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Of course, performing a full examination every year is not always pleasant — or possible for patients. If your recipe expires but you want new frames, it can be a pain to wait for the proper examination.
“Comfort is very important,” says Jorge Cuadros, a researcher at the telehealth clinic at UC Berkeley School of Optometry. “You have to call right now, make an appointment, go down, get out of work, and then do an eye exam. Then you’re using so much time to be able to do an online test to renew your recipe.”
He is very familiar with the limitations of Warby service. The app cannot detect serious eye problems such as macular degeneration or cancer. Gilboa, the company’s CEO, said he sees the virtual vision test as a complement to traditional eye exams, not a substitute. The goal is not to turn all the nuances of an entire study into one application.
“We don’t repeat all the pieces,” he says. “We’re really differentiating from a comprehensive health examination and focusing on the ability to see and the piece that is linked to visual acuity for both glasses and touch lenses.”
This separation of telemedicine services has spread in the Covid-19 pandemic, making many health checks much more accessible to many people. But the second effect of this trend is that it has fragmented how patients think about comprehensive health care.
“This isn’t just about optometry,” says Richdale. “We’re seeing that you can go online and get a birth control prescription or testosterone or something. And those companies are in the business of making money. So they take out parts that they think they can make because they’re pretty benign and sell directly to the consumer. You think: “They’re glasses. What harm can they do?”
Companies like Warby Parker can provide a lot of warnings, but that doesn’t mean users will pay attention to them. The easier it is to avoid traditional care, the easier it will be for people to ignore seemingly minor health problems until late.
“It seems that the overall philosophy of the U.S. is moving away from preventive care and health examinations and toward urgent care,” says Richdale. “You’re throwing the can on the road until one day it’s your problem.”
Experts say the problem is not with telemedicine itself, but with how it is implemented. Cuadros describes the optimal approach that replaces the care provided by physicians but does not replace it. And that can be used well by doctors at the local level. Virtual vision tests can be very helpful, especially if they are in the hands of a doctor who knows your needs as a patient.
“Maybe that person behind the curtain shouldn’t be an anonymous eye doctor on any medical company’s panel,” Cuadros says. “But it should be your local eye doctor, who you would see anyway. Involve local eye care providers in the equation.”
Warby Parker is there to see people who can build enough confidence to leave their local optometrist and take a hybrid approach to vision care — half online, half in the Warby Parker store. But as it expands its presence and capabilities both online and offline, the convenience of online services will be a strong selling point.
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