Insights into the FTC’s Contact Lens Rule

The ability to purchase contact lenses at various places and online has greatly impacted my family. It has made them more affordable and it more convenient to purchase them.

My office gets a call. Its a 10minute recording saying a patients purchased contacts online and I have to sit on the phone and listen to the 10 minute recording and at the end they finally tell me the patient name and contact lens prescription i can verify and if the prescription is wrong i can call and leave a message to the company. Now mulioly that 10 minutes by ten people and it is a very frustrating horrible process. Most internet companies havebno actual person to talk to and probably dont even check the recordings. But after 10 of these recordings a day. And them putting the info at the end of the recording it is very time consuming and useless as they dont even check to hear the messages i leave.

I love ordering my contacts online. I buy one box and it lasts me the whole year and i dont have to pay for an exam. I just keep ordering the same prescription thats on the box.

I am a truck driver and love sleeping in my contacts so i can just wake up and get to my destination. I am too busy to get an exam so ordering contacts online is great for me. Once i got a really bad infection when i was out of contacts so i just kept wearing an old lens for about 7 months. But i was able to just order contacts from 1800 contacts without a prescription. for another box and i was good for another 2 years. I do get some glare at night though. And i see a white thing on my pupil. I don't know what that is.

I only have one eye and eye doctors say i shouldnt wear contacts and sleep in them but i can order them online and they give it to me.

Last week, one of my patients, a 17 year old girl, just learning to drive, came in to the office to ask why her vision had suddenly blurred with her contacts. Her visual acuity, which had been 20/20 with her prescribed torics lenses just weeks ago, was now 20/100. Worried that something was seriously wrong, I asked to check her contact lens boxes and discovered that she was in possession of lenses she had purchased online. These were completely devoid of any astigmatic correction, they were a different material and size than the ones originally prescribed by my. The online retailer was contacted and said, simply, “no worries, we can refund her money.” No verification attempt had been made. No attempt to fill the correct Rx. Blatant disregard for both the health of her eyes as well as the safety of both the young lady and other drivers in the road. Every patient leaves my office with a written prescription free to purchase lenses anywhere they choose. Most of my patients are teens. Not many would be savvy enough to know that a substitution had been made which may endanger their eyes and vision. This problem is getting worse, despite the current law. Enacting new rules would create an undue burden on my practice without enforcing current rules that hold unlicensed dispensers of medical devices accountable for their illegal behavior. It is my sincere hope that instead of adding red tape and more useless rules, the FTC sees fit to simply hold all parties involved accountable and enforce the current rules already in place. Sincerely yours, Dr. Viola Kanevsky

There is a misconception with that statement and I'll explain why. Patients think that when they purchase contacts from the doctor's office, they will pay more because either the online places get a better volume discount (which they do to some degree) or there is a higher markup at the office vs online. A single box price is probably cheaper online but when you get a larger supply, (ie. a year supply) the doctor's office is usually better. This is due to the shipping costs being free from the manufacturer and availability of rebates from the doctor's office. Not to mention any additional discounts from the doctor's office for purchasing a years supply that add extra incentive. For example, we give patients an extra 10% discount for year purchases that they can pick up conveniently at our office, sometimes that day if we have them in stock, or we can have shipped to their house. At least we know the product is coming straight from the manufacturer where there is a controlled environment so it would be less prone to defects from extreme temperature differences. Earlier this week I had an established patient come in for a contact lens exam and expressed some desire to switch from the present brand of contacts she was using. When I asked what the problem was, she indicated she had liked her daily lenses in the past, but last year she purchased them from 1800 contacts and found that the lenses were blurrier than she remembered them being. Her eyes felt more tired and dry at the end of the day. She had brought a pair of the lenses in with her and when I looked at them, they were in the same packaging as I would have expected. The problem, though is that we don't know how they were stored at the warehouses. Now I can't say that there is a problem at the warehouses of 1800 contacts. based on this. However, I haven't had a patient complain about a supply of lenses they received directly from the manufacturer or from our distributor either. This patient made this complaint as soon as I asked how her contacts were doing and I had no knowledge of how she bought them. I hope this letter can add some insight to how doctor's offices try to keep the costs of contact lenses fair to the public. In In addition, I will always provide a prescription to the patient for their contacts at their offering and without hesitation following education of their options at the conclusionof the exam.

