As many of you who read Clay Christensen know, disruptive innovations create value in established markets by initially offering lower but new performance attributes. Over time, disruptive innovations improve upon their performance attributes, eventually displacing prior technology. We have all experienced disruptive innovations and live with them daily—think smart phones (versus land-lines and personal computers), the cloud (versus hard drives), and MP3s (versus CDs). There is no doubt that disruptive innovations can impact companies and business practices. However, many potentially disruptive innovations also fail to succeed. As noted in Forbes, “Making money and corporate survival now depend not merely on pushing products at customers but rather on delighting them so that they want to keep on buying.” ( ).

Did you know that there is now at least one online “prescriber” of contact lenses— ? As its website says, for $10 you “take the test” (using your current contact lenses), “select your contacts,” and “sit back and relax” while you wait to receive your prescription and contact lens order. There are several caveats including disease-based exclusions, the need to have a full eye examination (including dilation) in the last four years, and the need to have 20/20 vision to use the test, among others. Should we consider this a disruptive challenger in eye care?

This online prescribing approach raises lots of interesting questions that relate to its value. For example, how will patients learn about new technologies in contact lenses that provide greater ocular health benefits and better vision? Likewise, how will more comfortable materials (and care solution combinations) be recommended to prevent these patients from dropping out of lens wear without direct examination of the ocular surface, tear film, and contact lens interaction? While the intervals of receiving regular in-office eye care may be debatable and dependent on several factors, nearly all recognize that more frequent in-office care is associated with better long-term ocular health. To me, it is critical that eyecare providers ensure that their patients truly appreciate the value of in-office eye care.

While it is unclear what the ultimate success of this online prescribing approach will be, I believe it is important to consider the many ways this could impact our patients and practices while, at the same time, we strive to continue providing high-quality eye care that is valued by our patients.