A nonprofit publication of the Kentucky Center for Public Service Journalism

Commentary: Eye care legislation restricts innovation, dictates how doctors treat patients


By Dr. Saya Nagori
Medical Director/Simple Contacts
 
The Kentucky General Assembly is currently considering legislation, House Bill 191, that is bad for innovation, bad for consumers and bad for the health care system overall. House Bill 191 would radically restrict emerging ocular telemedicine technologies and undermine physicians’ ability to treat patients in the way they see fit.
 
Physicians go through rigorous schooling, training, licensing and certification, and ultimately, we trust doctors to make the best treatment decisions for their patients. With HB 191, optometrists, who are not medical doctors, are trying to use legislation to dictate how medical doctors deliver care.
 
The issue behind these provisions is an emerging telemedicine technology that addresses a simple problem: 79 percent of the time a contact lens user visits an optometrist to renew a prescription, they leave with the same prescription they arrived with. These trips, and the accompanying examinations, are costly and time-consuming, causing many patients to wear their lenses beyond the recommended timeframe. Over-wearing contact lenses is one of the leading cause of eye infections and other medical issues for contact lens wearers.
 
Innovations in mobile technology allow patients today to refill their contact lens prescriptions in a much more efficient and cost-effective way. Mobile app platforms such as Simple Contacts administer a basic vision test and anterior segment assessment that’s a fraction of the cost of an in-person optometrist visit and can be done from the comfort of a patient’s home.

Dr. Nagori

Each test is recorded and reviewed by a Kentucky licensed ophthalmologist who can renew the patient’s existing contact lens prescription. The physician cannot change, modify or issue a patient’s very first contact lens prescription — in the event of a change that could signify ocular or other health concerns, the patient must have an in-person appointment. 
 
This is not a replacement for a full eye exam. Instead, it is a way for physicians to treat low-risk, asymptomatic patients safely while saving time, money and resources for everyone involved. The technology works, and no physician would ever risk their reputation and license or endanger patient safety if they did not believe it to be completely safe or in line with medical best practices. In fact, the American Academy of Ophthalmology currently recommends comprehensive, in-person eye health exams for healthy adults who do not have risk factors for eye disease every five to ten years for patients under 40; two to four years for patients 40-54; one to three years for patients 55-64 years and one to two years for patients 65 years and older.
 
However, like other entrenched industries facing new competition, optometrists are using scare tactics and misinformation to vilify their competitors and have appealed to the legislature to intervene as just another business strategy.
 
HB 191 restricts telemedicine in such a way that physicians would no longer be allowed to use innovative, cost-effective services like Simple Contacts to renew a patient’s prescription. Kentucky should be embracing technologies that save health care costs, create efficiencies and encourage patient choice, rather than shutting them out.
 
Opponents of the technology have done much to muddy the waters with false claims that automated kiosks or a smartphone app are issuing prescriptions and that patients have been harmed through using our technology. Of the thousands of patients who have used Simple Contacts for vision exams, not a single one has reported any issues.
 
As a board-certified ophthalmologist, I can attest to the safety and efficacy of Simple Contacts’ platform. Requiring low-risk, adult patients to visit an optometrist or ophthalmologist in-person simply to leave with the same brand and strength contact lens is wasteful, especially when a medically valid and safe telemedicine alternative exists. HB 191 is nothing short of protectionism dressed up as patient protection, driven not by medical standards, but by the economic interests of a special interest group.
 
Ensuring patient safety should always be health care providers’ number one priority. That’s why everyone can agree that creating commonsense regulations to ensure only licensed physicians or optometrists are using technology to write or renew contact lens prescriptions is a valid and worthy objective. But these regulations shouldn’t come at the expense of innovation and a patient’s right to choose the care that works best for them.
 
Dr. Nagori is Medical Director at Simple Contacts, Chief of Glaucoma Service at Mount Sinai St Lukes, and Clinical Instructor at NYU Dept. of Ophthalmology and NYU school of medicine.


