A Comparison of Spectacles Purchased Online and in UK Optometry Practice

Abstract

PurposeTo compare spectacles bought online with spectacles from optometry practices.MethodsThirty-three participants consisting of single vision spectacle wearers with either a low (N = 12, mean age 34 ± 14 years) or high prescription (N = 11, mean age 28 ± 9 years) and 10 presbyopic participants (mean age 59 ± 4 years) wearing progressive addition lenses (PALs) purchased 154 pairs of spectacles online and 154 from UK optometry practices. The spectacles were compared via participant-reported preference, acceptability, and safety; the assessment of lens, frame, and fit quality; and the accuracy of the lens prescriptions to international standard ISO 21987:2009.ResultsParticipants preferred the practice spectacles (median ranking 4th, IQR 1–6) more than online (6th, IQR 4–8; Mann-Whitney U = 7345, p < 0.001) and practice PALs (median ranking 2nd, IQR 1–4) were particularly preferred (online 6.5th, IQR 4–9, Mann-Whitney U = 455, p < 0.001). Of those deemed unacceptable and unsafe, significantly more were bought online (unacceptable: online 43/154 vs. practice 15/154, Fisher’s exact p = 0.0001; unsafe: online 14/154 vs. practice 5/154, Fisher’s exact p = 0.03).ConclusionsParticipants preferred spectacles from optometry practice rather than those bought online, despite lens quality and prescription accuracy being similar. A greater number of online spectacles were deemed unsafe or unacceptable because of poor spectacle frame fit, poor cosmetic appearance, and inaccurate optical centration. This seems particularly pertinent to PAL lenses, which are known to increase falls risk. Recommendations are made to improve both forms of spectacle provision.

Optical characteristics of Alvarez variable‐power spectacles

“…In considering these questions of fit and lens centration, it must be remembered that similar problems may arise with current fixed-power, ready-made reading spectacles 53 and with prescription spectacles obtained either online or from an optometry practice. 54 We note finally that the existence of four optical surfaces for each lens will tend to increase reflection losses and reduce image contrast, even with anti-reflection coatings.…”

“…Prism induced by vertical misalignment may be a particular problem, since right and left lenses may not be adjusted to the same spherical power. In considering these questions of fit and lens centration, it must be remembered that similar problems may arise with current fixed‐power, ready‐made reading spectacles and with prescription spectacles obtained either online or from an optometry practice …”

What are patients' beliefs about, and experiences of, adaptation to glasses and how does this affect their wearing habits?

“…The authors of these reports accept that there are patients who are dissatisfied with new glasses but do not return to the original practice. It has been found that patients reported nearly 10% of glasses purchased from UK optometry practices as “unacceptable” 16 . Furthermore, results from our recent questionnaire study (Hughes et al ., in preparation) reveal that over 25% of patients older than 60 years of age have received a pair of glasses that they could not wear, and, of these, over 20% did not take the glasses back to their optometrist.…”

General ophthalmic services in Scotland: value for (public) money?

“…How much of this is perception or reality is unclear: with offers of £25 for a complete pair of single vision spectacles widely available and even less from online retailers (as widely advertised), it should be possible to control costs although people may not be widely aware of this. While low‐cost spectacles are available, they may be unsafe and not provide adequate fit, especially if purchased from online retailers …”