us on the leading edge of protectionism, not innovation,” Haley wrote. “This is the wrong message to send to the business community.”

The same week, the Senate voted 39–3 and the House 98–1 to override Haley’s veto.

Captive to Special Interests

Ashley Landess, president of the South Carolina Policy Council, says the optometrist lobby fought to ban the use of kiosks to obtain a prescription for corrective lenses.

“Right now, you have to go into a provider’s office, pay for your prescription, and get your glasses from an optometrist, and there are quite a few of those,” Landess said. “The optometrists were certainly fighting [the technology]. They’re no different than any other public interest.”

South Carolina lawmakers consistently place special interests and personal gain ahead of patient and constituent needs, Landess says.

“In our state, where [legislators] are literally legally allowed to profit from government while serving in the General Assembly and profit from their offices and policy themselves, it’s no wonder the right special interest can kill anything or pass anything,” Landess said. “It’s always about the money and the power in this state. It’s not about the patient.”

‘Glasses, Not Brain Surgery’

In contrast to the Eye Care Consumer Protection Law, which protects optometrists from competition, patients protect themselves from bad prescriptions by seeking better ones, Landess says.

“[Lawmakers] are not going to do anything to help patients’ rights,” Landess said. “What matters and what should matter is patient care. Consumers are the important thing. You’re talking about a pair of glasses here. You’re not doing brain surgery. If the service doesn’t provide the right prescription for some reason, the consumer will go back to the provider that does.”

Shutting Out Innovation

Aaron Dallek is CEO of Opternative, a company whose technology enables users to conduct a do-it-yourself eye exam using a computer screen as an eye chart and a smartphone as a remote control. Optometrists licensed in the same state as the patient review the results and prescribe corrective lenses or refer users for an in-person exam by an optometrist or ophthalmologist.

Dallek says the law denies patients access to innovative health care solutions produced in a free market.

“An online refractive eye examination can and should be made available to the public as conveniently and cost-effectively as possible,” Dallek said. “Legislators should embrace free-market solutions and the innovative technologies they produce that improve people’s lives, rather than fight progress to cater to entrenched special interests.”

Missed: 70 Percent Savings

Opternative’s digital exam costs $40, almost 70 percent less than the $127 national median cost of an eye exam in 2010, according to a 2015 report by the Management and Business Academy for Eye Care Professionals.

The new law deprives low-income, fixed-income, and rural patients of inexpensive vision care, Dallek says.

“Denying patients affordable and accessible vision care is simply wrong,” Dallek said. “Patients living in rural areas and even some underserved urban areas have need of additional eye care resources because providers may not be readily available. Practices tend to be concentrated in urban areas, leaving children, the working poor, the elderly, and veterans in rural America without access to vision care services.”

Irony: Fewer Patient Examinations

Dallek says automated health exams increase the likelihood patients will schedule in-person appointments with their doctors.

“No one feels that blood pressure cuff kiosks in drugstores have had a negative impact on patients seeking future complete examinations in their doctor’s office,” Dallek said. “Quite to the contrary, blood pressure cuffs prompt patients with elevated blood pressure to seek a health consultation, just as a patient would seek a comprehensive eye exam when prompted by Opternative.”

Jenni White ([email protected]writes from Oklahoma City, Oklahoma.

Internet Info:

Matthew Glans, “States Should Not Block the Growth of Optical Telemedicine,” Research & Commentary, The Heartland Institute, April 7, 2016:

Veto Letter from South Carolina Gov. Nikki Haley for Bill Banning Digital Eye Exam, May 16, 2016:

Key Metrics: Assessing Optometric Practice Performance, Management and Business Academy for Eye Care Professionals, 2015: