Optometry Australia has issued a warning to consumers that their eyesight may suffer if they take contact lens (CL) prescribing into their own hands when purchasing from online retailers who do not require them to validate their contact lens prescriptions.
Luke Arundel, Optometry Australia’s Chief Clinical Officer said, ‘While we do not have issues with enabling consumers to purchase contact lenses online with a valid prescription, we do have particular concerns about new online contact lens retailers who specialise in selling one type of lens only.
‘Patients accessing these websites are able to swap from their currently prescribed contact lens to an alternative product without undergoing an appropriate review to determine if the lenses fit and provide optimal health performance on the eye.
‘This one size fits all approach is concerning because one size and one type of contact lens material does not meet everyone’s eye health requirement.
‘Members around the country have flagged similar concerns and we are currently working with state government bodies on the matter,’ he said.
Research into the incidence of corneal ulcers in Australia lists internet supply as a risk factor (1), the authors suggesting that this increased risk may be due to CL care attitudes and behaviours.
On websites which let a patient ‘self-validate’ that they have a valid CL prescription, there is nothing to stop a patient renewing a contact lens supply indefinitely without a health check, or swap to other brands or styles of contact lenses which may have a different fit or material characteristics.
Luke said that it would be most unusual in general optometry to have a patient walk up to the practice counter, point to some contact lenses that they wanted to buy, let them reassure the optometrist or practice staff verbally that they had a valid prescription, and then be allowed to buy the lenses.
‘Online pharmacies don’t just let patients pick and choose what medicines they want without provision of a valid prescription, yet this practice is common for online optical retailers’, he said.
Within Australia, prescription contact lenses are considered medical devices by the Therapeutics Goods Administration (TGA) and Optometry Australia has recently provided a submission to the TGA to classify plano contact lenses as medical devices and close this legal loophole.
Prescription of optical appliances in Australia is regulated by AHPRA and the National Law, while supply of optical appliances is governed by different laws in each state.
In some states supply of an optical appliance without prescription carries a $30,000 fine so Optometry Australia urges members to be cautious in this area.
‘Your medico-legal liability may also be affected should it turn out contact lenses were supplied to a patient without prescription.
‘Best practice for online retail would be to confirm validity of the prescription from the patient’s prescriber, or require an upload of a valid prescription, as is common in the USA.
‘We also encourage you to always notify your patients when their prescription is due to expire and encourage them to have their eyes examined regularly’, Luke advised.
(1) Stapleton F, Keay L, Edwards K et al · Incidence of contact lens-related microbial keratitis in Australia. Ophthalmology 2008; 115: 1655–1662
Tagged as: Contact lenses, Patient management