Lawmakers eye contact lens prescription renewals using telehealth

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Capital News Service

LANSING — Telehealth has become a popular alternative to in-person appointments.

Now a recent bill aims to extend telehealth services so patients can renew their contact lens prescriptions through virtual appointments. 

Greg George, the director of legislative affairs for the Mackinac Center for Public Policy, said the bill would increase access to optometric care. The center is a free market-oriented think tank based in Midland.

“It’s strictly for renewal of an existing prescription that still works for the contact wearer,” George said. “We see it as a way to open up access to cheaper contact renewal services.”

The lead sponsor is Rep. Luke Meerman, R-Polkton Twp. 

Cosponsors include Ken Borton, R-Gaylord, Daire Rendon, R-Lake City, Robert Bezotte, R-Marion Twp, Tommy Brann, R-Wyoming, Sarah Lightner, R-Springport, Mary Whiteford, R-Casco Twp, Brad Paquette, R-Niles, Diana Farrington, R-Utica, Joseph Bellino, R-Monroe, Douglas Wozniak, R-Shelby Twp. and Julie Calley, R-Portland.

The proposal passed in the House and is pending in the Senate Health Policy and Human Services Committee.

Under the proposed legislation, telehealth patients who need their contact lens prescription would be required to have a comprehensive in-person eye exam every five years.

“There’s a lot of folks where their eyesight just isn’t changing,” George said. “If you’re going to an annual physical and your health has been fine, do you really need to have your eyes looked at every year?”

George said there are safety measures to ensure patients would still receive the same quality of care. “Patients have to go through the online platform, pass the online exam and their prescription cannot change. If their prescription changes, they must go in person to have their eyes looked at.”

However, Dr. Roger Seelye, an optometrist in Owosso, said online examinations don’t provide patients with the same type of comprehensive care patients receive in person.

“The telehealth eye exam is not an exam. It is a determination of the visual acuity over the person’s present contact lenses,” Seelye said. 

According to Seeyle, online eye exams can be dangerous for patients because “many things can be happening in the structure of the eye that don’t cause pain or blurred vision. Not getting comprehensive eye exams can have a devastating effect on eye health and can be life- threatening.”

Jeff Towns, the executive director of the Michigan Optometric Association, said an optometrist can see over 250 health conditions through an eye examination.

“Even if the patient doesn’t have symptoms, things like diabetes, hypertension which leads to heart disease and ocular conditions and all be seen during an exam,” Towns said.

Seeyle said there are two parts to an in-person eye examination.

“One is a determination of the ocular health of the eye, both internally and externally, and the second component is the refractive status, which determines the prescription,” he said.

“What they do online is a very incomplete evaluation of one of those components,” Seeyle said. “There’s no evaluation of the sensory motor abilities of the eye or of any ocular health components of the eye.”

According to Towns, contact lenses can be risky for the wearer if they are not monitored properly.

“Contacts can cause corneal ulcers and such, which is why it’s recommended that patients go back to see their optometrists annually,” he said. “It’s always good to make sure that the contact lenses are fitting properly and that the patient is wearing them correctly.”

Both Seeyle and Towns said they don’t consider telehealth to be beneficial for optometric treatment.

“Our position is that if telehealth can’t reproduce the examination of the eye, we can’t in good conscience call that telehealth — because it’s not,” Towns said.

Other opponents of the bill include AARP and Henry Ford OptimEyes, which is part of Henry Ford Health System, according to a House Fiscal Agency analysis. Other supporters include the American Telemedicine Association and AT&T.