editor's perspective
Get Your Lenses at the Gas Station?

Whereas we've improved patient safety by making sure plano cosmetic contact lenses require a prescription, a move is afoot to make all contact lenses available just about anywhere. Pending legislation in the US Senate would require contact lens manufacturers to guarantee availability to alternative suppliers, regardless of whether those suppliers are affiliated with any prescriber. HR 2744 is entitled, "Agriculture, Rural Development, Food and Drug Administration, and Related Agencies Appropriations Act, 2006." Robert F. Bennett (R-Utah) has proposed an amendment (S10314) that would prevent the use of any federal funds for the review, clearance or approval of any contact lens unless the manufacturer certifies that it will distribute the lenses in a non-discriminatory manner, directly to alternative channels of distribution. This would restrict the FDA in reviewing any applications from companies that don't make lenses available directly to all channels of distribution.

The author notes that his proposed amendment shouldn't be interpreted as waiving any obligation of sellers under the Fairness to Contact Lens Consumers Act, which would also be amended to reflect this change.

Although occasionally contact lenses are sold without a prescription, this legislation would force the FDA to "not discriminate in the distribution of, or restrict consumer access to contact lenses and make lenses available directly to all channels of distribution such as mail-order houses, Internet retailers, pharmacies, buying clubs, and other distribution alternatives." Under these new requirements, a prescription would still be necessary for patients to obtain contact lenses, but manufacturers would have to sell to just about anyone. I believe this could increase contact lens availability without a prescription.

You may wonder what prompted such legislation. Certainly not an interest in increased public health and healthy contact lens wear. Letting anyone sell contact lenses and thus discouraging follow up could be dangerous as we've seen with cosmetic lenses sold in tattoo and beachwear shops. Certainly the reason for this proposed amendment was economic. I've always agreed that if pharmacists who honor a prescription — or who wouldn't honor a request for purchase with no prescription — were involved, then I have no problem with non-eyecare practitioner dispensing. The question for Senator Bennett is: Are his constituents indicating they can't find a place to acquire contact lenses? Or are alternative (non-eyecare practitioner) vendors asking the Senator to increase contact lens distribution indiscriminately?

Anyone who knows me knows that I'm totally for free enterprise. But if free enterprise puts my patients and yours at risk, then I'm totally opposed. In this case, Senator, you need to get to work on how this would protect your constituents who may purchase their contact lenses in the wrong places — and I think you know what I mean.