This is apparently becoming a bigger and bigger issue in the U.S. First, some background. The main player is currently Opternative. My understanding is that they are the refraction service that one gets at 1-800 contacts.

$50 for a DIY test.

1-800. But the (opternative?) test is currently free. (for a limited time)

$40 at

Then there's things like this (Bottleneckers):

And this (Huffingtonpost):

And lobby groups like this:

And cool videos like this:

So is this the end? Will patients will stop coming to us becaue they can do it at home for half (or less, or none) of the cost?

Call me a bit skeptical, but I don't see THIS being the end. Can it move the needle? Perhaps a bit. For the 20 year old college student who is out of CLs, and whose Rx expired last year, and whose Rx hasn't changed in 3 years, will certainly prefer doing it at home, rather than forking out $90 for an eye exam. But for a 45 year old fully-employed person wanting an Rx update... Eye exams just aren't THAT inconvenient (in terms of time and cost) for people to find any means possible to circumvent it. And it's not as though the DIY is super-duper convenient either. My computer room as set up right now, doesn't allow me to step back 20 feet (or whatever) from my computer screen without having me bump into things. And you have to figure out how to do it also, even if it is "easy". The alternative is the patient pays $80, and has to find time to run to the mall for the eye exam, a trip that'll take maybe 1 hour out of their day. And there's no need to figure anything out. And they can do shopping at the same time. The gain/efficiency of DIY just doesn't seem that significant to me.

Again, will some people opt for this? Absolutely. But I don't see any 20-somethings doing online DIY indefinitely. Some of them will every few years check in at an optometrist "just to make sure" everything is OK. And certainly no "elderly" people will DIY. So I don't see onine refraction causing optometrists to end up on breadlines. But I think it's unfortunate this has to actually be discussed.