[This post is not just about glasses. It’s about an optimistic future.]
Curmudgeonly Gem Of Insight:
“You can’t stop the signal. But folks can royally fuck up the first few attempts attempting to delay the inevitable.”
The good news is the signal. You can’t stop it. The bad news is they’re trying. Even if you don’t notice it, they’re losing.
A pet future vision of mine involves prescription glasses. Yeah, I know. It’s boring. Yet it interests me as hard fought bloody dividing line between horrifically expensive and largely government managed / socialized medical services and mundane consumer goods. Wikipedia tells me eyeglasses were first made in Italy in about 1286. Why are they not $6 and available from a vending machine? I think we can do better than an expensive storefront with a dude in a lab coat who charges a week’s pay. I’ll admit I love the high quality of glasses (in America) but if you live in a mud hut in Namibia you’re screwed.
For this product, change is coming. All my life (and yours) prescription glasses have been an expensive PITA. Don’t get me wrong, the optics and glass, and build are superb. And for that matter, vision’s exclusion from most health insurance helps. (As I wrote in 2010: “opticians and dentists. They’re not covered by many insurance plans and therefore markets exist…. I have a range of providers, there’s always room for an appointment, and ‘glasses in an hour’ is not a punchline.“)
But it could be better. About a decade ago I saw this picture:
This image could be a big a deal as polio vaccines.
This is not a hipster. It’s a Zulu fellow wearing what was called at the time “adaptive glasses”. These are cheap glasses that a person with no help from an optometrist whatsoever can adjust to his or her own vision. Keep in mind that about half the population planet wide could benefit from corrected vision.
It’s fucking brilliant!
I’m not generally an optimist but I was starry eyed with two ideas:
- I wanted them (whoever “they” are) to drop these clever little gadgets by the crate-load on every impoverished shithole on earth. Every mud hut, every nomadic sheepherder, every peasant everywhere. Do to bad vision what we did to smallpox!
- I wanted a few of these scattered about my world too. One in my glove box when I’m traveling, one in my first aid kit when I’m in the wilderness, a few stashed in the pantry for when I break a pair of glasses on a holiday weekend. I like backups to my backups.
All that was necessary to accomplish most of #1 and all of #2 was damn near nothing. Just sell ’em cheap. Churn them out en masse. Fire up a factory in Bangladesh or Mexico or Alabama or wherever and make ’em so plentiful they’re everywhere. This ‘aint rocket science; use the same factory that makes Disney branded lunchboxes, crates of bendy soda straws, toys, novelty rubber chickens, whatever. The global economy is primed to bury us in cheap plastic shit so the table is set for a product like this!
Alas I saw the writing on the wall. The inventor made an inspiring TED talk. Whenever there’s a TED talk you can be assured that an idea is now in the hands of Utopians who will screw it into the ground.
Repeat that because it matters:
“Whenever there’s a TED talk you can be assured that an idea is now in the hands of Utopians who will screw it into the ground.”
Around 2008 there was a flurry of articles about this very cool idea. Everyone was positive. They loved the inventor’s 2020 vision: to help 1 billion of the world’s poorest see better. Did I mention the inventor is a professor? A professor who made a TED talk? If you want a cheap widget distributed to every mud hut, who’s the least likely to accomplish it?
In his TED talk (from 2009) he mentioned he’d already gotten 30,000 glasses out to the world. I liked that. Spot on man! Now turn it over to the market and let the purveyors of cheap plastic shit do their thing. Collect a penny or two on each pair and retire to a solid gold house in Tahiti… you earned it dude! If there ever was a man deserving of a Nobel it’s a man who fixed vision for a billion peasants.
So what went wrong?
He didn’t just go to market. Did I mention he’s a professor with a TED talk?
In 2011 I tired to buy a pair myself. (Partly out of curiosity.) I found it somewhere between impossible and very damn hard. I coined the term Crusader Product Inhibition and bitched that the social justice crowd was killing a very cool idea. I write stories about a dog ordering a Frisbee on Amazon and the glasses thing was the opposite; languishing exactly like every idea in the hands of starry eyed doogooders. (Note: there are similar object on Amazon now, very slow to market and oddly expensive but they do exist… guardedly.)
You can’t stop the signal. Since Hippie McSaveTheWorld wasn’t flooding the market, prescription glasses on the internet became a thing.