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53 Comments

  1. Robert Fleischer says:

    Of course YOU don’t charge anything for your opinion about their exam.
    Who checks their anterior segment.
    The reason patients wear their lenses too long is because they don’t want to pay for an exam is a reason. In Ohio we allow 2 yrs and the still over wear their lenses. With eye insurance the pay very little and they still over wear their lenses.

  2. Dr. W says:

    A contact lens fitting is a comprehensive exam ensuring the ocular health of the patient is prioritized over fulfilling a prescription. A board-certified doctor of optometry doesn’t dish out an automated Rx because taking care of the patient’s needs and good patient education is critical for maintaining healthy CL habits.
    She should be ashamed to mock another health profession in the name of telemedicine.

  3. james levinson says:

    I thinks its only fair that you disclose your conflict of interest and inform the public that you are a paid spokesperson for simply contacts.

  4. Alex says:

    She is the Medical Director for Simple Contacts. I see no reason to question her opinion here. Lmfao.

    • Dr. S says:

      If you don’t read things critically, you’ll believe anything anyone publishes. You can’t judge an authors credibility just by the title they’re given. Try thinking about her opinion with a critical eye. You seem like someone who’d believe anything to be true just because they call themselves a director.

  5. Justin Bazan, OD says:

    A video selfie is not standard of care. A slit lamp evaluation of the Cornea and the contact lens on the eye is. You should be ashamed of yourself as all the simple contacts app is, is a way to sell contacts to people who are conned into thinking they got a contact lens exam.

  6. Dr. N says:

    How in the world do you access the anterior segment of an eye without having a patient present behind a slit lamp?! Please explain that one. Contact lenses are medical devices. They must be properly fit and reevaluated by an eyecare professional (optometrist or ophthalmologist). Eye health can change at any time. How would you see neovascularization, corneal ulcers, dry eyes, CLARE, GPC, abrasions, “tight lens syndrome”, endothelial damage, and any other hypoxia related condition……without having a patient and proper equipment?

  7. An exam “every five years” would have been deadly to my 36 year-old healthy, asymptomatic Contact Lens wearing patient who developed choroidal melanoma in her right eye. You, of all people, should realize the number of patients diagnosed with systemic illnesses through “routine” eye examinations. Many of the patients we see yearly have no primary care physician, so we are the only health screening they receive. HTN, Diabetes, Thyroid conditions. An app won’t catch these – and your viewing a photo of their fundus and reviewing their VA’s won’t either. Shameful to put profit before good quality care.

    • Dr. N says:

      Yup….or the 14 year old patient of mine whom I, an optometrist, diagnosed with bilateral papilledema (sent for an MRI, was a brain tumor, had a craniotomy that same week!) Neurologist called and told me if it had gone just a day or 2 longer, she would have stroked and died. Did you read that Dr. telemedicine OMD? If she had done her “exam” with you, she would have DIED!

      • Sian Liem OD says:

        The exact same thing happened to my 17yo patient with no complaints and 20/20 vision and my 42yo patient who, despite having 20/20 vision, had a homonymous hemianopsia due to a brain tumor. These two people are alive today because a lowly optometrist picked up problems that this app could not in a million years.

      • Dr B says:

        That can’t be right because you are an optometrist, not a medical doctor.

    • Lan Nguyen says:

      I had a 42 year old WM who came in because he couldn’t read up close; last eye exam was 2 years prior with dilation; I found a stage 4 choroidal melanoma which had to be enucleated (removed); I manage to save his life but not his eye.

  8. Stephanie says:

    Oh good! I see you are a glaucoma specialist! Now I know if I have glaucoma you can diagnose it online. Awesome!

