# Optical Forums > General Optics and Eyecare Discussion Forum >  Should "over-the-counter" reading glasses be...

## Barry Santini

limited in power availability (as NY does at +2.75D)?

What are the potential medical consequences/liabilities in states, such as Florida, where one can obtain up to +4.00D as an OTC?

What are your feelings/thoughts/opinions on the above?

If a 65 year old mild myope, say -0.75 -0.25 x 180 O.U.; only requires a +2.50 OTC for reading, does this imply that they should be limited to say, a +1.75 in an OTC, in NYS, for instance, _by law?_

Your thoughts, again...

Barry

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## Jacqui

I think they should be available *only from licensed OD's and Opticians*. Not from Walmart, drugstores, grocerystores and Goodwill. And I think this *should be ENFORCED !!*

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## chip anderson

Medical consequences?  Zero.   I often find people with over the counter readers that have a *lot* more plus than they need.  Consequences, they hold thier reading material a lot closer than they need.
Medical consequences of not  having a good physical, or a good eye exam could be significant, could be nothing.  Or one could in some cases be "saved" by not having one.   Many people have medical consequences from being miss-diagnosed, miss-prescribed, etc.  
Very few have a same from taking a occasional asperine (don't quote me any sitatistics on bad results) when they have a headache, or a little pepto when needed..
Yeah, I know 300 people die each year from asperine, 600 from being run over by bicycles.  But you can't save the world by getting a monopoly on reading glasses.  Sure we see the occasional patient that felt thier world was vastly improved by a properly made pair of reading glasses, but realize how many millions are in use.
You can buy a lot of things in a drug store that can have far more terrible consequences than a pair of OTC readers.

Chip  (And yes, I am an optician that would probably profit quite a bit if readers could only be purchased in optical shops.):D

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## MarcE

> I often find people with over the counter readers that have a *lot* more plus than they need. Consequences, they hold thier reading material a lot closer than they need.


My experience is that these "overplussed" reader wearers have underlying/undiagnosed hyperopia because they have never been to the eye doctor.  They do OK accomadating until they get to be 45.  Then they go the drugstore and just love the +3.00s.  Their actual script should read +1.00 OU +1.75 add and normally a bit a cyl too.
They are the worst because they don't understand why they don't have the 20/15 vision that they always enjoyed.  Part of the reason they don't understand is they have never given an eye doctor a chance to explain it.

I don't want you to misconstrue this as me agreeing that readers should not be OTC.  I haven't made up my mind yet.  However, as an employer, I would require my employees to have an annual eye exam just as I require them to have a flu shot.  IT's too critical to job performance - any job.

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## chip anderson

Marcie:
You betta read dem posts on flu shots.   When I worked in the Medical Arts Building, the Baptist Hospital urged us to get flu shots when thier crew did.  We didn't but we did observe that the day after the shot 1/3 of their work force was off with flu like symptoms.
Odds on getting the flu: Less than 1 in 30, odds on getting a reaction from the shot 1 in 3.  
Not everything medicine can make money off is a good idea.

Chip

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## cocoisland58

> You can buy a lot of things in a drug store that can have far more terrible consequences than a pair of OTC readers.


Yep. They all over plus themselves. If they don't have the common sense to get an eye exam then that is what will happen. It won't kill them, it might give them a headache. If they get enough headaches they go to the doctor who recomends an eye exam. There you are. I really don't think we need another consumer protection law on the books.

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## apaul

In the UK (I think a few years ago) it was deemed that +4.00 was too powerful to sell over the counter so it was reduced to +3.50
however this has been largely ignored +4.00 is still available any where
even petrol stations sell them (i think thats gas to you guys!)
Alan

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## RichB

This is another argument to permit opticians (with advanced education) to refract. We would certainly be more accurate than a person using the DYI approach in front of a drugstore rack.

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## coffee joe

i think they should be banned entirely, because i hate having some one come in trying to save 80 bucks by handing me a drugstore reader and then reaming me because i tell them it can't be rx'ed because it has no screw.  otherwise, your health, your responsibility.  my dentist is alllllways lecturing me about the need for regular visits, but do i listen?

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## hcjilson

> limited in power availability (as NY does at +2.75D)?
> 
> What are the potential medical consequences/liabilities in states, such as Florida, where one can obtain up to +4.00D as an OTC?
> 
> What are your feelings/thoughts/opinions on the above?
> 
> If a 65 year old mild myope, say -0.75 -0.25 x 180 O.U.; only requires a +2.50 OTC for reading, does this imply that they should be limited to say, a +1.75 in an OTC, in NYS, for instance, _by law?_
> 
> Your thoughts, again...
> ...


