NEW YORK—On May 19, 2016, The South Carolina House of Representatives voted to override Governor Nikki Haley’s May 16 veto of the "Eye Care Consumer Protection Law" (Bill No. 1016) which seeks to ban companies from offering prescriptions for glasses and contact lenses after online eye exams. On May 18, 2016, the South Carolina Senate also voted to override the Governor’s veto.

Haley’s veto followed the bill’s unanimous approval by the South Carolina Senate on April 26 and its nearly unanimous passage (100 to 1) in the House of Representatives on April 28, 2016.

South Carolina Governor Nikki Haley said, “I am vetoing this bill because it uses health practice mandates to stifle competition for the benefit of a single industry. During my administration, South Carolina has expanded access to health care, including mental health services, to rural and underserved regions of our state using telemedicine. Unfortunately, a small group of eyecare professionals is seeking to block new technologies that expand low-cost access to vision correction services.”

The law fires a direct salvo at Chicago-based-Opternative, which announced the launch of its online refraction service in 27 states, including South Carolina, last July, as reported by VMail. By using a computer and smartphone, consumers can take a 25-minute or less eye test and receive a prescription within 24 hours to use at any online or physical optical retailer.

In response to a query from VMail, Aaron Dallek, Opternative co-founder and CEO said, “We appreciate Governor Nikki Haley’s support of patients in South Carolina who will no longer have access to safe, affordable and convenient eyecare services. S. 1016 was created because the lobbying of the South Carolina Optometric Association clearly demonstrates it does not want optometrists to compete with clinically proven and accurate technology-enabled medical services like Opternative.”

Industry opponents of the online service include the American Optometric Association (AOA). Steven A. Loomis, OD, president of the organization, lent his support of the action as well, and reiterated that protecting patients’ eye and vision health is a top public health priority for the AOA.

“We think that on an important public health issue, the South Carolina legislature got it right when both Houses overwhelmingly passed this critical patient protection legislation and subsequently overrode the veto,” Dr. Loomis said. “Confusing or potentially misleading alternatives to seeing an eye doctor for eyecare provides a false sense of security and results in a lack of proper diagnosis which threatens patients’ sight and general health.

“Every day our doctors examine asymptomatic patients who come in for ‘routine’ comprehensive eye examinations and diagnose serious eye and health issues. We know that apps used for self-vision assessment cannot and do not differentiate between patients requiring further treatment and those who do not. Patients deserve to have complete care and any delay in treatment for conditions such as diabetes, hypertension, glaucoma and macular disease to name a few is simply not acceptable.”

The AOA escalated its attack against Opternative and its online vision test by filing a formal complaint with the Food and Drug Administration (FDA) in April. The complaint challenges Opternative’s claims about its product's capabilities, and calls for the FDA to pull the vision test from the market until it can be shown to meet what AOA described as “appropriate Federal requirements for medical devices.”

Michael Campbell, OD, South Carolina Optometric Physicians Association (SCOPA) president, called the override a victory for eye health and vision safety. “The override vote taken by our legislators in Columbia reverses what could have been a detrimental action to the eye health of thousands. While we as doctors of optometry fully support innovative technology that is of benefit to our patients, the override and enactment of this bill will continue to safeguard these families across South Carolina.”

Other states are also enacting new laws aimed at tightening control over remote vision testing. In May, Georgia enacted House Bill 775 which restricts online vision testing services and could impact other forms of remote or mobile eye testing. Violators who issue prescriptions based solely on objective refractive data would be held accountable.

In April, Nebraska passed the “Consumer Protection in Eye Care Act (L.B. 235), which requires kiosks and automated devices to be approved by the U.S. Food and Drug Administration (FDA), comply with HIPAA, have a recognized Current Procedural Terminology (CPT) code and display the name and state license number of the provider who reads and interprets the diagnostic data produced by the device.