  9. Lan Nguyen says:

    I respect Ophthalmology as it was my foundation but for you to criticize another respectable profession for an App, your intentions are clearly established…for sole purpose of your pockets. While you are trained to be great at what you do with ocular surgery, Optometrists are trained to be great at the refractive aspects of the eye including a CL exam. You should know that CL is a medical device that requires a proper fit and assessment annually to see if their is any complications from their current Cls and their wearing schedule. Are there any pannus, neovascularization, infiltrates, papillary hypertrophy when lids are everted? And if any, what are the causes, materials, solutions, allergies, overwear? How are any of these assessed through an online app? An in person annual exam is to ensure proper wear and good ocular health to “prevent” over wearing. You are trying to sell convenience and saving money at the cost of your patients eyesight, and come in when there’s a problem? This is like selling car tires, no one looked at them to ensure if the treads are decent to drive or see if they are affecting the alignment which can damage the car, and if the tires blow, than come in and you’ll replace it? At least the tires can be looked at with the naked eye and are replaceable, your gift of sight isn’t.

  10. Roger A says:

    Who promotes not going to the doctor? In all my life I have never heard of any health professional, no health publication, book or article, no health advocate of any type ever promote NOT going to the doctor. What is different here? It’s a business just trying to sell a product with no concern but making money.

  11. Jennifer Stewart OD says:

    Do you treat and manage your glaucoma patients with a selfie? You are very misguided and giving dangerous advice under the guise of your “specialty”- you actually have no right to speak about the deliverance of care of something you are not an expert in. How many classes did you take in proper contact lens management? This is very dangerous advice you are giving to the general public, and I hope every person reading your article sees who pays for your information. I’m very glad I have reputable glaucoma specialists to refer to; you do not seem to be competent. You are picking the wrong battles and the wrong allies. Very sad to read.

  12. Ron G says:

    Crazy dangerous Doctor should be run out of the profession. Sell out with no concept of the dangers associated with this plan. FIRST RULE: DO NO HARM!!!!!!!!

  13. Ashley B says:

    Using telemedicine appropriately is not a bad thing, BUT what you are doing here is Disgraceful. You know full well as an ophthalmologist, and a glaucoma doc at that, the importance of yearly eye exams. And to slander your optometrist colleges..you ma’am are part of the ongoing problem between our two professions. She is a payed spokesperson everyone so I would take this article as the cheap advertisement with empty, cash minded medical advice.

  14. Dr Wood says:

    A glaucoma specialist recommending no physical interaction between a doctor and patient is irresponsible. You do realize IOP is checked at every annual exam correct? Their anterior segment health is obviously not important to you, now you’re proposing we ignore IOP too? Shame on you.

  15. Kurt Steele says:

    An ophthalmologist accusing an optometrist of misinformation to prohibit doctors from providing care as they see fit is one of the most jaw dropping, hypocritical things I have ever read. Just wow. So someone with a very direct financial interest in this company who belongs to a profession that has put out more misinformation about optometry than can be fathomed writes this. I feel sorry for her patients because I can’t imagine being so morally and ethically corrupt.

  16. Darryl Greggs says:

    I could not toll my eyes hard enough with this story. Her statements are 100% her own opinion. Her statistics are imaginary. What a complete buffoon of a woman. She’s a con man, trying to get paid to do medical work without actually having to “deal with troublesome people.” Ugh, she’s a slimy excuse for a professional. It’s obvious all she cares about is money. She should just marry a rich dude; fewer people would get hurt.

  17. Dr. M says:

    I don’t even see how a Doctor would ever consider or suggest this! She must be getting paid heavily from Simple Contacts.. This isn’t practicing medicine, this is just a way to make money selfishly.