Barry, I was unaware that New York placed a power restriction on readers. When did this happen and can you provide a link to where I might find this information.
thanks, harry

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## Diane

As one reads the statutes in our state, we specifically cannot limit this.  It bears consideration, but I don't know that the sale of OTC Readers cause harm to consumers.  Laws are there for the protection to consumers rather than to help a profession.  In order to regulate the sale, we would have to prove possible harm.

Diane

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## coffee joe

if you have to prove the possibility of harm to pass such a law, then the proof of harm is implicit due to the fact that you have to have a prescription to get any other corrective eye wear and the dispenser has to be licensed.

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## chip anderson

You don't have to prove the _possiblity_  of harm.  You have to prove _actual_ harm in one or more cases.  In most cases you have to prove several or more incidents with a potential for future incidents, except in California.

Appearently there, they had one woman knock down power pole with her car after being scratched by her cat which was in her lap.   The California legisature had a law passed in 24 hrs. (or close to it)  outlawing pets in the laps of drivers.

Chip

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## cocoisland58

> if you have to prove the possibility of harm to pass such a law, then the proof of harm is implicit due to the fact that you have to have a prescription to get any other corrective eye wear and the dispenser has to be licensed.


OTC readers are the equivilent of OTC drugs. OTC drugs can be harmful if taken incorrectly but do you really want to have to ask your physician for an Rx everytime you need ibuprofren? Maybe there should be a warning tag on OTC readers. In fact I can already see it coming to protect the nincompoops of the world. "CAUTION do not drive with this product directly in front of eyes." Or some other idiotic caption.

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## DragonLensmanWV

Seems to me I read an article where they had done a study on readers. They refracted the test subjects, didn't tell them their Rx, set them in front of a display of readers and told them to pick what they thought was the best for them. Fast forward a year. Turned out most people got ones that were too strong. Also turned out that some of them had their Rx changed to higher plus and some that were plano had moved to low plus.
Darned if I can find any link to the study though.:hammer:

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## chip anderson

I can see that if a patient injested or injected too many OTC readers some harm would result.  But harm from wearing them.  Get real.
There might be some harm in *not wearing* the proper Rx but one can't even prove harm from a drug if the harm resulted from the patient not seeing the doctor and not taking (or even having it prescribed) the medication.

One problem I do see is prescribers, especially those not involved in the merchandising of optical products actually telling the patient to get OTC readers while knowing that both the patient and the independent optician would be better served with Rx readers for that little bit of imballance or cylinder.  But the doctor's fees are so high, he wants to be the patient's friend and seem like he is saving the patient a buck.

Chip

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## jediron1

> limited in power availability (as NY does at +2.75D)?
> 
> What are the potential medical consequences/liabilities in states, such as Florida, where one can obtain up to +4.00D as an OTC?
> 
> What are your feelings/thoughts/opinions on the above?
> 
> If a 65 year old mild myope, say -0.75 -0.25 x 180 O.U.; only requires a +2.50 OTC for reading, does this imply that they should be limited to say, a +1.75 in an OTC, in NYS, for instance, _by law?_
> 
> Your thoughts, again...
> ...





They don't uphold that law. I have walked in an checked and most do carry +3.00.

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## hcjilson

Actually I've seen them in NY up to +4.00.....the Lucite jobs!

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## jediron1

> Actually I've seen them in NY up to +4.00.....the Lucite jobs!





Just my point. NY does know of unlicensed opticians and takes no action what makes you think they will take action on finding a +3.00 or a +4.00 reader. If it does not help them get re-elected they could care less about the laws regarding unlicensed opticians and readers that are over +2.75. Look what the news channel from NY city did on the expose' on unlicensed opticians did not even cause a stir. :drop:

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## Barry Santini

> One problem I do see is prescribers, especially those not involved in the merchandising of optical products actually telling the patient to get OTC readers 
> Chip


My opinion: This approach borders on being medically-negligent!.

Thoughts?

Barry

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## Jacqui

> My opinion: This approach borders on being medically-negligent!.
> 
> Thoughts?
> 
> Barry


As a nurse and optician, I agree.

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## tmorse

> This is another argument to permit opticians (with advanced education) to refract. We would certainly be more accurate than a person using the DYI approach in front of a drugstore rack.


Right.. especially if your binocular PD is not the standard, is it 64mm?

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## HarryChiling

> Right.. especially if your binocular PD is not the standard, is it 64mm?


I think that's where the focus should be, on the standard PD's of the OTC's they induce prism, which the patients eyes eat up, then before you know it they're having problems without the readers, diplopia and aesthenopia.  We have seen it and had to ween patients off of it.

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## chip anderson

The only reason they over plus themselves is they don't know how far to hold the reading material.  A simple sign on the counter saying "Hold reading material 18-22" from eye.  If you can't read go stronger or weaker until things are clear at this distance.  Duuuah
Of course if opticians could refract they would still be using this method to determine correct reading correction.

