A College Student Got Angry About Lens Prices and Changed the Law: The Story of America's Contact Lens Prescription Act
The previous article told how, in 1978, the United States required eyeglass prescriptions to be handed to patients automatically.
That rule had one hole.
Contact lenses were left out.
You could walk out with your glasses prescription, but your lens prescription stayed in the optometrist's drawer.
The person who closed that hole 25 years later was not a scholar or an official.
He was an advertising major in college.
February 1995, Utah
Jonathan Coon, a student at Brigham Young University, wore contact lenses.
Every time he reordered, the same thing happened.
It was expensive.
He waited a long time.
Same product, same power, and every time he had to go through the optometrist.
With a partner, John Nichols, he started a company that sold lenses over a single phone call.
The company's name was its phone number.
1-800 CONTACTS.
No prescription, no sale
The problem surfaced quickly.
Lenses are medical devices; you need a prescription to sell them.
But a large share of customers did not have their own prescription.
The optometrist had not given it to them.
From the optometrist's side, it made sense. Hand over the prescription and the customer buys elsewhere. You keep the exam fee and lose the lens sale.
From the customer's side, it was strange. The numbers came from my own eyes, and they were not mine.
The company decided to solve it through the law.
It went round the state legislatures and knocked on the door of Congress.
The optometrists' associations opposed it. Losing lens sales was one reason; the risk to eye health of buying lenses year after year without an examination was another.
6 December 2003
After eight years, the law passed.
The Fairness to Contact Lens Consumers Act.
The rule the Federal Trade Commission (FTC) wrote under it rests on three points.
First, the prescription is released automatically.
When a lens fitting is complete, the patient gets a copy without asking. The same principle as the eyeglass rule, now applied to lenses.
Second, a prescription is valid for at least one year.
A state may set a longer period, but to set a shorter one there has to be a medical reason.
Third, sellers ask the prescriber to verify, and the prescriber has eight hours to answer.
Eight business hours with no reply, and the prescription is treated as verified. The seller may ship the lenses.
The third point is the heart of the law.
It stopped prescribers from blocking a sale simply by not answering.
2020: one more signature
Even with the law, complaints of "I never got my prescription" kept coming.
So in 2020 the FTC amended the rule.
The prescriber must record, with the patient's signature, that the prescription was handed over.
On paper or electronically, a record that the patient confirmed receipt must be kept.
A device to end the argument about whether the prescription was ever given.
Where both sides were right
This is not a story with one side right and one side wrong.
Where the company was right: the prescription belongs to the patient. Having the numbers from your own eyes is only natural.
Where the optometrists were right: a prescription has an expiry date. So the law ordered automatic release, and also set validity at one year. After a year, you are examined again.
The law took both.
The patient holds the prescription, and gets examined every year.
Countries where you hold your prescription, and countries where you don't
The United States went the way of "the prescription belongs to the consumer, and the consumer chooses where to buy."
Other countries answered differently.
In Japan a prescription is not a legal requirement, yet the government objects to the advertising phrase "no prescription needed." See Japan Lets You Buy Contact Lenses Without a Prescription.
Taiwan bans online sales altogether and caps personal imports by quantity. See Why Taiwan Limits Contact Lens Imports to 60 Lenses.
Whichever way a country goes, the starting point is the same.
Get examined, know the result, and get examined again before it expires.
How to read the numbers on your prescription is in Six Codes Hidden on One Sheet of Paper.
References
- US Federal Trade Commission, The Contact Lens Rule: A Guide for Prescribers and Sellers — the Act (Pub. L. 108-164, 6 Dec 2003), automatic release, one-year validity, 8 business hours, the 2020 signed confirmation
- FTC, FAQs: Complying with the Contact Lens Rule
- Federal Register, Contact Lens Rule (17 Aug 2020) — the 2020 amendment
- Deseret News, A business with a vision (2005) — the 1995 founding, Jonathan Coon and John Nichols, the legislative campaign
- 1-800 Contacts, The First Online Contacts Business — the company's own account
This article provides general information. It describes US federal rules; prescription validity and purchasing procedures differ by country and region. Use contact lenses only under a valid prescription, with regular eye examinations.