  18. Dr. P says:

    As a fellow eye DOCTOR and optometrist, her statements are extremely concerning to me. An annual routine eye exam in person can detect serious health conditions. An online evaluation can never replace this because you lack the basic tools to properly assess an individual’s ocular health. She is promoting something that is not in the best interests of our patients. “Do No Harm”

  19. Heather says:

    So let me get this straight… you’re a spokesperson for an online company that you get paid from if people do NOT go to the doctor. Yet you treat glaucoma in person (never through an online exam) which is potentially BLINDING, generally PAINLESS, and usually isn’t diagnosed until a doctor finds it in an actual EXAM. Man. You are the EXACT person I’d want to listen to about this… sarcasm should be detected. You’re not biased at all… lining your pocket at the expense of unknowing patients who may have a sight threatening or even life threatening condition. I would never want to call you my doctor. Or colleague.

  20. Scott B says:

    This “lady” is clueless….seriously? Don’t fall for this MD who is biased and being paid off!

  21. Paul K says:

    Commoditizing eye exams now? Wow! You really should be ashamed of yourself and anyone who cares more about their fat bank account more than their profession? Did the Hippocratic Oath mean anything to you? American Greed is what you committed yourself to. Amazing how greed will change people.

  22. Ken says:

    What if I only want the free trial contacts? Do you send them to me?

  23. Peter Bui says:

    Dr. Nagori is putting profits over safety and ignores the countless problems that can arise from wearing contact lenses. A selfie picture will never be able to replace a thorough slit lamp examination and let alone an accurate contact lens prescription.

  24. Jake says:

    I have lost total respect for this M.D. That’s like giving an antibiotic for a red eye without evaluating the cause. Is it an infection? A foreign body? A virus? Glaucoma? Herpes? How can an medical professional prescribe a medical device without evaluating the cornea, fit and vision. Guess money must be good for taking a few seconds to approve an rx without any evaluations. Hope she gets investigated on this one and lawyers jump on the first sight threatening corneal ulcer this doctor approved contacts for.

  25. Neety K says:

    With all due respect, the issue is not about OMD or Optometrist, but rather, how are you able to view the complete anterior segment health from a mere photo? How does this replace a physical slit-lamp exam? How do you check the integrity of each plane of the anterior half of the eye? If this is something that you are claiming to be able to do with your app, then you should be able to explain in precise medical detail how a photo assessment let’s you reach the same conclusions as would a slit-lamp exam. Failing to outline your exact method or procedure leaves quite an unsettling feeling.

    The fact that a good percentage of asymptomatic adult patients show no change in their contact lens prescription or brand is not sufficient grounds to prove that an in-person visit is not needed,that too, especially when it is being replaced by simply photo-speculation. What is worse, you have evaded from outlining the entire process of how these photos are exactly analyzed and are unable to show that this technique will work equally well or superior to a slit-lamp’s capabilities.

  26. Daniel Galle says:

    This article quotes “without risk factor” eye exam frequency when discussing contact lens wearers who are one of the highest risk populations for anterior segment complications. Sad to see safety painted as “scare tactics”.

    It is simple fact, the more frequently you have a slit lamp exam the more likely you are to find potentially asymptomatic complications such as encroachment or sub epi infiltrates. Get an annual exam with slit lamp views if you want to wear contacts. Anything less is dangerous.

  27. Dr. Ivana says:

    Wow. I’m utterly disappointed at what I just read. I respect ophthalmologists because they’re my colleagues and together we help and treat people with eye problems and prevent eye problems. However, you should be ashamed of the statements you’re writing in this article because you’re misguiding people about us as optometrists and about eye safety. I hope you rethink what you claim in this article because it’s absolutely ridiculous. I had a patient that actually did her exam via “virtual eye exam” and after she got her prescription she still couldn’t see well. She came to my office, not only was she under corrected with her astigmatism but the contacts she received were too tight on her cornea……which can lead to severe corneal neovascularization. Another patient came to my office for contact lens exam because he’s been using the same pair of contacts for over three years because an online source kept renewing his prescription…….he started getting headaches………not only was he overminused but he had three retinal holes……completely asymptomatic. Retinal specialist stated that if the patient was not examined by me (optometrist) and referred out for retinal treatment he would have had a retinal detachment. What would you say to these statements? Please don’t disrespect another profession (a close profession to your own) and your own profession in order to possibly get a financial gain by promoting this app…it’s unethical and unprofessional.