This is becomming a very silly arguement.


Chip:D

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## rbaker

You all favor increasing government control of the eye care professions. Well, you got what you asked for, the FDA has determined that the risk/reward equation comes down on the side of allowing OTC readers to be sold. Or is it really your own pecuniary interests rather than the publics so called welfare that is your main concern. Come on now, you can tell me what your real agenda is.

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## Oedema

> I think that's where the focus should be, on the standard PD's of the OTC's they induce prism, which the patients eyes eat up, then before you know it they're having problems without the readers, diplopia and aesthenopia.  We have seen it and had to ween patients off of it.


PD greater than that 64mm standard?

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## chip anderson

Gee! If I could just get a court order that forbids eveybody but me from making eyeglasses, artificial eyes, and fitting contact lenses how much better off the public would be....

Look at ourselves wanting to legislate, license, and tax everybody else because we thinks we is mo' wonderfull.

Just because they have more money, more advertising, more marketing expertise, more control over the customer, they must be at the very least immoral.

Chip

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## fjpod

> Barry, I was unaware that New York placed a power restriction on readers. When did this happen and can you provide a link to where I might find this information.
> thanks, harry


I don't know where to look up the law, but I remember when it was passed by the NY State legislature some 20 plus years ago.  The law specifically restricts power to +2.75, monofocal lenses.  At the point of sale there is also supposed to be a sign or label attached to the glasses that says something like, "these magnifiers do not take the place of regular eye exams"  These rules are often ignored.  Nobody is dropping dead in the streets.  Being against OTC readers is like spitting in the wind.

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## jediron1

> I don't know where to look up the law, but I remember when it was passed by the NY State legislature some 20 plus years ago.  The law specifically restricts power to +2.75, monofocal lenses.  At the point of sale there is also supposed to be a sign or label attached to the glasses that says something like, "these magnifiers do not take the place of regular eye exams"  These rules are often ignored.  Nobody is dropping dead in the streets.  Being against OTC readers is like spitting in the wind.




I said the same thing in post #19. The optical laws in NY are laughable and most of the chains know it and flaunt it in the faces of all opticians and OD's and OMD's in our state. Again if it does not help them (officials) to get re-elected they could care less about these laws. :angry:

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## Barry Santini

The NYSSO State Office has recently heard from several members across New York--asking for a "refresher" on the State Education Department's ruling on the advertising and selling of "bifocals."  
In 1991, the State Education Department began discussions, negotiations and ultimately litigation against manufacturers and retailers who were advertising and selling over-the-counter frames which contained lenses of different diopter strengths in the upper and lower meridians. At issue was the appropriate interpretation of Education Law, Section 7106(2) and/or 7126(1), and whether Education Law authorizes retailers to advertise and sell "bifocal" glasses over-the-counter as a non-prescription item that can be provided without the presence of a licensed practitioner.
The 1988 revisions to Section 7106(2) authorized the over-the-counter sales of glasses with a maximum diopter of 2.75.  Retailers interpreted the relevant statutory language to authorize the sale of glasses with a diopter strength in the lower meridian and a clear lens with no diopter strength in the upper meridian.  They argued that the lenses were a form of magnification and were in fact only one magnification since the clear lens did not constitute a true "lens."
SED's Office of Counsel advised that there was little likelihood that the Department would prevail in their argument that these glasses met the clinical definition of "bifocal" or "dual lenses."  Thus, SED was forced to adopt the position that the law did not clearly forbid the sale of the lenses at issue.  However, SED was able to argue that the advertisement of these glasses as "bifocal" or "dual lenses" was clearly prohibited by the statute.
The settlement with Magnivision was completed in November, 1994.  As part of the settlement, the manufacturer agreed to cease using the term "bifocal" or any other term which indicates that its segmented glasses have more that one focal length or focal power in each eye


Barry

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## chip anderson

Phrasing of the ruling clearly indicates that this board or agency doesn't actually have a clear understanding of optics or the optical business or they would not have refered to the lens as having "diopter strengths" and would probably have used phrases like "haveing a focal length of less than one third of a meter."  Would also have referred to bifocals as "lenses having more than one focal lenght."  This would have clearly ruled out bifocals, multifocals, cylinders and lenses having aberration.