I have had patients order their lenses online and not received the astigmatism correction that was prescribed. This leaves these individuals with reduced vision that affects them during work, school, driving, and other activities of daily living. They also are not receiving proper wear schedules, insertion and removal training, and hygiene education based on the health of their eyes which put them at risk for blinding conditions that can affect their future employability. Third party vendors are known to take advantage of the verification process involving doctors. They have been known to send rx verifications after hours, weekends, and other non-business hours. They fill expired prescriptions based on the resulting slow responses from the prescriber.

I am an optometrist. I have no problem giving contact lens prescriptions to patients or companies, what I do have a problem with is these companies changing my prescription without authorization, refilling a prescription year after year without a current prescription or using deceptive practices to obtain an authorization. All of these practices endanger the eye sight of my patients.

Please keep it as medical device. Without proper education and testing from eye doctors people can order wrong contacts with wrong prescription and getting infections. It's dangerous to have any device in the eyes with doctor approval.

The passive contact lens prescription verification process needs to be fixed. This proposed rule is a step in the wrong direction.

I strongly agree with the free market being the most efficient driver for economic growth; however, some of the recommendations for improving competition in the contact lens marketplace appear anti-competitive and dangerous to the contact lens consumer. The recommendation that patients sign a document confirming the receipt of their contact lens prescription from their provider places an excessive administrative burden on the healthcare provider. This added administrative would force independent health care providers to raise their prices making them less competitive. Furthermore, the nature of the document would implicitly cause a distrust of the patient of the doctor, as it would cause the patient to question why the doctor is required to provide such a document. The doctor-patient relationship is key to a working health care system, and it goes without saying that patients need to be able to trust their doctor. Lastly, many online retailers and "market disruptors" have used tactics to avoid verification of prescriptions in order to complete the sale that day. These tactics have led to improper dispensing of medical devices. As vision is imperative to being fully engaged in society, when improper contact lens prescriptions are dispensed, blurred vision can lead to decreased work performance, decreased performance while operating motor vehicles, decreased school performance, and many other unwanted consequences. Likewise, filling expired prescriptions without verification encourages patients to not seek preventative healthcare that is included with the determination of a contact lens prescription. Ocular diseases such as glaucoma may not be managed properly because the contact lens retailer is suggesting a comprehensive eye exam is not necessary to wear contact lenses. Please keep fair competition and consumer health in mind while making your decision on the Contact Lens Rule. Thank you for your time, Ben Konynenbelt

Your mission is to protect the consumer and your policies are contrary to your mission. I see many of my patients wearing contact lenses that I did not prescribe. The contact lens verification process is a joke and is a constant burden to my staff. There are many contact lenses that were made in foreign countries that are being diverted to America. The playing field has been tilted towards the on-line retailers. Your rules supersede state rules and regulations. These guidelines were put in place to protect the consumer. If you really want to protect the consumer, then enact stiff penalties for diverted product and selling contact lenses on an invalid prescription. The result from these practices are corneal scarring from infiltrating keratitis secondary to contact lens over wear or hypoxia from lenses like Hubble. I never fit a lens made from polymacon which is the original contact lens material. Please stop allowing prescription diversion.

As an eye care professional in the field for 30 years I have witnessed the complete disregard by online contact lens retailers especially Hubble , Lensdirect , and walgreens to fill contact lens orders despite our response to them not for whatever reason ( expired rx, wrong rx , wrong brand ) please stop these and other companies by doing this ASAP! Thank you

Please enforce these laws to safeguard my patients’ eye health. Regular corneal evaluations are crucial to preserving the gift of sight!