  28. Joshua McAdams, OD says:

    Does she even carry contact lenses in her office? When is the last time a glaucoma specialist fit a contact lens? None of the great glaucoma specialists I’ve worked with would even consider dabbling in this effort. Feels like a money maker to me.

  29. GCE says:

    Weird!! AND for people who have diabetes, high blood pressure, birth control pills AND glaucoma; they leave with the SAMA medicine prescription every time too! Does that mean no copay or office visit billing because the doctor didn’t change anything!?! You are a disgrace and a danger to the general public and should be ashamed.

  30. Virtual Doc says:

    I work in telemedicine. It’s a promising field that wil revolutionize medicine. This is not telemedicine this is snake oil mixed with greed and laziness. Do better Doctor Its medicine not money

  31. Pj says:

    What a sham. How much is Simple Contacts paging you as a medical director to spew this opinion out?

  32. Lan Nguyen says:

    I had a 14 year old pt who I saw for a Cl exam, she didn’t want her eyes dilated, neither did her mom bc they thought since she’s young and healthy, everything should be fine esp since she was dilated 2 years ago and “asymptomatic”. I encouraged a thorough exam and found a Retinal Detachment superior temp quadrant in her right eye in which she had surgery to repair and her prescription has now changed bc of the buckle. I asked again did you not experience any light flashes at all, she replied I thought that was “normal”. They moved out of state and returned 5 years later to visit and stopped in to see me. The pt was now 19, they stopped by and asked if I remembered them, I said refresh my memory, the 19 year old said “I just want to let you know I’m a pre med student now and want to become an Ophthalmologist so I can save ppl eyes but I want to thank you again for giving me the opportunity.” Although Ophthalmology has given me a start at my career, I am the Optometrist who has given this young patient a start at hers. I’m sure if I see her now, she will discredit this misguided telemedicine so called exam and will encourage her patients to go see an eye care provider in person.

  33. Anastasia T says:

    The iPhone anterior segment exam is literally just looking in different directions… they call it a “redness test”. And if your eyes are too red, the app will tell you to see only an OPHTHALMOLOGIST and not optometrist. I work for an well known ophthalmologist in Houston who loves optometrists. He says he has had 0 training in CL or CL complications and would prefer CL pts be seen by optometrists.

  34. BD says:

    OF COURSE she’d say that, SHE WORKS FOR SIMPLE CONTACTS! Someone has a little “conflict of interest” to disclose! All the cash rolling in for Dr. Nagori from Simple Contacts is gonna dry up if Kentucky passes this law, protect her payroll! Shameful and unethical physician behavior. You know very well the risks entailed with contact lenses.

  35. Dr. P says:

    Most ophthalmologists don’t have any interest in contact lenses, since there is not as much money involved as something they can cut or bring you back for multiple follow-ups with expensive diagnostics. As such, they’re rarely any good at contacts or vision aside from ocular health that meets the aforementioned criteria. Optometrists are many times trained in surgery, but I bet the good paid shill for Simple Contacts would not want us doing surgery for the same reasons she proposes half-a**ed CL Rx renewals.
    So why the sudden interest in contact lenses from all these ophthalmologists who are pimping out their licenses for “telemedicine”? Simple – it’s easy money. Get a contract with a company, let them use your name, and sit back and collect a few hundred checks every week for $10-20 or whatever the companies pay them. The truth is that optometrists are PROHIBITED from doing telemedicine exams because we have HIGHER STANDARDS. Ophthalmologists, who are less educated regarding contact lenses and vision, have LOWER STANDARDS because their associations have lots of money and they don’t have to maintain higher standards to maintain their power.

