Costs for Contact Lenses and Eyeglasses

By: Dr. Don Miller

A brief review of how normal eye-care prices are made can help in choosing sources.

The starting point, for someone aware of focus problems, is the exam. The easy part is the refraction, which is the test for focusing.

If the eye is too short, the focal point is behind the retina, so near objects will be blurry. This far-sightedness is called hyperopia.

The too long eye will focus in front of the retina, so distant objects will be out of focus. This near-sightedness is called myopia.

If the cornea shape is not quite on a spherical curve, differing around the eye axis, there is astigmatism.

The focal point depends somewhat on the wave length of light. If you set a computer monitor to show text in red, green, blue, different colors can seem to be in front of or behind the plane of the background, an apparent 3-D effect.

An optometrist is licensed for refractive examinations. An ophthalmologist, a physician who specializes in the eye, can also dilate the pupil with special drops and visually examine the inside of the eye, as well as take pressure readings. Not surprisingly, the ophthalmologist usually will charge more for services than the optician, as more education was needed. Even if you are not aware of any problems in the eyes, an ophthalmologist should do the exam at least every several years.

Contact lenses require an additional set of measurements than do spectacles. For rigid contacts, the challenge is greater than for soft lenses. If the shape and thickness of the contact do not match the eye and eyelid well, the contacts will be uncomfortable or will simply not stay in.

Before trains, trucks, and planes, transportation was rather slow. Eyeglasses would likely have been made in the nearest large city, through joint efforts of lens grinder and jeweler or other metal worker. Frames tended to be wire constructs, hooked around the ears, so adjustments would have been limited, as was comfort. Lenses would have been mono focal or bifocal.

As technology evolved, lens grinders had an assortment of standardized glass blanks to work from, and frames were developed which did not need to dig behind the ears in order to stay on. Bifocals were followed by trifocals, then variable focus or progressive lenses designed by computer. With faster transportation, fabrication could be at regional facilities. Along the way the lens grinding became automated.

With mass production, costs of both lenses and frames could come down. However, "designer frames" could be as costly as the traffic would bear.

Note that final fittings would be by dispensing optician or ophthalmologist.

If you have ever worn eyeglasses, you probably realized that you can go to nearly any dispensing shop and get adjustments for little or no charge. This "good will" gesture is part of advertising.

As dispensing chains become more common, wait times go up, and quality of fitting becomes more variable.

Online Discount Spectacles have brought in a new variable. Savings can be tremendous, compared to local dispensers. However, final adjustments still need to be made locally, because no head is perfectly symmetrical. Frames are not intended for adjustments by amateurs. Therefore, people who buy spectacles online are a cost burden on what ever local shop does the final adjustment, and can help drive local prices higher.

Vicious cycle. Please don't be part of it.

There are now about six large makers of contact lenses in the United States, due to buyouts. Unless you live near a factory, there is no possibility of local sourcing. Originally there were long wait times for contact lenses, unless the dispenser could make a "standard" prescription work well enough to fit. Contacts were rather high priced until a Federal Law, called the “Fairness To Contact Lens Consumers”, went into effect on February 4th, 2004. No longer can an eye care professional deny you a copy of your prescription, nor prevent you from purchasing via mail or internet. Therefore, discounts of up to 70 percent from mail order or online dispensers are quite common.

The initial fitting and follow up really should be done by a local professional. However, there is no reason to buy refills locally if the remote source can deliver quickly. 3 day filling of online lens orders is now available. If your prescription is simple, a local shop might well have it in stock. The more complex prescriptions will be ordered from a factory or regional facility, whether you or your optometrist place that order.

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For more articles about safe and enjoyable use of contact lenses and spectacles, see by Dr. Don Miller.

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