Article Date: 5/1/2010

British Columbia Removes Eyewear Purchase Restrictions

British Columbia Removes Eyewear Purchase Restrictions


■ Effective May 1, British Columbians (B.C.) will no longer have to see an eyecare practitioner in order to purchase eyewear. This is the result of changes to the province's Health Professions Act (HPA).

“After lengthy consultation on some of these issues, and a recent court decision [see below] that caused us to take a broader look at all the existing regulations, now is the time to take action,” says B.C. Health Minister Kevin Falcon, in a press release. “With advances in technology and more consumers turning to the Internet, it makes sense to modernize a decades-old system to give British Columbians more choice while maintaining public safety.”

In October 2009, The B.C. Court of Appeal found Coastal Contacts — a B.C.-based online eyewear retailer — guilty of violating the HPA, which stated contact lens refills could not be filled without a prescription.

Specific changes

The changes to HPA now allow B.C. patients to order eyewear online without providing the seller with a copy of their prescription. Also, B.C. O.D.s and opticians must provide their patients, free of charge, a copy of their prescription, sight-test assessment or contact lens specifications regardless of whether the patient requests it, and also provide a copy, free of charge, to a third-party eyewear seller or other person, if the patient requests it.

Further, B.C. opticians are now able to independently conduct sight tests for healthy clients aged 19 to 65. This eliminates the HPA's mandatory sight-test review by an eyecare practitioner, who ultimately issued the prescription. The Ministry of Health Services plans to institute a screening process to ensure that patients are healthy enough to be eligible for the sight test and understand the difference between a sight test and an eye health examination. The screening process will require the optician to refer the patient to an eyecare practitioner, should the patient have a specified pre-existing condition, says a press release.

Putting vision and lives at risk

“These changes put the vision and the lives of British Columbians at risk. If a patient has a vision change, they need to have their eye health assessed by an eyecare practitioner to determine the cause of the vision change,” says Antoinette Dumalo, O.D., president of the British Columbia Association for Optometrists (BCAO). “The fact is that roughly 10% of patients who present for a routine eye exam are asymptomatic for serious eye diseases, such as age-related macular degeneration and glaucoma, systemic diseases, such as diabetes, and in the worst case scenario, brain tumors. These changes will increase the incidence of blindness, which will cost British Columbians more tax dollars.”

Defending changes

In an e-mail to Optometric Management, Mr. Falcon disagrees that the HPA changes will put anyone's health and safety at risk. He claims that after examining data, no strong scientific evidence reveals that regular eye health examinations for asymptomatic individuals between the ages of 19 and 65 improve health outcomes.

Also, he says opticians have been doing sight tests in B.C. since about 1997, and that allowing opticians to independently conduct these tests keeps up with innovations in technology.

In response to Mr. Falcon's comments, Dr. Dumalo says there is indeed “substantial” scientific and medical research that reveals both the risk of forgoing a comprehensive eye exam and the benefits of undergoing one. Her examples: a Canadian Journal of Optometry article that reveals one in seven patients who present for an eye exam have asymptomatic eye disease; an Ophthalmology article, which reveals the risk of eye infections linked with Internet/mail order-bought contact lenses is nearly five times higher than those bought from an O.D.; and a Canadian Journal of Optometry article, which shows B.C. residents are unaware of blinding eye disease risks.

Eyecare Companies Form Coalition


■ Essilor of America, Luxottica Group and VSP Global have joined forces to create the Think About Your Eyes coalition, a multi-million dollar two-year public awareness initiative designed to increase consumer awareness of the importance of vision health and comprehensive eye exams.

“Through the Think About Your Eyes Coalition, we will help raise awareness of not only how important comprehensive eye exams are, but also what an important role an eye exam plays in monitoring your overall health,” says Rob Lynch, CEO of VSP Global. “A primary goal of this coalition will be to highlight all the preventative health benefits that a comprehensive eye exam can deliver, including the detection of diabetes, high cholesterol and other disease.”

