Saving on Eye Care: Bargains and Risks

Why cutting costs on eye care sometimes goes too far.

Medically Reviewed by Laura J. Martin, MD on April 24, 2012
5 min read

In a tough economy, saving money is on everyone's mind. But when it comes to eye care, experts say that what you do to save money today may put you at risk of much higher costs in the future.

"As people try to ration their income, they will often choose to forgo or skip their routine eye exam," says Samuel Pierce, OD, a Trussville, Ala.-based optometrist and a board member of the American Optometric Association. "It's penny-wise and health care-foolish."

According to the CDC, 61 million Americans are at high risk of losing their eyesight, yet only half that number saw an eye doctor in the previous year. Pierce says that many people equate the health of their eyes with their ability to see. If they don't have vision problems now, or they have glasses that correct their vision, they often believe that their eyes are doing just fine.

The trouble is, blinding diseases such as glaucoma, macular degeneration, and diabetic retinopathy -- the top cause of blindness among U.S. adults -- often don't have any noticeable symptoms until after the disease has progressed to a point where the damage is irreversible. Caught early, however, many eye diseases can be treated before they do permanent harm.

"Never equate how well you see with how healthy your eyes are," Pierce says. "That is the biggest misconception out there."

Ophthalmologist Mark Fromer, MD, agrees.

"There are all kinds of systemic diseases, but people like to think it is all about eyeglasses and don't see the bigger picture," says Fromer, who practices at Lenox Hill Hospital in New York and is the eye surgeon for the New York Rangers hockey team.

Fromer says that patient education plays a big role in how often people see the eye doctor, but budget is an important factor as well. When he talks to patients, he puts eye health in perspective by comparing it to skydiving and brain surgery.

"You don't want a budget parachute or a budget neurologist, do you?" Fromer says.

The American Optometric Association recommends adults ages 18-60 who have no risks for eye disease have an eye examination every two years. Adults 18-60 at risk for eye disease should get an eye exam every one to two years or as recommended by your eye doctor. Those who are ages 61 and older should get an eye exam annually or as recommended by your eye doctor.

"There are lots of blinding diseases without symptoms up front," Fromer says. "That's why it is so important to come in early and be tested."

Skimping on routine care is not the only place where budget seekers can run into trouble. Where and how you get your glasses can also be a problem. Pierce points to online eyeglass retailers in particular. They may offer low prices, but he says that too often, what you get for your money are cheap, inaccurate, and unsafe glasses.

For a study published last year in the journal Optometry, researchers ordered 154 pairs of glasses from the 10 most heavily trafficked Internet eyewear retailers. Nearly half of the lenses either failed to match the prescription submitted or did not meet impact safety standards, meaning they would be more likely to shatter if something hit them.

The study authors found other problems as well. Some vendors did not bother to verify prescriptions with the prescribing doctor before filling them, even though some states to which they were being shipped require such verification. Finally, the authors point out that, as far as they could learn, no one is overseeing the online eyewear industry.

Safety and accuracy are not the only considerations when shopping for glasses. A proper fit is also important. Some sites offer customers the ability to upload pictures of themselves, which can then be used to create a virtual image of the customer wearing a selected pair of glasses. But, Pierce points out, that doesn't give customers a complete picture.

"How can you look at a computer monitor and know how well the glasses will fit and how heavy they will be?" asks Pierce, founder and senior partner of Trussville Vision Care.

Richard Schoen, OD, says that certain essential measurements, such as the distance from the center of one pupil to that of the other pupil, should only be made by an experienced eye care professional.

"You want a real human being to work with you," says Schoen, an optometrist at the Wilmer Eye Center at Johns Hopkins University in Baltimore.

Schoen is also concerned about what recourse online customers will have if things go awry.

"What would happen if the customer can't adapt to the frame or prescription? Are there returns? Remakes? Redos? I'm not aware of any governing body standing behind online ordering," says Schoen. "These are new frontiers."

Pierce advises patients to use the Internet as a way to educate themselves about what is available, to find frames that they think they might like, and then seek out a local store that can fit them properly with a pair of glasses that matches what they need and what they want.

"In my mind, the online experience could be positive if it is used as a means rather than an end," Pierce says.

But there must be a way to save money on eye care, right? In fact, there are several.

Pierce says that these days, more and more of his customers are keeping their old frames when they update their prescription. For most people, that will be the best way to keep costs down.

"The frame accounts for roughly half the price of new glasses," Pierce says. "So if your current frame is in good condition, keep using them."

If you have to have new frames, skip the designer brands and go with the generic. Pierce says the only difference in the frame itself may be the name printed on it. The difference in price, on the other hand, can be quite significant.

Pierce also says that close-outs or discontinued models might be available at a low cost. However, they might not be on display, so be sure to ask if any are in stock.

Schoen says another way to save money is to make use of budget eyewear chains, but first do your homework. He says that the quality of care can vary from place to place.

"The most dependable way to find a place that does good work is through word of mouth," Schoen says. "Talk to your friends first and see where they have had good experiences."

Lastly, both Pierce and Schoen say there is nothing wrong with a cheap pair of reading glasses like the ones found at the supermarket or drugstore.

"If that is all you need, that is all you need," Pierce says.

But both of them also say that even if you need nothing more and can save money that way, that doesn't mean you can skimp on your eye exam.

"There's definitely a place for OTC eyewear," Schoen says, "but only if you are also getting your eye health screened."