I recently saw a 30 year old female patient who have reported that her eyes have been red for the past few months. She tried to used many different over the counter eye drops to resolve the issue but could not. I asked about her contact lens wear habit and she mentioned that she started using Hubble contact for the past few months. I asked her who approved that RX and she said no one. She simply just entered her own RX online and received her Contacts within a few days. We on our end never received any request for contact versification from Hubble. Upon examining her eyes, I saw significant bad blood vessels grow on her cornea- which indicative of lack of oxygen to the eye and poor contact lens fit. If continues, these problems will lead to permanent blindness in the eyes. I informed her of the exam findings and the patient were completely shock to find out that her red eye were associated with her Hubble contact. She said if she were to know that Hubble contact material is more than 40 year old and would harm the health of her eyes as well as threatening her sight, she would never order it. She also assumes that she thought it is ok to use since she never get a rejection from Hubble saying that her doctor didn’t approve the contacts . Please law makers, put a stop to these uncontrolled online ordering. If not one day, your kids or grandchildren will find themselves in this patient shoes.

Atleast once a week I see a patient with complaint of headache or asthenopia , who has been wearing wrong prescription for months since they bought contact lenses online and online vendors failed to verify the prescription or fulfil the order rightly. All my patients leave with contact lens prescription after exam . Recently my staff members started complaining that if online vendors do send verification request, voicemail is all jumbled up , they don’t leave patients full name and no phone number to call back to speak to a person. Only voicemail to call back to leave a message. No follow up calls. If we do make out patient’s name we send out yes to fill if Rx is right and not to fill because prescription is wrong or expired. We also call patients when we say no to fill contact lens Rx, and learn 9/10 times that vendor has already send supply to them even though our office said not to fill. This new rule only puts more burden on small office like mine and does not do anything to enforce the current laws and rule on online vendors. Patient issues will not be solved by this. Patients will still receive supply on wrong or expired prescription. Sincerely Dimple Kapoor

Every one of my patients is given a copy of their contact lens prescriptions as soon as it is finalized. I do not profit from the sale of contact lenses. It is not a part of my business. I follow the state rules on the expiration dates of contact lenses. I am a part of a small business that follows the rules and looks after the best interest of my patients. I treat each of them how I would want myself or family treated. I have been very disheartened by the tactics of many online contact lens sales companies. We receive faxes and passive phone verifications in the middle of the night with orders being filled with or without denial/ corrections for the prescribed contact lenses. I recently had a patient that finally came in after ordering lenses online for several years without a valid prescription. She was not my patient previous to this visit but told me that she would just order what was on her box from 4 years ago and she thought it was Ok since they just kept sending more lenses. She finally came in because she no longer could see out of them, and had 20/40 and 20/60 vision (barely making the legal driving cutoff for MN). It was discovered through the exam that she had severe Contact lens induced keratitis and corneal edema, and we were initially unable to correct her vision for any improvement. She was removed from contacts, treated medically, and was successfully refit back into a more appropriate lens 1 month later thankfully now able to be corrected back to 20/20 in both eyes. This cost her and the insurance company hundreds of dollars in medications and office visits (not the online company that illegally sold her the lenses). This is just one example and the problem is getting worse, despite the current law. Enacting new rules would create an undue burden on my practice without enforcing current rules that hold dispensers accountable for their illegal activity. It is my sincere hope that instead of adding more rules, that the FTC simply hold all parties involved accountable and enforce the current rules already in place. Sincerely yours, Dr. Jessica Loehr Optometrist, MN

how about enforcing the law that currently exists? Contact lens verifications do not occur consistently. Unauthorized substitutions are made all of the time. Verifications over the phone are often not understandable, and often do not even give the patient name. Tricks are attempted to try to get the person answering the phone to say 'yes' and then then are hung up on, as they've received 'verification'. (i.e. "can you hear me ok" is NOT the verification of a contact lens Rx, when no patient name has been given, nor any Cl Rx parameters given). If my business has to follow the laws, so should online retailers.