Currently, the coalition is working on developing a public awareness initiative comprised of T V, radio, online ( and social media communications.

Its first TV and radio announcements are currently airing in New York, Los Angeles, Chicago, Denver, Atlanta, Houston, Sacramento, Cincinnati and Portland. (To view the TV announcement, visit

Industry leaders interested in joining the Think About Your Eyes coalition should contact Wally Lovejoy, senior vice president of eyecare development for Luxottica retail and chairman of the coalition at, or at (513) 765-6340.

As we go to press, the Foundation for Eye Health Awareness has signed a letter of intent with the coalition to integrate their public awareness eye health messages.

Blog Features Latest Glaucoma Research

Interested in research from the American Glaucoma Society's annual meeting? Then, visit Here, Ophthalmology Management's Executive Editor Jack Persico breaks it down for you via blog. Among the meeting blogs: the relative merits of three parameters used to assess intraocular pressure (IOP): mean IOP, peak IOP and fluctuation/ variability of IOP. (Ophthalmology Management is Optometric Management's sister publication.)


Global Cost of Vision Loss Revealed

■ The worldwide cost of vision loss is almost $3 trillion for the 733 million people who have low vision and blindness in 2010, says the AMD Alliance International (AM-DAI)'s report: “The Global Economic Cost of Visual Impairment.”

These costs include direct healthcare expenditure, informal caregiver time, loss of productivity and inefficiencies in raising tax revenue to fund health care. The direct cost to North America alone: $512.8 billion, with the indirect costs totaling $179 billion, says the AMDAI report.

The report includes estimates from 2010 to 2020 and also reveals vision loss costs linked with specific eye conditions, such as age-related macular degeneration (AMD). It costs the United States $343 billion, including $255 billion in direct healthcare costs.

To access the complete report, visit

Correction: The April issue's “Spectacle Lens Focus” should have read that Goldstone Vision Center, Fountain Valley, Calif. is the only iZon co-branded high-definition vision center in the world, not the only practice in that area that offers the lenses.

Reform Opens Patient Access To O.D.s


■ On March 23, President Obama signed into law healthcare reform legislation, one of the most ambitious pieces of healthcare legislation enacted in decades. In signing the bill, the President said that America has “enshrined” the “core principle that everybody should have some basic security when it comes to their health care.” House Republican leader John A. Boehmer countered, “It amounts to a government takeover of health care, and the middle class will get a raw deal once again.”

Putting aside partisan political arguments, organized optometry approached the legislation from the perspective of patient access.

“If national healthcare reform was going to be about new coverage for more than 30 million uninsured Americans, [the American Optometric Association's] (AOA)'s goal was to extend the focus of the debate to the more than 70 million individuals with coverage through [the Employee Retirement Income Security Act] (ERISA) plans that can and do discriminate against optometry,” says Randolph E. Brooks, O.D., president of the AOA.

Key to patient access was the passage of the Harkin Amendment Section 2706, which prohibits insurance issuers from discriminating against any healthcare provider who acts “within the scope of that provider's license or certification under applicable State law.” The legislation would also establish a Federal standard of provider non-discrimination, which would apply to all health benefit plans.

The legislation enacted other measures that were endorsed by the AOA, including:

► Recognizing children's vision as an “essential” health benefit.
► Recognizing vision care in school-based health settings.
► Recognizing the role of optometry in the “healthcare home” model of patient-centered care.
► Exempting spectacles and contact lenses from a 2.9% medical device tax.
► Exempting the cost of vision plans from an excise tax on “Cadillac” (high cost) health plans.
► No disruption in coverage of existing stand-alone vision plans.

Dr. Brooks says he is confident that optometry can handle the additional patients that the legislation would bring into the healthcare system: “Optometry is ready, willing and able to step up.”