In 2012 I ordered pair of Rx glasses from the internet. “Which brings me to today’s victory. My glasses ‘wore out’…. As an ‘experiment’ I ordered prescription glasses on-line. … Here’s the punchline; they cost 1/3 what I usually pay.”
Full disclosure, I break glasses a lot. That pair were OK for a few years until I nuked them. I ordered another set and they weren’t so good. I wound up buying expensive “glasses in an hour” from a storefront place. The combined cost of both “internet” glasses was less than the cost of five minutes breathing the air in a regular glasses storefront so I call it a win. Also I occasionally wear contacts and I always get contacts on-line. Another win.
In 2013, I bitched again that “Adaptive Eyewear” was not getting to market in a big way. For me it’s just an amusing interest but those poor bastards in mud huts were missing out!
Now it’s 2017. How well has Utopian Professor Magnanimous done getting his incredibly cool idea to the masses?
Well a website exists… it’s inspiring and won’t sell you glasses. There’s another website that’s equally inspiring and won’t sell glasses. There are a smattering of vaguely similar products on Amazon and another place that has some mechanically adjusting glasses. (Both look like they’re not liquid filled, possibly due to licensing/patents?).
What about the masses? The TED talk promised good things for the goddamn masses! How is Utopian Professor Magnanimous doing on his audacious (and laudable) goal of helping a billion poor people?
As far as I can tell he’s done almost nothing. His 2009 TED talk claimed he’d shipped 30,000 pairs and the best I can find is now the count is 40,000 pairs. (I can’t find a solid number. If you see it, notify me.)
The point is that a smart man came up with a brilliant idea and he (along with what looks like dozens of participating NGO’s) are totally fucking up the delivery. Dudes in mud huts are getting nothing. That sucks!
But wait, it’s 2017 and I’m trying to be a ray of sunshine this year. So here’s more of that unstoppable signal:
Holy cow! I had no idea that you could get an eye exam from a smartphone. Apparently you can (*I haven’t tested this). If you’re interested, check it out here. (Hat tip to Maggie’s Farm.)
Holy shitsnacks! You can’t stop the signal! No matter how long Professor SaveTheWorld sits on liquid filled glasses it didn’t stop the bespoke Rx glasses I ordered. Now another front in the war has opened up with smartphones. The signal is going right around every speedbump it meets.
It may not help the dude in the mud hut but then again it won’t hurt. Even people in mud huts sometimes have smartphones. A $40 exam and $50 glasses aren’t the $6 vending machine solution I imagined, but it’s a step on that path. It’s far closer than the guy in the lab coat who ‘aint available in Botswana.
I also promised a Universal Theory of Technology. This is it:
“Prescription glasses are one of many precursors to the automation/robot revolution nerds have been talking about. It’s here. It’s here right now. And I’m impressed!”
Rx glasses are shifting. I was born in a world where we drove an hour to see a dude in a lab coat who needed esoteric specialized equipment. He ordered up very expensive glasses that took 2 weeks for delivery and my parents grumbled at the cost. (I would promptly break them because I was a kid and the glasses went wherever my face went. I wasn’t alone in this continuing disaster. Which happened to many kids.) The world improved and soon we had “glasses in an hour” at most malls. Then came glasses much cheaper from the internet. Now the dude in a lab coat is a smart phone app.
There are pros and cons to everything. When people fret over automation “taking white collar jobs” this is exactly it. (I notice they weren’t quite so worried when it was blue collar jobs in the 1970’s.) Optometrists thought they were irreplaceable (I thought so too) but now they’re probably shitting their pants. Then again when I dreamed of having my every need delivered cheap and easy from the internet this is exactly it. I for one like automation so it’s OK with me.
