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Although mobile refraction is relatively new and accounts for only a small number of the total refractions performed in the U.S., the technology and its purveyors are coming under fire from some optometric organizations as well as independent optometrists.

As Vision Monday recently reported, Blink, the on-demand, mobile refraction service that launched in New York City this spring, is encountering pushback from state and national optometric associations. In a complaint filed July 7 with the New York State Education Department and Office of Professional Discipline, The New York State Optometric Association (NYSOA) claims that the business model behind Blink is “fundamentally inconsistent with New York State law and regulation and may pose a significant risk to the health of New Yorkers.”

NYSOA filed the complaint following a June 19 presentation by Blink before the New York State Board of Optometry. In its complaint, NYSOA objects to Blink’s use of unlicensed visioneers to perform refractions, and claims that the Blink employees may be violating the law by exceeding the scope of practice.

A Blink “Visioneer,” (r) collecting and recording a patient’s health data.
One of the special vehicles used to transport Blink Visioneers to patients.
The Blink toolkit consists of three compact,
handheld devices: the Netra, which measures the eyes’ optical power through an interactive test, the Netrometer, which reads the prescription of existing eyeglasses and the Netropter (pictured here), which tests new optical powers to fi nd the patient’s optimal prescription.

The complaint also claims that licensed optometrists working with Blink may violate New York state rules by delegating “patient evaluation and data-gathering tasks to the Visioneers” while failing to supervise them appropriately. NYSOA also objects to what it claims is illegal fee-splitting between an unlicensed referral service and a licensed practitioner.

“We are concerned, regardless of whatever disclaimers Blink might make, that patients who receive mobile refractions from unsupervised and unlicensed ‘Visioneers’ will assume that they have received a comprehensive eye health examination,” NYSOA president Michele Lagana, OD, said in a statement.

NYSOA is asking the Department and Office of Professional Discipline to review Blink’s operations and policies and stop its operations in New York State if Blink is found to be violating state law and regulations. When NYSOA filed its complaint in July, Blink founder David Schafran told VM, “We are aware of the complaint. However, we are not yet prepared to comment, given the formal nature of the complaint and the request by the NYSOA for an investigation.”

The American Optometric Association (AOA) supports NYSOA’s position, stating that there is no substitute for an in-person, comprehensive eye exam. “AOA is not opposed to cutting-edge technology. But AOA is opposed to bad patient care,” AOA president Steven A. Loomis, OD, said in a statement. “When technology is abused in a manner that undermines the critical doctor-patient relationship, the AOA will speak out and act to insure patients receive the care they deserve.”

The AOA has also been critical of online refraction services. On its website, the organization said, “While online programs tout consumer convenience, albeit with ambiguous and sometimes inaccurate claims, the AOA contends there are severe pitfalls in separating refractive tests from annual comprehensive eye exams performed in-person by an eyecare professional.”

“The AOA continually monitors and advocates for the public in many areas,” said AOA immediate past president David A. Cockrell, OD. “We are concerned where violations of Federal or state law might exist. The AOA and our state associations will be monitoring and pressing for enforcement of all regulations and statutes. If state or federal laws need to be clarified or made more specific to better protect the public, we will advocate in every arena for passage.”

Dr. Loomis, called upon the American Academy of Ophthalmology (AAO) to rebuke what the AOA characterized as “dangerously misleading product claims” made by “online eye exams”—a thinly veiled reference to Opternative—and work with the AOA “to safeguard public health and healthy vision.”

The Illinois Optometric Association (IOA) and the Michigan Optometric Association have also challenged Opternative’s business model.

akarp@jobson.com