Eye exams at home: A safe way to update your eyeglass Rx in the age of COVID-19
As the pandemic drags along and we continue to be aware of the risk of face-to-face contact, what happens when you need new glasses? We look at an affordable device that can take you from test to new glasses, all without risking COVID-19 exposure.
Getting an eye exam has always been a moderately annoying yet ultimately benign chore that doctors recommend you do every year or so. But now, in the times of COVID-19, getting an eye exam involves prolonged face-to-face contact with another human being in a small, enclosed space.
Sure, masking up and contact precautions can reduce the risk, but getting an eye exam went from merely unpleasant in the before times to a calculated risk of life in the new normal.
Depending on where you live, your local optometrist's office might not even be open. And whether or not you feel you're at extreme risk from the virus, every encounter is now a bit of a gamble. Do you need a new glasses prescription right now? Is it worth potentially putting your life on the line to get a new set of numbers? Couldn't you get by for another year or so with slightly blurry vision?
With an innovative new device from EyeQue, you may no longer need to make such a decision. You can perform a test to measure your vision in the comfort of your own home.
In this article, I'll tell you how I checked my eyes, determined a new set of glasses numbers, and ultimately got a new set of glasses without ever having to leave my house. I'll also introduce you to two optometrists and an ophthalmologist, who will weigh in on the validity of this technology. Finally, we'll look into how this technology may well disintermediate the process of getting eyewear, especially for people with limited access to convenient optometrists.
We have a lot to cover -- and it's game-changing.
Introducing the EyeQue VisionCheck
EyeQue is a Bay Area-based company founded by guy with a Ph.D. in atomic physics and the CEO of discount optical supplier Zenni Optical. Together, they put together a product and service offering called VisionCheck based on technology licensed from MIT.
According to an MIT profile, the licensed technology is a "patented smartphone eye refraction test using the inverse of the Shack-Hartmann method." It's a low-cost solution for estimating refractive errors in the human eye, developed as part of the MIT Media Lab Camera Culture Group. According to the school, "While Shack-Hartmann sensors measure localized slope of the wave front error using spot displacement in a sensor plane, the MIT technology has the user shifting the spots until they are aligned."
All of that is incorporated in a small Bluetooth vision testing device that temporarily attaches to your smartphone. You stare into the device, which works in concert with an app on the phone, and based on where you see the intersection of a green and red line, it takes a series of measurements.
After ten measurements taken of the left eye and ten of the right eye, it spits out a series of numbers the company calls "EyeGlass Numbers." These are specifications you can send to some online eyeware suppliers, and get back a pair of vision-correcting glasses.
A second component in the $69 kit is a pair of white frames with special markings on them. These are the PDCheck frames and are designed (again, in concert with an app) to measure your pupillary distance, or how far apart your eyes are from a focal perspective.
My troublesome eyeglass exam background
I am not an easy patient for an eye doctor. In fairness, it's not entirely my fault. My eyes don't open as wide as many folks (as anyone who has read my YouTube channel comments surely knows). Eye exams are very difficult for me and I dislike them intensely.
The optometrists who have had to examine me also disliked my eye exams. I tend to move my eyes before the automated machines can get a proper measure, and I'm never convinced one lens option is better than the other when the optometrist asks me to compare. This usually results in longer-than-necessary visits with less than satisfactory results.
My last prescription update was in 2017. I've been meaning to get my eyes checked for a new prescription since the end of 2019, but somehow never got around to it. By the time the pandemic hit, my glasses were definitely out of sync with my eyes.
But, given the lockdowns and ongoing COVID risk, it was clear I wasn't going to be updating my prescription for quite some time. My eyes were not amused.
So, as soon as I found out about the EyeQue system, I reached out to the company and requested a review unit. They were kind enough to supply one (and then kind enough to put up with me being troublesome). That's next.
PDCheck determines pupillary distance
PDCheck was easy enough to almost be fun. You start by putting on these oh-so-attractive white frames and launching the PDCheck app. It will provide some prompting to guide you through how the process is supposed to run.
Then, you snap a picture of the frames on your face. That's shown in the picture on the left, below. Once you have that image, you need to move the little green crosshairs so they're over the T marks on the glasses. The image below shows the interface before I adjusted all the crosshairs.
Once you're done, you hit the Confirm button. The app produces the PD data you'll need to order glasses, as shown below.
And yes, I blurred out my PD numbers. There's probably no reason to do so, but it feels like personal identifying information.
Bottom line is the PDCheck process was simple and easy, and way more accurate than trying to hold up a ruler in front of your face while looking into a mirror.
The why-does-this-always-happen-to-me VisionCheck process
VisionCheck also seems easy. Once you have the device connected via Bluetooth, all you do is affix the VisionCheck device to your phone with the attached strap and look at a couple of lines.