  36. Lance Bloom, OD says:

    “These trips, and the accompanying examinations, are costly and time-consuming, causing many patients to wear their lenses beyond the recommended timeframe.” Yep, that’s exactly why people over wear their contacts, because THE EXAM is too expensive. I’m sorry Dr. Nagori, but it’s very clear you don’t work with these patients. “Saving” some money on a contact lens exam does not mean they will go spend the extra cash on a full year supply of contact lenses. And it certainly doesn’t mean they will suddenly start wearing their contact lenses properly. Contact lens abuse and over wear will still occur, exam or not. If anything, it will occur more frequently by removing the need for a complete in-person eye exam. Your argument to support your stance is a reach, and a terrible one at that. With all your years of “rigorous schooling, training, licensing and certification” you should be able to put together a better argument. The fact that you would use that argument shows how dumb and ignorant you think your average reader is. As if they won’t see through the poor logic. At least with a yearly renewal we have a chance to educate our patients on risky contact lens behaviors.

    Here is a legitimate argument. Of the three contact lens patients I saw today, two of them admitted they wore their contacts for 3-6 months before replacing them, or in other words, “until they didn’t feel comfortable anymore.” One was in a monthly lens, the other in a two week lens. Each of them had their last eye exam over two years ago. Each stated they wouldn’t have even come in if they didn’t have to. One complained of significant daily dry eye. The other had a corneal scar just off the central axis, and said she had been having eye irritation in that eye for three weeks prior to coming in. These stories are not a one day fluke. This is a daily occurrence for me and thousands of other eye doctors. And this is only anterior segment we’re talking about. Not to mention posterior segment that needs to be examined. But you’ve already heard those powerful real life stories from other eye doctors regarding their experiences. And you throw them out saying they are scare tactics? Really? Just extremely disappointing. “no physician would ever risk their reputation and license or endanger patient safety if they did not believe it to be completely safe or in line with medical best practices” Clearly you are that physician risking your reputation/license and endangering patient safety. And with your poor logic and distinct ties to a marketing campaign, I find it hard to believe that it’s because you think it is safe and in line with medical best practices.

  37. Dillon says:

    How much did they pay you to say this? This is why you went thru so much schooling to be a fake sellout good job no respect for you no matter how ling you went to school.

  38. Dr.Gaan says:

    I have had multiple cases of young women come in for their routine eye exams having 20/20 vision with their contacts, eyes look healthy with no symptoms… then I look inside to the back of their eyes and they have Papilledema from increased cranial pressure for no reason or due to their acne medication. You want women like this to go blind… then we should support this awful M.D. who thinks we Doctors of Optometry are harming and inconveniencing people with our eye exams. Just this week, diagnosed a 54 year old man who had severe glaucoma and had no idea. As a glaucoma specialist, you should know better then to tell people they do not need to be seen.

  39. Stephanie Woo, OD says:

    I’m interested in the references of your statement regarding 79% of contact lens wearers leaving the office with the exact same Rx (because this is absolutely NOT the case in my practice). Even if that is accurate, it is a completely irrelevant fact. What if 79% of patients with high blood pressure left their primary care physician’s office with the exact same blood pressure medicine? Would you recommend that they just get a blood pressure cuff and monitor themselves and forget seeing their PCP each year? Of course not! Contact lenses are medical devices (according to the FDA) and should be treated as medical devices. A comprehensive eye exam is essential in determining if the patient’s ocular health status is even appropriate for contact lens wear. As a physician, we DO NO HARM! Diluting eye care in this way is unacceptable and unsafe.

  40. Dr. Alan says:

    I wonder if Ms. Nagori remembers how much vision a patient has to lose before they report vision loss to their optometrist? No? It’s 50%. You know what catches glaucoma, her ‘specialty,’ before it gets to 50% loss?
    Routine annual eye exams! She clearly doesn’t want to practice medicine anymore because she’s seen how lucrative it is to sell out patients to greedy corporate interests.

  41. April says:

    “The physician cannot change, modify or issue a patient’s very first contact lens prescription — in the event of a change that could signify ocular or other health concerns, the patient must have an in-person appointment.”

