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Calling it a matter of personal freedom, the head of the House Health Committee wants to allow contact lens wearers go up to two years between required eye exams.
Rep. Heather Carter, R-Cave Creek, said there’s no medical reason for current laws that limit contact lens prescriptions to one year. Carter said HB2523 would allow a patient, in consultation with an optometrist or ophthalmologist, to decide whether to go up to two years.
But the measure is drawing strong opposition from both medical groups.
Annette Hanian, who is a full-time optometrist and heads the legislative committee of the Arizona Optometric Association, said contact lenses are medical devices regulated by the U.S. Food and Drug Administration.
“They have inherent to them things that can affect the corneal integrity, the surface of the eye, the ocular surface that patients aren’t necessarily aware of,” she said. “We need to be able to diagnose and intervene at an appropriate time so they don’t become more serious complications.”
Carter sniffed at that explanation, saying there are other states that have two-year limits. And she said there is no medical evidence that contact lens wearers there are having troubles that don’t exist in other states.
Hanian conceded the point but said it’s meaningless. She said optometrists and ophthalmologists in those states still only write year-long prescriptions even though they can now do more.
In some ways the legislation is a fight about money.
Unlike medical doctors, who write a prescription that patients fill elsewhere, optometrists and ophthalmologists are allowed to not only prescribe contact lenses but also sell them directly to patients.
But since 2003, patients can purchase lenses online from discounters, often at lower prices. And some of those firms want to be able to sell amounts larger than needed for just a year.
At the same time, the Federal Trade Commission is looking into practices by manufacturers to require contact lens discounters to charge a certain minimum price or face cutting off their supply.
Carter’s legislation would mean that patients would have to go in for an eye exam only half as often — meaning half as many opportunities for optometrists and ophthalmologists to make a sale.
“This is a commerce issue and not a health issue,” she said.
Several lobbyists for the discount supplier 1-800-CONTACTS already have signed up in support of the measure ahead of a scheduled hearing on Wednesday.
And Carter stressed that her legislation is an outer limit, not a mandate.
“If there is a medical reason that your eye professional would like to write (a prescription) for one year, they still have the authority to do so,” Carter said. And she questioned why the state is involved in this decision at all.
“This is the only type of statutory provision that dictates by the government how you prescribe a medical device,” Carter said. “The government shouldn’t be in the business of mandating the doctor-patient relationships.”
Hanian said it’s not that simple because eyes are different.
“Every year you wear contact lenses you have to have the health of your cornea reassessed,” she said, pulling out photos she said shows what can happen when eye problems go undiagnosed because a patient does not know the lens is causing problems.
Yearly eye exams have the purpose of helping the contact lens wearer remain successful in wearing contacts for the long term. At yearly eye exams, the wearers hygiene habits, early side effects and other factors that lead to contact lens intolerance are assessed and addressed. Patients want to wear contacts for decades, not have some adverse event or events inherent with non compliant contact lens wear that makes them intolerant of contact lenses. She says there is no data that shows a difference between states, linked to length of prescription. That is because the records are not adequately kept or reported. There is no data of how many patients live every day with contact lens intolerance problems or have discontinued wear on their own due to problems. In patients with catastrophic problems data is not taken about the cl wear or compliance unless there is some big outbreak and it is investigated. So conveniently for her there is no data. Somehow it seems Ms Carter and 1800 contacts think deregulation will help sell contacts but in the long run it will probably be less if there is deregulation. Patients will save money on eye exams, and also on contacts because they will become intolerant and stop buying them.
No anecdotes. Just real-world evidence please. Show me the studies, or the bodies!
According to this legislator, then the general public should have drug prescriptions that don’t expire for 2 years. I think we can all agree that this would not be in the best interest of the preserving and maintaining the vision of patients. If this does pass, then I’d expect there to be a commensurate increase in the cost of the contact lens fitting fees that doctors are charging to make up for the increased risk incurred by the doctors.
Supporters may not understand that specific serious and potentially vision threatening eye conditions are more likely in contact lens wearers and we want to minimize the risk of these cases occurring. Also, consider this. Dentists recommend checkups and cleanings every 6 months. You can get functioning artificial teeth. There are no fully functional artificial eyes. Also if you lose vision, you may lose your ability to perform certain jobs or may qualify for disability. Again, if you lose all of your teeth, you just get dentures, but you can still work.
Could the legislator open his books to see much 1800 contacts donated to his Super PAC?
Freedom from eye exams! Can I get my high blood pressure pills for 2 years as well?