Online contact lens ordering has been an issue for years, and practices have adapted.
But Internet sales channels such as Warby Parker and FramesDirect.com are also on the scene in the eyeglasses market, similar to the availability of online contacts through the likes of 1-800 Contacts and others.
The first time the issue really came to everyone's attention in the industry was with online contact ordering, said Dr. Donna Buraczewski, immediate past president of the Harrisburg-based Pennsylvania Optometric Association who practices in northeastern Pennsylvania. The association represents more than 1,250 doctors of optometry in the commonwealth.
In both cases of patients ordering online, quality control is the chief concern, Buraczewski said.
Through the American Optometric Association, the profession worked to get federal legislation passed to bring compliance rules to online ordering, she said.
"Our biggest concern was that people, you know, we write a prescription for one year for contact lenses, and they'd be able to have that renewed forever and ever," Buraczewski said.
The subsequent rules require online retailers to verify with the practice that a prescription is valid, correct and not expired, she said.
At the same time, availability online has led to billing and sales changes, Buraczewski said.
Patients buying contacts online do have advantages, Buraczewski said — mainly because they don't have to wait until the doctor's office is open to reorder. So practices have entered the online ordering realm themselves.
"I think most doctors are trying to be more Internet savvy, having people order them through our websites or some other way, (such as) email, so that we can help our patients get the contacts correctly," she said.
Lebanon County-based Lebanon Eyecare Associates has direct Internet ordering for contact lenses in addition to a phone ordering option, General Manager Robert Rittle said.
Patients get prescription copies, and they can sign up for the Internet option so they can have the contacts shipped directly to them from the company's supplier, he said.
"There are a lot patients who are doing 1-800 Contacts or things of that nature, so to give us a bit of a leg up, we also allow them to order online," Rittle said. "It's just as if they had ordered them from us."
The practice does offer some remote ordering of eyeglasses, such as a replacement of a pair under warranty if a student is away at college, he said. Lebanon Eyecare can replace them by mail if the person contacts them, or the practice can send a copy of the patient's prescription to get a pair, Rittle said.
The office has seen people try on frames, write down information and leave, he said. But its philosophy is that if the staff treats patients well and they have a bad experience ordering online, those patients will buy from the office the next time, Rittle said.
"The best way to sell glasses is to have the patient put them on their face," he said. "Online still requires a brick-and-mortar building with opticians."
Also, a practice years ago might have included the cost of its professional services with the price for glasses or contacts, Buraczewski said. Now, it's important to show the patient what the separate charges are for the practice's services and the products separately. Buraczewski said she does attribute the change to online options.
Buraczewski's practice does not see many cases of patients ordering glasses online, although it might be an issue in larger cities, she said. For that matter, online contact ordering isn't a huge share of her patients either, Buraczewski said.
But there have been a few patients who have ordered eyeglasses elsewhere, and they have raised the question of whether the practice should charge for a fitting if the patient comes in after the order, Buraczewski said. Normally, the fitting would be free if the patient bought the glasses from the practice, so in the limited number of these cases, the staff has done it for free, she said.
"At this point, we are still wrestling with the question," she said.