There are three buttons on the top of the device. One moves the lines closer together. One moves the lines farther apart. You press the third button once the lines overlap and turn yellow.
That's it. That's the whole process. Do it ten times for the right eye, as the lines change position and orientation on the screen. Repeat for the left eye.
And, you're done. Not me. I wasn't done. Oh, no. These things are never easy for me. Only this time, I couldn't blame the doctor for lack of patience.
I was able to get the first few measurements, but I had no end of difficulty getting the last seven or eight measurements for each eye. I squinted. I moved my head. I moved the device. I grunted. I groaned. I think I even growled at one point.
I eventually completed all the measurements, at which point the app told me I was too inconsistent and would need to do it all over again.
I'll tell you this. I was dedicated. This wasn't just for some random review. I really did need new glasses and if I could make this work, I could avoid a COVID-19 risk situation. Plus I could avoid the optometrist. I dislike going to the optometrist almost as much as I hate getting my hair cut.
In the case of VisionCheck, I stuck with it. I tried five or six times over the course of about three hours before I gave up and contacted the company.
We set up a meeting and some of their very patient support folks walked me through a full exam sequence. I discovered that I got my best results while leaning the device on a raised surface (in my case, a 3D printed engine block) and then looking into it.
I did three more full test passes with much more success. This time, each pass took only about 15 minutes. Once I sent EyeQue my test results, they took a look at them and sent me back the numbers needed to order eyeglasses.
One thing of note: the company says they'll do this extra hand-holding with anyone who runs into difficulty using the VisionCheck. I found this support made the difference, so it's worth reaching out to them if you hit a snag.
Did it work?
After we established my EyeGlass numbers (EyeQue is very careful not to call this a "prescription"), the company sent me a set of what they call TryOn Glasses. This is actually a very nice set of bottle cap lenses in a frame, very reminiscent of John Lennon or Harry Potter glasses.
The TryOn Glasses are not part of the basic product. You can order them for $19 from EyeQue. They take a week to arrive. If you're concerned about saving money or you want a different style, I found a number of discount eyeglass companies that sell lenses and frames for as little as six bucks. More on that in a minute.
Unfortunately, I neither have my last prescription numbers nor my PD measurement from 2017. After we moved across country, I did a dig through my files, but never found them. As such, I can't compare any before and after information. All I can provide is my subjective impression.
I am impressed.
I am nearsighted, which means I see close up objects clearly, but objects farther away are blurry. I use glasses to drive and watch TV. I've also had a separate prescription for computer glasses, to be able to see the screen clearly from about 18-inches away.
The computer glasses were always very hit or miss, because no optometrist I ever met was able to understand that I use many different displays at many different distances.
In any case, the EyeQue solution is for nearsighted folks. It will help you see at a distance. It's not really designed to let you see close-up work, like beading or knitting or soldering.
I have been wearing my John Lennon glasses now on and off for about a week. I can't wear them full time because the lenses are just too tiny and I find the edge of the glass distracting. My intent is to order a pair of much larger, yet super-inexpensive glasses and see how they perform. If they work, then I'll up my spend a bit and get a nicer pair.
That said, it's the vision correction you want to know about. It works. The new glasses are a bit clearer than my old glasses and my eyes hurt a bit less. I definitely feel better (small lens notwithstanding) wearing the EyeQue TryOns than my tried-and-true glasses from 2017 both in front of the TV and in front of my computer monitors.
That is amazing. I'll tell you this. It was worth the effort and, even if I had to pay the $69 to order the kit from Amazon, it would have been a cost well justified.
I can confidently say that, at least for me, the EyeQue VisionCheck is a solution for updating your glasses during the pandemic. Of course, your mileage may vary and I'm not a doctor, so you should probably turn to a doctor for advice. Next up, we get some input from three of them.
We spoke to three doctors
So let's be clear. There is no substitute for seeing a real doctor and getting a careful eye exam. EyeQue does offer another gadget, which I didn't test, that does check the quality of your vision. It's interesting, but if you're concerned about eye health, you need to get a real exam.
That said, this solution does solve the pandemic problem rather nicely. I did, however, reach out to some optometrists and ophthalmologists for their perspective on EyeQue.
Dr. Gary Heiting received his Doctor of Optometry (O.D.) degree from Southern California College of Optometry in Fullerton, California in 1984. He has more than 30 years experience as an eye care provider, health educator and consultant to the eyewear industry.
His clinical experience has included primary care positions at Ophthalmic Surgeons & Physicians, Ltd. (Tempe, AZ), Park Nicollet Medical Center (Minneapolis, MN), and Eau Claire LASIK (Eau Claire, WI). He also has served as director of education and director of product development at Pentax Vision, Inc. (Minneapolis, MN).
