As eyecare professionals, perhaps our most fundamental task is treating refractive errors. To treat my own, I use monovision in contact lenses. One morning before I applied them, I was working on a project at home and removed my three-year-old glasses for a better look up close (God bless moderate myopia). I inadvertently leaned on the glasses and bent the temples. Now having the need for a backup to my backups (curse moderate myopia), and as I was several months shy of my annual examination, I decided to look into alternatives.

I tried something that one of my patients used. He had become disillusioned with our optical and ordered his spectacle lenses from a popular online retailer. He was a particular absolute presbyope with a moderate myopic refractive correction and 1.00D of cylinder OS. His spectacle-lens prescription was filled as I had specified. His vision was 20/20 in each eye and, as important, he was satisfied with his visual performance. He continued to see me annually to monitor lattice retinal degeneration (had to include that).

My Ordering Experience

My refractive correction is –2.25 OD, –4.25 OS // 2.50D add. At the time, there was a two-for-one offer on this retailer’s website. Before I began my order, I did a trial-lens over-refraction and found no change, so I went through the online ordering process. I ordered one pair with a blue-blocking coating and one grey tinted as sunglasses. Frame selection given my prescription was limited, which narrowed my choices to only a few. I was unable to specify either base curve or center thickness. But, it took less than 10 minutes. The completed jobs arrived within a week.

How did this all work out? Let’s start with specifications. The clear lenses were –2.25 OD, –4.00 OS // 2.50 progressive. The sunglass prescription arrived as –2.00 OD, –4.00 OS // 2.50 progressive. The interpupillary distance measurement was as specified in both cases.

What about performance? My immediate impression of vision was “adequate” at distance and near but not as comfortable as my previous prescription that was recommended, measured, and ordered by our optician. My visual acuity measured 20/20 OD, 20/20– OS, and OU 20/20 through the clear lenses. Remember that I am typically a 20/Happy monovision contact lens wearer, which is a different world visually than when corrected with spectacle lenses.

With further experience, I would describe my reading performance as acceptable through the add but not as easy to adapt to as my previous spectacle prescription had been, especially OS.

What perhaps is most interesting was the number of compliments I received on the frames from friends and neighbors as well as from my optometric colleagues. My personal impression of the frames is that they don’t appear to be as sturdy (non-reinforced temples, integrated hinges, for example) as my three-barrel spring-hinged name-brand frames, nor did they have the CE (European specification) stamp; but, the sunglasses did have spring hinges.

The Bottom Line

What will be the future of “e-tail” frame selection? Will our patients be satisfied? How would a naïve consumer compare a professional frame and lens recommendation? What is the recourse for failing tolerance standards?

As for me, I am now going to enjoy my monovision as I drive to my optometrist appointment for my annual evaluation—and to get refractive treatment and a professionally recommended, selected, and fit frame and lenses. CLS