editor's perspective
Contact Lens Abuse: Things to Think About

About a year ago, an optometrist I know asked one of his assistants to order contact lenses from 1-800 Contacts to test their rebate system. On January 11, 2005, she received a letter from 1-800 Contacts telling her to order more lenses before her prescription expires or, if she'd rather, that the company could make her an appointment with one of its network of doctors who would offer her discounts. The optometrist wondered how many boxes they would let his assistant order with less than three weeks until her prescription expiration, so he instructed her to order 80 boxes (10 years worth) of lenses. 1-800 Contacts had no problem with this amount; in fact, after the company placed the order, it must have decided to reward her because it applied a discount to her order. As my friend says, this may not violate the letter of the law, but it certainly violates the intent of the law. If you're tired of this type of business practice, then contact the Federal Trade Commission (FTC) at www.ftc.gov.

In February, the FTC released its "The Strength of Competition in the Sale of Rx Contact Lenses: An FTC Study." Among other things, it finds no problems with private-label lenses and it finds that independent ODs represent 64 percent of sales (compared to 14 percent for mass merchandisers, nine percent for retail chains and eight percent for mail-order/Internet sources) and 46 percent of prescriptions filled (compared to 18 percent for chains and retailers, 13 percent for mail-order/Internet sources and 11 percent for independent stores and OD groups). Whether you agree with the data or not, given that it finds that independent ODs charge more for contact lenses than the other sources in the study, you'd have to wonder why our patients are willing to pay more in most instances. I think it's probably because of service and a perception of (not the reality of) better safety. By the way, consistent with most of its statements, the FTC thinks the competition for sales of contact lenses is healthy, and as usual it says nothing about patients' eye health.

Finally, some of our readers have pointed out that large continuing education meetings seem to offer fewer contact lens lectures and that the lectures that are available seem too "dumbed down". Certainly we've seen growth in the number of lectures at optometry CE programs that relate to diagnosing and treating ocular disease. We wonder if you have any thoughts on these observations and if we can do anything about it if it's true.