Joe Ellis, AOA president-elect agreed, noting that the AOA has been looking into manpower issues even before the current debate over healthcare reform began.

The legislation, formally known as the Patient Protection and Affordable Care Act, would expand coverage to 32 million uninsured individuals and families (with income between 133% and 400% of the poverty level) who will be able to buy insurance through state-based exchanges. Separate exchanges would be established for small business, effective in 2014.

In addition, the law would ban insurance companies from denying coverage to anyone who has a preexisting condition.

Effective 2014, all Americans will be required to purchase health insurance or face a $695 annual fine, with some exceptions for low-income people.


  • A total of 35% of keratoconjunctivitis sicca (KCS) patients who were part of the Sjogren's International Collaborative Clinical Assistance registry possess all the ocular diagnostic parameters of Sjogren's Syndrome, though none of its nonocular characteristics, says March's American Journal of Ophthalmology. This has lead the study's researchers to believe another form of KCS aside from Sjogren's Syndrome-associated KCS exists.
  • Infants who have retinopathy of prematurity with dilation and tortuosity of posterior retinal vessels in at least two quadrants and are treated early (cryotherapy) achieved improved visual acuity outcomes at age six, says April's Archives of Ophthalmology. Meanwhile those who had pre-threshold disease — whether high risk or not — and were treated early did not, the study shows.
  • Tufts Medical Center researchers have developed a formula that has an 83% certainty for predicting the likelihood of individuals with certain genetic profiles and lifestyle behaviors developing advanced age-related macular degeneration, says May's Investigative Ophthalmology & Visual Science.
  • Floppy eyelid syndrome (FES) is strongly linked with obstructive sleep apnea, says April's Ophthalmology. Further, the study confirms previous findings that FES is linked with keratoconus.

FDA News

■ ACU-4429, an investigational oral daily pill for dry age-related macular degeneration that slows the rod visual cycle, from Acucela Inc. and Otsuka Pharmaceutical Co., Ltd., has received the FDA's Fast Track designation. This designation facilitates the development and expedites the review of new drugs designed to treat serious or life-threatening conditions and that show the potential to address unmet medical needs. Fast Track drugs may be eligible for priority regulatory review by the FDA.

■ Addition Technology, Inc. has received FDA approval for an expanded size range of Intacs corneal implants for keratoconus. The company produces Intacs and Intacs SK corneal implants, AlphaCor artificial cornea and AlphaSphere orbital implants.

Essilor Launches ECP Online Retail Site


■ Essilor of America, Inc. has launched, an e-commerce website that enables independent eyecare professionals (ECP) to compete with online retailers.

“E-commerce is rapidly emerging in our industry as more consumers enjoy the convenience of online purchasing,” says John Carrier, president of Essilor of America. “However, a solution including the ECP did not exist, and our research indicated that most ECPs felt ill-equipped to compete. As long-time industry partners, Essilor felt responsible to provide our customers with a solution to meet this challenge.”

The e-commerce solution, which links to the ECP's website, enables that independent ECP to sell 100,000 items, such as frames, ophthalmic lenses, sunwear, contact lenses and contact lens solutions. Also, it allows patients to use try-on technology 24/7. The independent ECP maintains complete control, determining the product pricing and selection and preserving the look and feel of their practice website. (In other words, the ECP controls the branding.) To secure and deploy this technology, Essilor acquired a majority stake in

My requires a $250 annual set up fee, though Essilor will waive this fee in the ECP's second year of use if the ECP sells more than six items. In addition, Essilor ships the chosen product directly to the consumer.

Groups seek knowledge on safety of online eyewear


■ The American Optometric Association (AOA), the Optical Laboratories Association and The Vision Council have teamed up to study the safety and compliance of prescriptive eyewear purchased online.

The reason:

“… Preliminary studies of online dispensing sites not under the direct control of the prescribing doctor have raised concerns in the areas of prescription accuracy, material safety and regulatory compliance of some online vendors,” says optometrist Beth Kneib, associate director of Quality Improvement for the AOA.