I appreciate your time and efforts, but without enforcement of these rules they are just a waste of time. Many of the big online cl sellers ignore these rules and nothing happens to them.

Every single patient that I fit for contact lenses leaves with a written prescription after I have finalized the Rx. We have made efforts to reduce the paper consumption in our office and this change would put a dramatic burden on our day to day operations and efforts, as we are trying to provide medical care rather than having patients sign documents like they are buying a new car. Contact lenses are medical devices, and should be treated that way amongst all involved parties. That includes retailers that are not licensed to comply to standards as well. It is outrageous that people are encouraged by online retailers to skip the doctor visit and renew their Rx. It is my sincere hope that instead of adding red tape and more useless rules, the FTC sees fit to simply hold all parties involved accountable and enforce the current rules already in place

I just had a patient in his 20s come in two weeks ago for an annual contact lens exam. He had no symptoms and no other concerns. Through the exam I ended up saving his life as he had a mass in his brain and was told by the neurosurgeon had he not come in for his annual eye exam the condition would have been fatal. If it was up to these online contact lens re-sellers who have avoided the law and acted unethically since their inception this young man would be dead. Contact lenses are a medical device and these re-sellers should have to follow the rules already on the books. Their end goal, unlike doctors who take an oath to protect their patients, is only profit and greed. They (the online re-sellers) care nothing about eye health or the importance of in person exams and continue to pour money into buying off legislators.

Receive between 5 to 10 Robo calls a day from contact lens online companies such as1 800 contacts for contact lens prescription verification of patients who don't belong to my practice. The majority come on off hours. .Because they get no response one way or another they will designate my office uncooperative and sell the contacts to the patient without any kind of authorization.

I am an optometrist and I have had several patients order free contact lens trials online that were not approved under my care. These lenses have cause damage to the patients eyes. Unfortunately, these lenses were marketed on social media with no mention of how dangerous ordering the wrong prescription or a material that was not suited for their eyes could be. They were also lucky to not be permanently blinded. Since these new companies are not held to the same standards as doctors they are getting away with unsafe practices. The FTC should look into all companies dispensing “free trials” without medical professional supervision. This is a medical device and should be treated accordingly with a licensed doctor.

I have to re-educate patients on their poor (often extremely poor) contact lenses wearing habits in the office; it is way too often for my liking and way too often for the overall health of their eyes. I have no issue where patients choose to buy their supply, but there should not be substitutions due to situations like, poor vision and fitting then followed by red eye complications. More time spent re-educating patients on proper wearing compliance, risk of ugly eye complications due to CL overwear, etc. Often, this comes too late and damage is already done to their special sensory organs—you only get the eyes you are born with, and it’s not exactly replaceable. First and always, do no harm. Keep others from harming themselves.

I am an optometry student. I have no problem giving contact lens prescriptions to patients or companies, what I do have a problem with is these companies changing my prescription without authorization, refilling a prescription year after year without a current prescription or using deceptive practices to obtain an authorization. All of these practices endanger the eye sight of my patients.

As an optometrist there are serious implications when it comes to patients and how they abuse their contacts. I know all of the online sales have no care about patients eyes and seeing these comments of people who abuse their contacts regularly is just another reason not too allow it to continue. I know 1800 only cares about how much money they make and they have no problem giving patients conact lenses regardless of correctness. This Is another serious issue. As long as patients just refill their lenses without proper verification, they can be seriously under corrected and harm themselves or others. As long as people abuse contact lenses, they put themselves at risk of going permanently blind because of lack of oxygen getting to the eye. That is why it is so important to make sure they are evaluated by an optometrist who actually cares about the longevity of the patients vision to ensure proper fit and proper corrections. Sincerely, Dr Cody Patterson