Dr. Heiting's current special interests include nearsightedness, myopia control, and the effects of blue light on the eye.
When I asked Dr. Heiting about EyeQue, this is what he told me:
I took a quick peek at the promo video for the device. It looks like it could work to determine a glasses prescription for single vision lenses (including astigmatism correction), but not a prescription for progressive lenses for someone with presbyopia.
Also, I don't see any research that verifies the validity of the prescription it produces compared with an eyeglasses prescription produced the conventional way during an eye exam.
Finally, consumers should be made aware that this is not a substitute for a comprehensive eye exam, as it does not evaluate the health of the eyes or test eye pressure to rule out glaucoma. I'm not even sure it measures visual acuity accurately.
He also recommended this article: Why an online eye test can't replace your eye doctor. In a normal world (or the Before Times), I would have agreed completely. Now, with everything changed, contact precautions make in-person doctor visits inherently risky. Just keep in mind that eye problems like glaucoma are very serious so, if you're concerned at all, go in person.
My conclusion about technology like EyeQue is that the optics and technology is possible based on noticing where the patient is holding the device away from their face/ armlength. But none of these technologies have yet been compared with the gold standard, which is a prescription by an optometrist/ophthalmologist. That would be the first step in approving these technologies moving forward: making sure the prescriptions are accurate.
I was also curious about how the pandemic has affected doctor visits, especially in New York City. Dr. Rapoport reports:
My own practice at the moment is actually up in patient visits. Many patients were not seeking care during the last six months and are perhaps nervous that doctors will be closing their doors again if there is a second wave in the winter and are eager to get all their care now.
Finally, I reached out to Dr. Mesheca C. Bunyon. She earned her degree at the Pennsylvania College of Optometry in 1999. She co-owns a private practice with her husband, Dr. Lamont Bunyon, at Special Eye Care in Camp Springs, Maryland.
She tells ZDNet:
I do think that technology such as EyeQue can work. The technology appears to be innovative and has the ability to offer a clear prescription if someone is unable to see their eye doctor.
My thought is that it still can not replace a comprehensive eye exam which includes the refraction, the portion of the test that gives the eyeglass prescription.
Optometrists have the ability to fine tune the prescription in ways that a piece of technology cannot. For example, there are instances in which a patient's prescription may be high in astigmatism and we might decrease it based on what the patient might be able to tolerate. Technology can't determine this.
I also asked about how business is for her and her husband. She has an interesting observation on how the new normal of Zoom meetings might affect work-from-home fashion:
Fortunately, our business is not down but performing very well, better than this same time last year. With the increase in telework and distance learning, adult and younger patients are entering the office with complaints of eye strain, dry eye syndrome, blurred vision and more. Additionally, with teleworking and video calls, patients are telling me that they want to look better in front of the camera with fashionable eyewear.
So, while you can wear pajama pants to work in your home office, you're relying on your face more than your clothes to make a good impression.
Big thanks to doctors Heiting, Rapoport, and Bunyon for taking time with us to explore this important issue.
Potential outside of COVID
Before I close out this rather long deep-dive, I'd like to talk to you about the potential of this technology outside of COVID. Again, we realize it's always better to have access to a doctor to, as Dr. Bunyan suggested, find the nuance in the numbers. But not everyone has that access.
I'm thinking particularly about developing countries and very rural communities. You don't need one device per person. As long as each user has a smartphone to enroll the app, multiple people can share one device (after taking proper cleaning precautions first, of course).
I can certainly see a case where a missionary or a visiting doctor carries a VisionCheck and a pair of PDCheck frames in their kit bag. Anyone who needs corrective lenses can get a quick set of EyeGlass numbers and low-cost spectacles can be shipped to whoever needs better glasses.
I can see this in other locations where better eyesight is needed, but might not be immediately available. Imagine a school nurse who can crank out a quick set of glasses numbers for students. Or imagine a nursing home where patients aren't mobile enough to travel to an eye exam. On-site professionals (and even volunteers) could be trained to coach patients on using the machine.
I'm sure we'll learn more over time, but these are some scenarios to get your imagination sparking.
Recommendation and future tests
Like I said, I ordered a pair of larger glasses to test. My wife also wants to run through the PDCheck and VisionCheck process and order a pair of glasses. I'll be back with a follow-up article when we get results from those tests.
In the meantime, do I recommend this product? Yeah, I do. The usual disclaimer of seeing your doctor does apply, but it does appear to be a viable pandemic solution.
If the company is true to their word and gives other problematic customers the one-on-one attention they gave me, then it's likely you can come out of the process with better glasses.
Have you tried the VisionCheck product? Are you concerned about eye exams during a pandemic? Do you see the potential for a mobile eyeglass numbers device? What about this technology sparked your imagination? Let us know in the comments below.