In addition, the AOA wants to assess ways to best prepare its members for the future of eye care with doctor-driven competitive solutions to thrive in the growing world of online dispensing, an AOA press release states.

The AOA will make the study's results available to its members at its completion, which is expected sometime around the 4th quarter of 2010, says Dr. Kneib.


Alimera Sciences has offered an initial public offering of 6.6 million shares of common stock at a price of $11 per share. The company is conducting phase 3 clinical trials for sustained release fluocinolone acetonide (Iluvien), a drug to treat diabetic macular edema.

Sirion Therapeutics announced that ganciclovir ophthalmic gel (Zirgan) — a topical antiviral indicated for the treatment of acute herpetic keratitis — is now commercially available.

The Aresty Institute of Executive Education at the Wharton School of the University of Pennsylvania and The Vision Care Institute will host the first Chief Executive Optometrist Webinar developed specifically for optometrists. The webinar, scheduled for June 8 at 8 p.m., focuses on decision framing and is available at no cost. For more information, visit

Aton Pharma launched a generic version of its timolol maleate ophthalmic gel forming solution (Timoptic-XE), a non-selective beta-adrenergic receptor blocking agent designed to treat elevated intraocular pressure in ocular hypertension and open-angle glaucoma patients.

Stephanie Su, O.D., manager of research clinic operations, Bausch + Lomb, received the Young Optometrist of the Year Award from the New York State Optometric Association. The award recognizes an O.D. in practice for less than 10 years who has demonstrated great leadership and promise.

The International Medical Alliance (IMA) is seeking O.D.s to volunteer their time and talents on a 10-day medical mission to So-moto, Nicaragua, from July 28 to August 8. For information, contact Ines Allen at (760) 485-8963, or visit

Reichert Ophthalmic Instruments is now known as Reichert Technologies. The new logo (see below) includes a representation of the cornea above the company's name.

Eyecare Companies Launch Mobile Clinic


■ At this year's Transitions Championship for Healthy Sight, held at the Innisbrook Resort and Golf Club, in Tampa Fla., Transitions Optical and VSP teamed up to launch a mobile eye clinic. Its purpose: to provide charitable eye exams and eyewear to those in need across the United States. In fact, the event kicked off a five-year partnership between the two companies to carry out this mission.

“With one in four children having an undetected vision problem that can interfere with their ability to learn, proper eyecare and eyewear is critical to their performance inside the classroom and in their everyday lives,” says Dave Cole, managing director, Transitions Optical. “We are proud to partner with VSP to provide this important service to families and communities most in need throughout the country… This effort embodies our mission to help raise awareness about the need for healthy, quality sight.”

Here, one of more than 50 elementary school children is evaluated by a VSP eyecare practitioner at the unveiling of the mobile clinic at Transitions headquarters in Pinellas Park, Fla. Of the those children evaluated, 45 required and were provided with eyewear.

More than 50 pre-screened students from Pinellas County, Fla. were the first to benefit from the new clinic, which contains a comprehensive eye exam room, full eyeglass dispensary and a full-service finishing lab with the capability to produce and distribute customized eye glasses. (The finishing lab was donated by Santinelli International.)

The evaluation process for students in grades kindergarten through fifth grade included initial screenings by Prevent Blindness Florida. Those who failed screenings received free comprehensive exams from VSP eyecare practitioners.

Transitions Optical and VSP provided those students who needed prescription lenses with complimentary eyewear fit with Transitions lenses on site.

“Transitions and VSP both have a strong commitment to supporting the community and helping people see better,” says VSP Global's CEO Rob Lynch. “By leveraging the strength of our two organizations, and in partnership with our 26,000 private-practice eye doctors, we will be able to extend our reach even further to help more people in need!”

Optometric Management, Issue: May 2010