COLORADO SPRINGS Federal regulators have stepped up oversight of eye care providers across the country, issuing cease and desist letters in response to reports that some are not complying with consumer protection laws. Central to this effort is a rule requiring providers to give patients their prescription information immediately after an eye exam.
The Federal Trade Commission (FTC) has received reports that some eye doctors are not providing this prescription at the end of appointments a practice that violates federal law. Patients have a legal right to receive their prescriptions, allowing them to shop for eyewear freely and compare pricing.
1. What the Eyeglass Rule Requires
The Eyeglass Rule, enforced by the FTC, states that ophthalmologists and optometrists must provide patients with a copy of their prescription, even if the patient doesn’t request it. This must be done before the provider or any staff member offers to sell eyeglasses.
A prescription, as defined by the Rule, must include:
- Patient’s name
- Exam or issue date
- Expiration date
- Doctor’s name, contact information, and signature
It must be complete and legible. Some states also require pupillary distance (PD), and while not mandatory federally, the FTC encourages including it if measured.
2. Timing and Cost Conditions
The prescription must be given immediately after a refractive eye exam, regardless of why the exam was conducted or whether the patient paid separately for the refraction. Patients shouldn’t be charged extra or asked to complete forms to receive it.
3. Staff Training and Enforcement
Front desk and clinical staff must be trained to hand over prescriptions automatically. Simply asking if the patient wants it isn’t enough. If a patient declines, it must be documented.
Prescriptions must be provided before any sales discussion. This prevents providers from using the prescription as leverage to pressure in-office purchases.
4. Business Motives Behind Withholding Prescriptions
Some providers withhold prescriptions to secure in-house eyewear sales. As Sydney Detrolio, an optical manager, points out, many practices rely on selling glasses as a business model.
The FTC is clear: doctors cannot require patients to buy lenses or sign waivers in exchange for their prescription.
Patients must understand their rights. As Ms. Detrolio advises, always ask for a signed copy with exam and expiration dates. An expired prescription will be rejected elsewhere.
5. Digital Prescription Delivery Rules
Digital prescriptions are allowed only if the patient agrees in writing to this format. Paper remains the default option.
If sent digitally, the patient must be able to access, download, and print the prescription. If via portal, it must stay available for the life of the prescription.
Timing still applies: it must be delivered immediately after the exam and before sales offers. Consent records for digital delivery must be kept for at least three years, and longer if reuse continues. Patients can revoke consent anytime.
6. Confirmation of Prescription Receipt
Practices with a financial stake in eyewear sales must ask patients after providing the prescription to confirm in writing they received it. This cannot be buried in pre-appointment paperwork. Confirmation records must be retained for three years. A digital copy can also serve this function.
7. Non-Compliance Penalties
Violating the Eyeglass Rule can result in fines over $50,000 per violation. State agencies also enforce rules and may issue penalties for systemic failures.
In California, Stanton Optical received 21 citations in 2018 that could lead to over $655,000 in fines. The company is appealing the decision.
Alleged violations included:
- Advertising free eye exams without a license
- Filling prescriptions without proper registration
- Failing to submit timely renewals
- Operating as a dispensing optician without authorization
8. Administrative Proceedings
Shara Perkins Murphy of the California Board of Optometry confirmed that Stanton’s appeal is being heard. An administrative law judge will recommend a decision for the board’s final review. The board can either adopt or independently decide.
Craig Steinberg, O.D., J.D., representing one Stanton location, argues that the fines may be arbitrary if mitigating factors aren’t considered.
9. Additional Legal Action
In 2013, the Ohio Attorney General sued Stanton Optical after nearly 80 complaints. The case ended in a 2015 consent judgment, requiring restitution and compliance payments of $6,588.69 each. Ongoing disputes are resolved through informal mediation.
Stanton Optical may also face scrutiny in Oklahoma. The Medical Board has acknowledged receiving information from the Optometric Board but offered no comment on any investigation.
10. Technology, Business Models, and Regulatory Debate
Vision Precision Holdings (VPH) parent of Stanton Optical and My EyeLab uses telemedicine eye exams. In 2018, it announced a partnership with Visibly (formerly Opternative) to offer online prescription renewals.
However, the American Optometric Association (AOA) has repeatedly raised concerns about such apps. The AOA points out these tools lack FDA approval and may lead patients to skip vital comprehensive eye exams.
The AOA maintains that separating refraction from full eye health evaluations risks leaving conditions undiagnosed. Dr. Christopher Wolfe of the AOA states this undermines the doctor-patient relationship and could result in preventable vision loss.
The AOA recommends high standards for telehealth tools and has lobbied federal agencies over regulatory violations by online eye testing companies.
11. Clashing Views on Eye Exams
The CEO of Stanton Optical has labeled traditional eye exams “archaic” and “tedious.” Dr. Wolfe argues this attitude prioritizes sales over patient well-being and underlines the conflict between retail interests and healthcare standards.