Chip

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## jediron1

> Phrasing of the ruling clearly indicates that this board or agency doesn't actually have a clear understanding of optics or the optical business or they would not have refered to the lens as having "diopter strengths" and would probably have used phrases like "haveing a focal length of less than one third of a meter."  Would also have referred to bifocals as "lenses having more than one focal lenght."  This would have clearly ruled out bifocals, multifocals, cylinders and lenses having aberration.
> 
> Chip




Chip if you knew NY like I know NY you would understand why they haven't a clue what they wrote in the above. And if you note it's from a law that was enacted in 1991 and their just getting around on what to do about it. And then they said it was settled in 1994. I can walk into a number of stores right now and find readers over +2.75.  It's like I said a number of times on this board, NY politicians don't care about unlicensed opticians or fraudulent reading glasses unless it will help them get re-elected. Sad but true. Magnivision and your large chains all laugh at the way NY does business because they all know they can get away with it. Don't get me started!  :Mad:

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## Senorwes1

I don't think that OTC readers can cause harm to people but why can't OTC glasses be sold for myopes?  Think about it.  A patient can tell when they can't read up close and a patient can tell when they can't see at a distance.  Why is it legal to sell plus powers OTC and not minus powers??  Just a thought.  Thank God that minus powers can't be sold OTC or we would all be out of business.

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## HarryChiling

> You all favor increasing government control of the eye care professions. Well, you got what you asked for, the FDA has determined that the risk/reward equation comes down on the side of allowing OTC readers to be sold. Or is it really your own pecuniary interests rather than the publics so called welfare that is your main concern. Come on now, you can tell me what your real agenda is.


If patients can self refract why can't opticians refract, now back to the bunker before the shells drop.:D

I say they have proved no harm except maybe the issues from prism which can be corrected.  I say get rid of all restrictions on OTC readers let them go as high as +14.00, then have the opticians test monocle versions in some sort of modified frame to come up with the correct OTC power.:D

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## Against the Rule

I think the point we're missing here is that OTC readers are sold for reading.  If it's negligent and dangerous to sell them without an Rx, we'd better stop the sale of magnifying glasses and microscopes while we're at it.

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## jediron1

> I think the point we're missing here is that OTC readers are sold for reading.  If it's negligent and dangerous to sell them without an Rx, we'd better stop the sale of magnifying glasses and microscopes while we're at it.




Never said it was not for reading what were saying is the NY state law says anything over +2.75 cannot be dispensed and most have laughed at that law. Whether it's right or wrong it's still the law. Thats all!  :Rolleyes:

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## coffee joe

are magnifying glasses and microscopes corrective opthalmic devices?

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## jediron1

> are magnifying glasses and microscopes corrective opthalmic devices?





It depends if your fit with microscopic readers because it's the only way you can read then yes. They also fit telescopic and they do prescribe magnifying glasses mostly for the legally blind.

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## harry a saake

and while we are talking about NY, keep in mind if you think the eyeglass laws are absurd this is the same state that has a statute making it illegal to have sex with a bird.

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## jediron1

> and while we are talking about NY, keep in mind if you think the eyeglass laws are absurd this is the same state that has a statute making it illegal to have sex with a bird.




Never said it was perfect.

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## kws6000

> If patients can self refract why can't opticians refract, now back to the bunker before the shells drop.:D
> 
> I say they have proved no harm except maybe the issues from prism which can be corrected.  I say get rid of all restrictions on OTC readers let them go as high as +14.00, then have the opticians test monocle versions in some sort of modified frame to come up with the correct OTC power.:D


Why does it have to be an optician trying to practice optometry.Using optician reasoning,anybody should be able to refract and have prescribing power.

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## opticalwoman

> I think they should be available *only from licensed OD's and Opticians*. Not from Walmart, drugstores, grocerystores and Goodwill. And I think this *should be ENFORCED !!*


If we start that, then asprin, malox, vitamins and such would have to be regulated also.  That's why some things are over the counter.  Readers serve a purpose, I'm just glad that only plus powers are available.  I have had many people ask where they could purchase negative powers.

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## Barry Santini

> Why does it have to be an optician trying to practice optometry.Using optician reasoning,anybody should be able to refract and have prescribing power.


Heck, they do that now....by choosing any 'ol spare pair they like...

why shouldn't the public self-refract? Just what is so important about clear vison anyway?

Barry

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## Against the Rule

Let's say one has a bad knee...You can go to an orthopedic specialist, or you can self-diagnose and treat and go to the drugstore, and buy a brace and some Tylenol.  You might be ensuring you'll never walk correctly again by doing so, but you do have that choice.  Most people with severe joint issues, who can afford real care, will see a doctor.
So with eyes...If someone could buy OTC minus lenses, why not let them?  If they can pass a screening and show 20/20 acuity to drive, for instance, it is only they rather than the public who are "at risk" (and in this case "at risk" refers only to not having the best vision possible).
There are countless analogies we could use...Don't sell OTC cough syrup because the patient might have lung cancer...don't sell porn because the guy might actually be suffering from ED...
I've not heard of one optical, independent or otherwise, that went out of business because Rite-Aid stole their presbyopic customers.  This is just the typical desire to protect people from their own stupidity by means of legislation, and it costs the taxpayers more to police OTC sales than it does to scrape up one or two bodies that decided to drive wearing +5.00 OTCR's.

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