Patients are already free to take their contact lens prescription anywhere they want. At the end of the contact lens fitting process, patients get a printed prescription and can purchase lenses anywhere they choose. I have seen countless patients who order lenses online but are given the wrong ones, or they are able to keep ordering them over and over without an eye exam. I end up seeing them later when they have a nasty eye infection or have other complications as a result of wearing the wrong lenses. Then people have to pay for their high deductible medical visits to treat the infection and spend much more money than they would have if they paid their $10 VSP copay, or even paid full price out of pocket for an exam. This problem is getting worse, despite the current law. Enacting new rules would create an undue burden on my practice without enforcing current rules that hold unlicensed dispensers of medical devices accountable for their illegal behavior.

First, the FTC is attempting to assert authority in the commerce of a medical device. While the economic impacts and fairness to consumers may fall under the FTC’s jurisdiction it must not put commerce over safety. It must also not place undo burden on an entire profession when current rules for contact lens prescription release and verification are statistically violated in higher numbers, not by the prescribers, but by the filler of said prescriptions. One more form to sign is ridiculous in today’s atmosphere of exponential growth in health care regulation. Apply existing laws. It is that simple. If the FTC has no intent on sanctioning those who improperly fill contacts lenses while at the same time implying more regulation on prescribers, especially without evidence to support it, then the FTC may as well sell adds to internet sites because they appear to have you all bought and paid for.

I'm sick and tired of 1 800 Contacts and other companies approving contact lens prescriptions that are over a year old without the proper follow up from the optometrist. These people are compromising the corneal health of our patient's in the name of turning a profit. Contact lenses are medical devices and can therefore affect the adversely if not properly monitored. This unauthorized refilling of year old contact lens prescriptions undermines our patient's ocular health. Make it stop!

I'm sick and tired of 1 800 Contacts and other companies approving contact lens prescriptions that are over a year old without the proper follow up from the optometrist. These people are compromising the corneal health of our patient's in the name of turning a profit. Contact lenses are medical devices and can therefore affect the adversely if not properly monitored. This unauthorized refilling of year old contact lens prescriptions undermines our patient's ocular health. Make it stop!

I find it shocking that a patient can receive contact lenses (medical devices that can affect eye health) without a prescription or physical evaluation of the fit of the lenses. All of my patients are automatically provided a written copy of their prescription when the fit is completed. The prescription is specific for the lens they were fit in as all contact lenses fit differently. Material, curvature, modulous, diameter, edge design are just a few of the parameters in prescribing a lens. Online sellers are not concerned about the ocular health of their customers. They are only interested in making a quick sale. Why else would they call after hours or have a automated call that is impossible to understand? Rather than waiting for an authorization, the prescription is simply filled. Recently I had a patient that came in for her annual eye examination. She told me she had refilled her Rx through Hubble. I was surprised as I NEVER received a verification request. Thankfully she was unable to wear the lenses as they were very uncomfortable and were the incorrect curvature for her. Please do not let online retailers risk patient’s ocular health. Just like prescription medication, contact lens prescriptions must be properly verified and dispensed as written. Sincerely, Rita D. Cook, OD, FAAO