    Just making sure I have this correct…you are stating that patients should pay “a fraction of the cost” to take a selfie to get a “renewed” yet the same contact lens prescription they already have (since you can’t modify or issue a first CL Rx) vs paying more for a comprehensive eye and contact lens exam that provides both a complete eye health check and an up to date prescription?

    You call yourself a glaucoma specialist, so you of all people know the importance of a complete IN PERSON eye exam. Nothing else can substitute. And you also know very well that patients can present as 20/20 but still have vision threatening issues looming- a lot like a patient of mine who failed to get a comprehensive eye exam for many years, presented as 20/20, and unfortunately had very advanced glaucoma (something your vision test would more than likely miss). I diagnosed him as legally blind that same visit.

    This bill isn’t about profit, this bill is about eye care providers fighting for what’s best for patients because we KNOW what’s best. We didn’t go to years of schooling to encourage patients to decide what they think is best or WebMD their ailments. You only cheapen your education by not educating patients on the importance of comprehensive eye exams just to support your cheap “vision test”.

    Shame on you for selling out and putting profit above patient care. If that’s your mentality, perhaps you should reconsider your profession.

  42. Kerry Gelb, O.D. says:

    Ms Nagori’s dangerous advice would have blinded my 22 year old contact lens patient. Thanks to those drops that are now being demonized by online refraction companies that widen the the pupil during a comprehensive eye exam, I would have never diagnosed his retinal detachment and he would be left with only one eye. This patient went on to become a retinal surgeon and is now saving eyes. Ms Nagori is denigrating a whole profession that saves lives and eyes. Over 170 systemic diseases manifest in the eyes and often the the Optometrist is the first to diagnose; thyroid disease, MS, myasthenia, brain tumors, high blood pressure, diabetes, etc.

  43. Dr Jenny says:

    I am so glad I have competent ophthalmologists to work alongside, who care and respect the oath they took, and are not just chasing dollars. I wonder what the OMD community thinks of your opinions? Sad to see you are willing to put your education and schooling behind making money to fund all of your trips. How do you sleep at night?

  44. Dr. Heidi Johnson says:

    Responsible medicine requires a doctor to perform an actual examination to renew a prescription whether the prescription is for medication, therapy, glasses, contact lenses or any FDA regulated intervention including eye drops for glaucoma!
    While telemedicine has its place, this platform can not replace a comprehensive examination. Sorry Dr. Nagori, you can NOT sit at home and make money renewing prescriptions online.

  45. Heather S says:

    Dr Nagori, there are so many inaccuracies with your piece that I cannot begin to address them all. Just to be clear, optometrists go through ” rigorous schooling, training, licensing and certification”. That is not exclusive to medical doctors. Furthermore, optometrists have years of training regarding the cornea, anterior segment of the eye, and how contact lenses can affect the eyes. Ophthalmologists receive very little training in contact lenses and as a glaucoma specialist you most likely received very limited exposure to contact lenses and their potential negative impacts on the eyes. Contact lenses are medical devices for a reason: because they can cause significant and potentially blinding harm to the eyes. You listed recommendations for how often a healthy adult without risks for eye diseases should receive a comprehensive eye exam. You failed to mention, however, that contact lens wear is itself a risk for eye disease therefore your recommendations are incorrect on this particular subject. Your hypocrisy in accusing optometrists of being financially motivated when your motivations are clearly ONLY financial is astounding. I question your commitment to your patients and to patient health care in general. You would never tell your glaucoma patients that because their glaucoma drops are controlling the disease and the patient hasn’t noticed any changes that they do not need to see you routinely. Shame on you for your greedy selfishness.

  46. alex says:

    I applaud Dr. Nagori for taking a stand here. The wrath she has attracted of some angry forum of Optometrist’s is evidence of how difficult it is to speak truth to any eye health debate. Kudos for speaking your mind and not letting Big Optometry shout you down.

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