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Executive Summary
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Findings
- Two of 83 optometrists surveyed
would not release a prescription at all, while four more would not release
it unless patients first agreed to buy an initial supply of contact
lenses from them. These are clear violations of the Contact Lens Prescription
Act.
- 57% of optometrists surveyed
would not release a prescription unless patients came back for a follow-up
visit, even if the patient had previously worn the same type of contact
lenses. About a third of the contact lens complaints to the Texas Optometry
Board reviewed by Consumers Union involved follow-up cases where doctors
refused to release the prescription because patients did not come back
for their follow-up exam.
- Shopping for lenses and
services saves money. The cost of an eye exam ranged from $55-$180.
Prices for replacement contact lenses ranged from $18 to $42 for the
same brand and type. Since buying lenses from the eye doctor may cost
more, consumers benefit from immediate access to their prescriptions.
Survey method
We conducted
the survey in October 2000 by telephone in nine Texas cities: Austin,
Corpus Christi, Dallas, El Paso, Laredo, Midland/Odessa, San Antonio,
and Tyler. We compiled a list of 83 optometrists and eye care discount
centers from area telephone books. Posing as long-time contact lens wearers,
we asked questions designed to find the best buy in contact lens care.
We asked what a contact lens exam and replacement lenses would cost. We
also asked if our prescription could be released and if the procedure
regarding initial exams and follow-ups could be explained to us.
To obtain consistent data, our questions focused solely on frequent replacement
soft lenses because they are the most commonly used contacts (see page
7 for a description of common types of contact lenses). Of the 34 million
contact lens wearers in the United States, 85% wear soft contact lenses.(11)
Prescription
Release
Of the 83 respondents, most
said they would release the contact lens prescription. Only two indicated
that they would not. This is a significant improvement since the passage
of the new statute.
But we found four additional offices that will not release contact lens
prescriptions unless the patient buys the first supply (generally two
boxes for use over three months) of lenses from them. By refusing to release
contact lens prescriptions without strings attached, these eye doctors
are not complying with the law. The Texas Contact Lens Prescription Act
forbids eye doctors from refusing to release contact lens prescriptions
or conditioning the release of a contact lens prescription on the patient's
agreement to buy contact lenses or other ophthalmic goods.(12)
For consumers shopping for contacts and exam services, the terms that
eye care offices use to describe what is required can be misleading. In
our survey, many eye care offices said we would need to buy a "first
set of lenses," or "first lenses," or a "first supply"
or "pair of lenses" from them. In some cases this meant only
a "trial pair" or two contact lenses (one for each eye). State
law allows a charge for the lenses consumers take away in their eyes.
To check the accuracy of our understanding, we made a second round of
phone calls to all the doctors who required the purchase of lenses and
determined that in four cases these general terms actually meant that
the consumer must purchase boxes of lenses (a three or six month supply)-a
clear violation of the statute.
Increasing shoppers' confusion, most eye care offices we called initially
quoted us a package price that included the cost of a three month, a six
month, or even a year supply of lenses. In most cases we had to specifically
ask the office to give us only the cost of the exam and fitting (and any
follow-up charge where mandatory), and then ask for the cost of lenses
so we could compare these costs to other lens dispensers.
Despite the confusion, shopping still makes sense. Consumers who call
for the best price can save $40 on each three month supply of lenses (two
boxes), and as much as $90 on the cost of an exam. Exam costs ranged from
$55 to $180.(13) While Tyler had a $30 difference
in the highest and lowest cost of their exams, Austin had an $89 difference.
When a person chooses an eye doctor, cost should not be the only factor,
of course. Finding a doctor you can trust to provide quality care at a
fair price may take time and research, but it pays off in the long run.
A consumer who can take a prescription anywhere to be filled may save
significantly. When we shopped for a box of Acuvue soft lenses (each box
has six lenses, or a three month supply) we found prices ranged from $18
to $42 per box, although prices within some cities tended to be closer.
On average, optometrists in most cities charged $20 to $25 a box, although
in Houston and El Paso the difference in the highest and lowest costs
for boxes of Acuvue soft lenses was actually $20-with some offices charging
twice as much as others.
Some optometrists quoted their prices in terms of six months or a year
supply. In some cases-but not all-consumers can save money by buying in
bulk. It can also pay to buy online. For example, on the day we checked,
1-800Contacts charged $19.95 per box of Acuvues, and the shipping was
free for online orders. Lens Express also charges $19.95 per box of Acuvues;
however, the price does not include a $5.95 shipping charge.(14)
Consumers in Texas face barriers to shopping on line or at discount centers.
According to the Optometry Board, eye doctors are only required to give
an original prescription to a patient once.(15)
And faxes or photocopies of the original cannot be filled. Therefore consumers
who lose their original prescription must purchase their lenses from the
examining eye doctor thereafter.
And consumers who buy online may be told by their eye doctor that they
must come in person, pick up an original prescription and mail it to the
online service.(16) If consumers want to
choose a different online service with a better deal a few months later,
the eye doctor can refuse to provide a second original prescription. Finally,
each prescription is written for a specific number of lenses. If a consumer
tears a lens or loses a box, then the prescription can "run out"
long before the year is up, and the eye doctor can require a new exam
before writing it out again.
Notes:
11 Contact Lens Council, Landover, Md., www.contactlenscouncil.org,
download 11/1/00, based on 1999 data.
12 Occupations Code, Chapter 353, Contact Lens Prescription Act, Article
353.156 and 353.158(2).
13 Many of the optometrists surveyed had two different prices: a price
for exams and a package price. Packages include the exam, a set of lenses,
a follow-up visit, and a cleaning kit.
14 https://order.1800contacts.com/, http://www.lensexp.com
15 Texas Optometry Board complaint, TOB#00047, December 2, 1999.
16 Interview with Joe Zeidner and Jonathan Coon, 1800-contacts, December
11, 2000, and eye doctor written responses to Request for Release of Contact
Lens Prescription.
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