Would I like to see an overhaul of the contact lens law? Absolutely. I would like it to be changed so that it is actually meaningful. I have been in practice for 16 years, working inside a Walmart Vision Center. I would estimate 80% of the prescription verifications we receive are for prescriptions that are expired, wrong, both, or for patients that have never been seen at our office. We duly send them back immediately, but I have no doubt 90% of them are filled anyway. If at first they don’t succeed, they try try again, until they get lucky and somone misses the ridiculous 8 hour verification window, or they find a vendor who will sell to them anyway. Most of the phone verifications are deliberately vague or difficult to understand, so offices cannot properly verify them. The only thing stopping patients from buying their lenses outside their doctors’ offices are the few denials that are actually properly handled. Patients can make up anything they want, order online, and receive the lenses. Passive verification should end, and prescriptions should be regulated as they are at a pharmacy. The proposal to require a signed receipt of contact lens prescription is an unreasonable burden on the patient and the practitioner. The last thing consumers want is more paperwork to sign. I often give my patients more than one option to try, and have them call to finalize the prescription. This new law would require me to have all of these patients return to my office to sign a piece of paper. I don’t think that will make consumers happy; it would be a waste of their time and mine. It is extremely rare we have any difficulty obtaining a prescription from another office; this is simply not a problem. The vast majority of doctors provide the CL prescription as soon as it is finalized, and again later if the patient needs another copy. Of course there are a few who don’t follow the law, but does it make sense to create an additional burden for all other doctors and their patients rather than punishing the few who don’t comply? I don’t believe so. Don’t believe the online retailers trying to claim they are protecting consumers’ rights. They only thing they care about is their own profit. I write all of the above as an optometrist who has never made any income from selling contact lenses. These sales mean nothing to me. The health of my patients eyes (and the rest of their bodies—you can diagnose a lot of conditions through an eye exam) does. The proposed changes are not to help consumers, they are to help retailers make more money.

I live and practice in an arrid, high altitude environment. Lens choices matter in this climate. Annual corneal health checks are crucial. Efforts to enforce online companies to verify and comply with my medical eye recommendations in a less obstructionistic manner, to properly enforce current rules rather than adding more, are crucial for public safety.

Contact lenses are medical devices that need to be properly regulated. Not doing so places patients at risk for permanent vision loss. Routine eye care not only protects a patient's vision, but may reveal serious health issues. Illegal sales of contact lenses places patient's vision and overt all health at risk. The FTC needs to enforce current regulations on all dispensers of contact lenses, including online resellers and retailers. The numerous sources of contact lenses have made the price of contact lenses very competitive. Price and convenience are no longer the major issue, it's patient safety. Prescribers are already unfairly held liable for prescriptions that resellers often illegally change to make a sale. Additional regulations only further penalize small businesses with additional costs.

I've had many occasions when retailers have filled expired prescriptions even after we have sent them documentation within the ridiculous time requirement. There seems to be increased propensity for this behavior with the addition of new retailers in the marketplace. Convenience for the customer is important but it should never take the priority of proper healthcare out of first place.

This change will add an unnecessary burden to practices and patients. As it is people are becoming more and more wary of paperwork, signing documents, etc. Medical offices are being buried by paperwork, data storage, unreasonable compliance demands and inane policies. Giving a patient a copy of their contact lens prescription is easy. Forcing them to sign an acknowledgment of receipt of said document is excessive and silly. And certainly proposed by someone not at all involved at providing eye and vision Care to patients. Don’t we have more important things to work on?

Buying contacts online without appropriate verification is like buying prescription drugs without a doctors prescription. If the contact lens does not fit right and is too tight it can lead to conditions like corneal ulcers and infections which sometimes leads to permanent vision loss. I've had many patients who buy online like from Hubble who complain of their eyes hurting and they can't see. This company doesn't even verify prescriptions which is illegal but this still goes on. We need the FTC to enforce these rules in order to protect patients eyes, prevent people losing vision and going on disability.

I always dispense a contact lens prescription after a complete evaluation has been performed to evaluate the vision, health and fit of this medical device that we call a contact lens. I do not hold a patient's prescription "hostage" because it is their right to have access to their medical information. However contact lenses are not just a consumer product that patients are simply entitled to- there are very real medical consequences to the way online retailers sell contact lenses and subvert the medical examination required to wear contact lenses in a healthy manner. I vividly remember a teenage patient that I saw when I was a resident doctor who developed permanent corneal scarring from contact lens abuse. She will never see better than 20/70! Contact lenses are a medical device that require prescriptions (and therefore routine examinations) and the FTC should enforce the regulations in place to recognize what that means. I proudly and dutifully carry out my responsibility to ensure that my patients are seeing well and that this piece of plastic that sits on their eyes all day does not impair their health. I sell contacts but I do not care where patients buy their supply as long as they have a current prescription. I do not depend on selling contacts and do not alter my responsibility as a doctor just to sell more of them. In contrast the retailer's only burden is to ensure they make a profit. They make no profit from making sure a consumer has healthy eyes nor the proper vision from their contact lenses. Thank you for your consideration, Amy Lee, OD

