Ever since the dawn of online eyeglass sales, technology trend watchers have speculated about the possibility of online refractions. Technical barriers existed, but many believed it would only be a matter of time before someone figured it out.

That someone has now emerged in the form of a Chicago-based company called Opternative, which recently announced plans to market a digital refractive eye exam that can be self-administered by anyone with a computer and an Internet connection. The resulting Rx would be certified by an ophthalmologist.

Opternative is working with the National Institutes of Health to conduct a study to test the accuracy and efficacy of its system, which they believe compares favorably to traditional refraction. (Full disclosure: Opternative co-founder Aaron Dallek spoke at VM’s Global Leadership Summit.)

Predictably, the prospect of online refraction is receiving mixed reactions in the industry. The AOA quickly issued a statement cautioning consumers that online eye tests are no substitute for an in-person comprehensive eye exam by an optometrist or ophthalmologist. Whatever forms online refraction ultimately takes and no matter who offers them, this new technology is likely to appeal to some consumers, particularly those who prefer the convenience of shopping for eyewear online. Just as online retailing once did, online refraction threatens to disrupt the status quo, in this case by empowering patients in a way that fundamentally alters the traditional doctor-patient relationship.

By doing so, it raises many questions such as who should control the Rx, what methods are acceptable for refraction, what should the tolerances be for refractive error, and who should be liable in the event of an error in measurement. Although these questions have yet to be answered, one thing seems clear: the ensuing debate will help prepare us for the changes online refraction will inevitably bring. ■

akarp@jobson.com