RUN OR STRIKE?
How well do these systems work? That all depends on whom you ask. That being said, according to the article “Refracting Error in Baseball Players” in the May issue of Optometry and Vision Science, “In 50 visually normal young adults who underwent retinoscopy, subjective refraction, as well as evaluation with two other commercially available autorefractors (Topcon KR-1W and Righton Retinomax-3), the SVOne results were not significantly different.”
Take one part telemedicine, one part disruptive technology, one part convenience, and one part accessibility. Stir the pot and you have new—albeit controversial—ways to extend the reach of optical retail, both in the dispensary and off the grid.
Remote refracting devices are no replacement for a complete eye exam, nor are they intended to be. And, don’t confuse them with the at-home tests. Though some companies offer both consumer- and ECP-directed systems, they’re definitely not the same.
To find out how remote refracting is being used by eyecare professionals, we spoke to one optometrist and one optician who are set up with the systems. Each uses his system of choice to fill very different voids in his delivery of services.
On Melrose
Optician Sung Kim uses the Smart Vision Labs SVOne five-minute vision exam. The system consists of a handheld autorefactor that attaches to a smart phone and measures refraction errors in the patient’s eye using wavefront aberrometry. If needed, a prescription is generated remotely, and an online portal retains the information.
New Customers
Kim has been using the system since early this past winter at Eyetailor, his tony, upscale Melrose Avenue optical shop in Los Angeles. “I’d been thinking about it for the past few years—if I should hire an optometrist or what,” he says. “I get a lot of new customers at this location, and I felt I needed to do something and then looked carefully into the legality and viability of all the options.”
Updated Prescription
How does he position this service? “We always emphasize the importance of eye health and what this eye test is meant to do, that the eye doctor is the No. 1 priority, but that this will give them an updated prescription,” says Kim. “I stress that what I give is not an eye exam, and I tell my patients that. It’s mostly younger people who are excited about this—and that’s who I target for the system.”
EyeNetra’s portable suite: (from left) autorefractor, phoropter, and lensometer
SVOne Enterprise UX 4: a smart-phone-based autorefractor
Off the Grid
In Phoenix, AZ, Frederick Buensuceso, O.D., uses EyeNetra’s smart-phone-powered refraction system to take eyecare on the road, as well as to provide in-office services to special populations.
He uses the system in a multitude of remote settings—from nursing homes and corporate offices to wellness events and corrections facilities. It’s great for mission work, as well, he adds.
On the Road
“I’ve been doing this for 10 years,” explains Dr. Buensuceso. “I started with nursing homes and have done corrections for eight years. Now we’re also doing B-to-B for both safety and regular glasses.”
How has EyeNetra’s phoropter and lensometer changed his ability to service these clients? “When I started going to nursing homes, there wasn’t much equipment, and what was available required a lot of ‘polishing’ on my end,” he says. “I had to jury rig everything.”
The EyeNetra system is also much easier to move around than before. “The facilities I visited used to call the rig I lugged around ‘the coffin.’ Now, to do a full eye test, everything fits in a messenger bag,” says Dr. Buensuceso.
“It’s like the normal equipment, but in a different setting. I print or write out their prescription, and patients can take that anywhere. It’s theirs.”
Special Populations
How about in-office? “I have traditional equipment in my office, but, for special populations, I use the EyeNetra there, too. It’s great for paraplegics, for example, because I can place the equipment around them. It also allows me to see special needs kids. It’s a lot less intimidating for them, and it’s fast.”
Whatever the setting, concludes Dr. Buensuceso, “The private ECP can use all the help he can get.” 
JUST SAY…
Some states say yes, others no to remote refracting. At-home testing definitely raises the most concern. More than a dozen states have decided to regulate online exams in recent years, according to the American Optometric Association (AOA). In Virginia, for example, online eye exam providers must meet certain consumer protection standards. And, last year South Carolina barred consumers from getting a prescription for glasses or contact lenses from an online exam.
Lawsuits and countersuits are swirling around some at-home systems, and, in a recent statement, the AOA stood steadfast in its objections to them: “The progressive answer to eye and vision health care is not to focus on being the next big consumer brand or app…Instead, innovators need to focus on delivering tools that help advance patient care, because ‘virtual’ care is no substitute for actual health care.”