I always dispense a contact lens prescription after a complete evaluation has been performed to evaluate the vision, health and fit of this medical device that we call a contact lens. I do not hold a patient's prescription "hostage" because it is their right to have access to their medical information. However contact lenses are not just a consumer product that patients are simply entitled to- there are very real medical consequences to the way online retailers sell contact lenses and subvert the medical examination required to wear contact lenses in a healthy manner. I vividly remember a teenage patient that I saw when I was a resident doctor who developed permanent corneal scarring from contact lens abuse. She will never see better than 20/70! Contact lenses are a medical device that require prescriptions (and therefore routine examinations) and the FTC should enforce the regulations in place to recognize what that means. I proudly and dutifully carry out my responsibility to ensure that my patients are seeing well and that this piece of plastic that sits on their eyes all day does not impair their health. I sell contacts but I do not care where patients buy their supply as long as they have a current prescription. I do not depend on selling contacts and do not alter my responsibility as a doctor just to sell more of them. In contrast the retailer's only burden is to ensure they make a profit. They make no profit from making sure a consumer has healthy eyes nor the proper vision from their contact lenses. Thank you for your consideration, Amy Lee, OD

This ruling has a significant impact on both the patient and the prescribing doctor. This is, I believe, unnecessary work in times when the provider is struggling to abide by countless regulations, reduce paperwork, and streamline work. All the while in an environment of decreased reimbursement. Oftentimes, this will require the patient to come to the office to sign the paperwork proposed by this regulation, creating additional burden on both the patient and the staff. There should be more emphasis on closing down the online contact vendors (I said vendors - not doctors - because they are not qualified to do anything but keep shareholders happy) because current regulations are not being enforced.

This ruling has a significant impact on both the patient and the prescribing doctor. This is, I believe, unnecessary work in times when the provider is struggling to abide by countless regulations, reduce paperwork, and streamline work. All the while in an environment of decreased reimbursement. Oftentimes, this will require the patient to come to the office to sign the paperwork proposed by this regulation, creating additional burden on both the patient and the staff. There should be more emphasis on closing down the online contact vendors (I said vendors - not doctors - because they are not qualified to do anything but keep shareholders happy) because current regulations are not being enforced.

I have been in practice for 18 years. The current state of CL sales is quickly turning into a FLEA MARKET situation. Doctors are required, by law, to follow state requirements, Standards Of Care and are held responsible for outcomes that result from not following those guidelines. Online CL retailers have no such guidelines but when patients have an unfortunate outcome from buying CLs that were not prescribed by their doctor such as a corneal ulcer, the subsequent lawsuit ALWAYS includes the patient’s doctor because, of course, they are the professional and they should have somehow stopped this from happening. Of the three parties involved here(Doctors/U.S. Government/Online Retailers), only one party has no interest in the care and safety of the public. The online retailers are strictly focused on sales of WHATEVER lenses they can sell to patients. Doctors are restricted as to how and what services they can bill Medicare and other insurance plans, but online retailers can sell CLs from EXPIRED prescriptions with no consequence. This isn’t the American way, it’s not even logical. Federal, state statutes and industry Standards of Care should apply to all parties involved with our patients.

