Opternative: Disrupting Traditional Optometry

Instead of wasting your time and money at the eye doctor, try this.

Telemedicine has been a major beneficiary of our digital world, especially when it comes to refractive technology (i.e. eye exams). Opternative is the first online eye exam that is taking advantage of the telemedicine trend and disrupting traditional optometry.

Currently, only 35% of employers offer vision insurance to their employees [2]. Those who pay out-of-pocket spend between $50 and $250 [3] — Opternative costs $40 [4]. Not only does telemedicine provide more access to low-cost prescriptions, but also increases consumers abilities to purchase eyewear online, especially for those who are price sensitive.  

What is Opternative’s business model?

Opternative is creating value for both eyewear consumers and optical companies, especially online retailers. Currently, most eye exams are administered by optometrists in the location where glasses are sold [5]. Consumers either get an eye exam and then purchase a pair of glasses from their optometrist, or visit an optical store and get an eye exam from an optometrist there.

Opternative is different and creates a unique customer promise. They’ve developed a technology that allows customers to conduct a refractive exam from the comfort of their home using a smartphone and computer. Opternative promises consumers the convenience of obtaining an eye exam anywhere at any time without an appointment, complying with regulations, and providing the flexibility to shop where you want. The American Optometry Association (AOA) has lobbied with the FTC to relax requirements for glasses prescriptions that actually serve as anti-competitive measures [5]. An example of this is the Pupillary Distance (PD). Optometrists are not required to provide PD’s on a prescription. While they are easy to measure, optometrists are not required to include them, making it impossible for customers to purchase glasses online. Now, with additional technologies, online providers have been able to measure it virtually, but it’s an extra step in the buying process that creates friction for consumers. By providing a low-cost and convenient way to obtain get a refractive exam, Opternative has made it easier for consumers to shop wherever they want.

Tangentially, one can argue that another set of customers for Opternative are alternative eyewear providers which include online eyewear companies such as Warby Parker, Zenni Optical, Glasses.com. Opternative’s promise is to provide these companies with 100% legal prescriptions that provide their customers with a prescription comparable to what they would have received had the customer gone to an optometrist.

What is Opternative’s operating model?

Getting an eyeglasses prescription is an extremely time-consuming process. For those of you who wear glasses, you know how this game goes. Whenever you want a new pair of glasses and you do not have an up-to-date prescription (which expires every year), you either visit an optometrist and purchase your glasses from him or her, or visit an eyewear boutique where you get an exam from an optometrist on hand. Whatever the method, optometrists work with the FTC to ensure that the eyeglasses shopping process remains within their ecosystem, which limits consumers ability to make purchases online which is both more convenient and can be cheaper.

Alternatively, Opternative works differently. The team has developed a technology that allows it to measure refractive error by testing your ability to recognize shapes on your laptop using your smartphone at varying distances. Upon completion, an ophthalmologist in your state reviews the prescription generated by the automated refractive exam and approves your prescription within 24 hours resulting in a signed prescription that can be used anywhere.

Opternative’s entire model relies on the digital space. It requires the ability for your smartphone to connect to their software on the website, and their ability to transmit that information to ophthalmologists to review prescriptions and sign off on it. Because of this model, they are also able to reach scale by having ophthalmologists prescribe more eyeglasses prescriptions than they would have the ability to had they had patients visit an office.

What additional steps should Opternative take?

This new method of refraction technology has been met with skepticism and pushback, especially from the optometry community. Opternative should focus on building trust with consumers by temporarily having a physical presence that creates buzz and buy-in from skeptical consumers. Alternatively, they could partner with credible online optical retailers who will jointly assume the risk with Opternative so that consumers feel comfortable spending the money on a prescription that will be sufficient for their purchase.

What’s next for Opternative?

Eyewear is being disrupted left and right, and Opternative is a business that can help fuel other online retailers. Their biggest challenge will be building credibility and fighting existing regulations, but it’s clear that Opternative is on the right path.

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[1 – Cover Photo] Jennifer Jolly, “Take an Eye Exam on Your Laptop,” New York Times, [http://well.blogs.nytimes.com/2015/09/29/take-an-eye-exam-on-your-laptop/], accessed November 2016

[2] “What percentage of companies offer vision insurance?” Zenefits, [https://www.zenefits.com/answers/what-percentage-of-companies-offer-vision-insurance/], accessed November 2016

[3] Gary Heiting & Jennifer Palombi, “Eye Exam Cost and When to Have an Eye Exam,” AllAboutVision.com, [http://www.allaboutvision.com/eye-exam/preparing.htm], accessed November 2016

[4] General Information, Opternative.com [opternative.com], accessed November 2016

[5] Anjali Kumar, “Re: Advance Notice of Proposed Rulemaking, Eyeglass Rule, 16 CFR Part 456 Project No. R51199,”, Financial Trade Commission, [https://www.ftc.gov/system/files/documents/public_comments/2015/10/00813-99442.pdf], accessed November 2016

[6] Anjali Kumar, “Re: Advance Notice of Proposed Rulemaking, Eyeglass Rule, 16 CFR Part 456 Project No. R51199,”, Financial Trade Commission, [https://www.ftc.gov/system/files/documents/public_comments/2015/10/00813-99442.pdf], accessed November 2016

Elisabeth Rosenthal, “Toward Sustainable Tabel: Breaking the Flying Addiction,” Yale Environment 360, [http://e360.yale.edu/feature/toward_sustainable_travel/2280/], accessed November 2016


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Student comments on Opternative: Disrupting Traditional Optometry

  1. Intriguing post! I personally support more efficient eye exam and prescription. However, I can see some issues raised by the online business model presented by Opternative, mainly being the potential future regulation interference. This is because while eye exam can differ itself from other medical exam, one can also argue that the two are essentially the same–there are health issues that could be detected through a physical visit to the eye doctor just as issues be diagnosed through visits to primary care doctors, while they are unlikely to be detected through online platform. For example. in the past there were people who visited doctors for contact lenses and left with a diagnosis for papilledemaI, followed by the emergency identification and removal of a brain tumor; there were also patient complaints of different vision between the eyes, which were revealed a retinal blastoma by the doctor. I think in future, physical eye clinics are likely to argue that the presence of Opternative undermines public health and thus pressure the government to impose regulatory restrictions on the operations of platforms like Opternative, thus challenging the profitability and sustainability of the business.

  2. In addition to the question posed above regarding the inability to detect conditions that may be observed when visiting a clinic, how does Opternative ensure adequate quality in their eye exams? Does allowing users to conduct exams online by recognizing shapes at different distances introduce more error into the design? Opternative may be responsible to ensure quality of exam, including user error in conducting the test. Would we want the drivers on our roads to use glasses that were prescribed without seeing a doctor?

    How does quality compare with digital exams?

  3. So interesting, thanks Divya! I can certainly see how the current system benefits optometrists. Assuming it is accurate, this software could be very useful in rural locations. During my childhood, it was necessary to drive over an hour to see an eye doctor, and many people skipped going for long periods of time as a result. In theory this would be fine for those with good eyesight, but it resulted in some serious consequences for older people who developed advanced cataracts and other age-related eye diseases. While these customers don’t have the familiarity with technology to use Opternative, I could easily see Opternative stations being set up in local clinics and administered by a county nurse.

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