I am not aware of any offices that are not releasing a valid CLRx after a fitting has been done. What I am aware of is the lack of action taken against online companies from illegally selling contact lenses to consumers. I have seen multiple occurrences where 1-800 will send an authorization verifying a prescription when the office is closed, even though it's been reported back numerous times that the office is closed during those hours. It is just a ploy to pretend they are abiding by the law so they can go ahead and send expired and incorrect contact lenses. I had a patient last month who has been able to receive her contact lenses for 10 years without coming in for an eye exam because 1-800 continued to send boxes. Hubble is the newest contender and is even worse than 1800; they market an outdated contact lens as a new option to consumers. They send boxes to patients without any rx at all. I have so far seen one patient in the last two months come in with a corneal ulcer from said contact lenses. Hubble pretends to verify the Rx by calling and leaving a garbled message with the intention of trying to trick staff into saying yes at some point in order to fill Rx. These contact lenses are unhealthy for the eye, and I am not aware of any Dr that would actually prescribe such a terrible lens.

Enforcing the current laws that exist to protect the public health would be a more efficient way of using our time instead of adding new ones. I agree with “Contact lenses are medical devices, and should be treated that way amongst all involved parties. That includes retailers that are not licensed to comply to standards as well. It is outrageous that people are encouraged by online retailers to skip the doctor visit and renew their Rx.”

Contact lenses are medical devices, and should be treated that way amongst all involved parties. That includes retailers that are not licensed to comply to standards as well. It is outrageous that people are encouraged by online retailers to skip the doctor visit and renew their Rx.

Contact lenses are medical devices, and should be treated that way amongst all involved parties. That includes retailers that are not licensed to comply to standards as well. It is outrageous that people are encouraged by online retailers to skip the doctor visit and renew their Rx.

Dear FTC Commissioners: I am a doctor of optometry providing essential frontline eye health and vision care in my home community of Central Oregon. It has been my experience that patients ordering contact lenses online tend to over-wear the contacts, which are medical devices, resulting in damage to the eyes and vision. Contacts received from online orders are frequently a different power, brand or manufacturer that what was prescribed. It is already burdensome for my staff to listen to a garbled verification voicemail from online contact lens sales companies. Having to provide additional paperwork for my office is beyond unreasonable and will not provide any benefit as many online companies fill prescriptions even after we have told them they are invalid, inaccurate or otherwise expired. There is no justification for targeting eye doctors—optometrists and ophthalmologists—and our patients with new paperwork and document storage requirements as your misguided Contact Lens Rule proposal would do, while the Commission allows retailers who blatantly violate the law to operate unchecked. Your agency’s own complaint data confirms that doctors comply with the law, a finding that Members of Congress have specifically recognized in Congressional hearings with FTC officials and further affirmed on March 23rd through passage of 2018 government funding legislation (Public Law 115-141) and the following report directive: Contact Lenses—The [Senate Appropriations] Committee is disappointed in the FTC’s decision not to include the proposed patient safety improvements related to the prescription verification process in its draft contact lens rule and instead impose new paperwork requirements on patients and doctors that are unnecessarily burdensome. The Committee directs the FTC to prioritize patient safety and consider enforcement mechanisms under its existing authority or revisions to the draft rule that address sales of excessive quantities of lenses, illegal substitutions, and communication challenges associated with prescription verification, including robo-calls. The Committee further directs the FTC to continue to confer and consult with other Federal agencies, including the Food and Drug Administration, to optimize its enforcement and consumer education activities. There are many voices purportedly paying consultants to voice unfounded claims about why you should continue with the proposed rule. I urge you to listen to the nation’s eye doctors and other public health experts in recognizing contact lenses as a medical device and by joining with the Food and Drug Administration (FDA) and the Centers for Disease Control (CDC) in making quality care and patient health and safety a priority in Washington, DC. Sincerely, Audrey Brumley, OD

The verification process (when I get one ) is horrible. You can't understand the name of patient. It is an automated voice. I had a patient this morning. He couldn't see with his online contacts. He didn't know which one was right eye, which one was for his left eye. The boxes were not marked for him. Visual acuity 20/60 and he drove to my office! Dr Lisa Williams