Dear Curmudgeon,
As an individual who practices the art and science of optometry, I find your article ineffectual. You have a very myopic view of the world, its people and their vision disorders (pun intended.) I assume as an under 40, healthy, -2.00 or so myope, you have a very easy spectacle prescription to fill and luckily no binocular vision problems. An eye doctor not only assesses the visual system, but checks the health of the eye. Refractive terminals in malls and online refractive services have not only prescribed and dispensed completely incorrect spectacle prescriptions for people, they have missed sight-threatening and life-threatening conditions. Just yesterday I sent a patient to the emergency room for a condition they thought glasses would correct. I can only imagine what would have happened to this person had he made the poor choice to seek care from a refracting robot or online optical. Also, as an eye doctor who has volunteered to provide care in the third world, these online and non-eye doctor refractive services would be incredibly dangerous. We had patients lined up in Central and South America for hours for our services- many of these patients had conditions they thought could be simply corrected with glasses- advanced diabetic retinopathy, acute angle closure glaucoma, hypermature cataracts, amblyopia…..just to name a few. It’s real cute that you’d like to help out those less fortunate, so you will be happy to know that there are many optometric philanthropic organizations doing just that. I suggest you donate to Volunteer Optometric Services to Humanity (www.vosh.org) or Optometry Giving Sight (www.givingsight.org) if you’d like to make real change. Even if you don’t, sleep tight knowing that there are thousands of eye doctors around the world volunteering their noble services and time to save sight and even save lives.
Regarding the cost of frames and lenses- just like anything, you get what you pay for.
Thanks for the info. Let me start by saying I applaud you for volunteering to provide care in the third world. Well done! I envy your ability to contribute in that way. You should be proud of your contribution and I acknowledge it as awesome. I also encourage my meager audience to check out Volunteer Optometric Services to Humanity (www.vosh.org) or Optometry Giving Sight (www.givingsight.org) and give as they see fit.
As for the rest of the discussion let’s not throw the baby out with the bathwater. Eye care medicine (and many other services… maybe most of them) come down to a spectrum; no service, excellent service (which is necessarily expensive), and half assed service (which is somewhere between the two). You most certainly are part of a system that supplies excellent care. Good for you!
Excellent service is obviously the best. It’s right there in the name; excellent services. Suggestions to the contrary would be nuts. So let’s put a stake in that right here: excellent professional personalized service is best, half assed automated workarounds are inferior, and stumbling around in the desert with no care whatsoever sucks big time.
It never for a minute crossed my mind that “work arounds” such as smart phone diagnoses, internet delivered Rx glasses, or “adaptive eyewear” was superior to excellent, high quality care provided by a professional such as a Doctor of Optometry. It would be silly to think that. There’s no way in hell an iPhone is better than a pro. There’s no way “adaptive glasses” are better than lovingly custom fitted individually “tuned” high quality lenses in well fitted comfortable/fashionable frames. I went to pains to mention that the internet Rx glasses I purchased were inferior to the top end pairs I also buy. Further, just as you mentioned, surely there are times when an OD does amazing things that save their patients untold misery and that’s great for anyone who wants such care and gets it.
So now that I’ve totally and completely accepted that excellent professional care is best, what about people who have no care? The TED talk fellow said there are some people, many people in fact, that get no care. Is that incorrect? I took it at face value but what the hell do I know? There’s that cool photo of the Zulu fellow. I presumed he was likely to get no care and now he was benefiting from the half-assed care of adaptive glasses. This is in keeping with my theory that half assed care is better than no care. I can’t imagine anyone who needs glasses and has none would be disappointed with self adjusting cheapo optics as opposed to stumbling around half blind!
Am I wrong? Do most or nearly all third world people get excellent care? I know you donate your time. Have you and fellow selfless people reached the half of the planet that needs care? I presumed that was a task not even Superman could do. Maybe I’m wrong, 2017 is an amazing time and other miracles have occurred. Is the idea of a guy who needs vision correction and has no care knocked out of the park like smallpox and childhood polio? Maybe everyone everywhere really does have access to the excellent ministration of an OD. If that’s the case then I’d be delighted to hear it.
Speaking for myself, if I didn’t have access to a true OD and real bespoke Rx glasses I’d sure as hell prefer a less elegant solution to nothing. Which brings me to the next part of my ideas. Historically, in America we’re rich and we generally get excellent service; whether we want it or not. The “signal” as I call it, is the freedom to entertain a range of ideas; including shitty care from an iPhone and low end optics so cheap as to be nearly disposable as well as the option of $600 tri-focal, custom fit technological marvels. These new options, which suck compared to a real OD, are new freedoms. Are humans in general and Americans in specific to be allowed this freedom? I’m rather delighted to see the potential.
Obviously automated workarounds will never be as good as true professional excellence, but in some cases (like maybe an under 40, healthy, -2.00 or so myope, with a very easy spectacle prescription to fill and luckily no binocular vision problems…. or a Kalahari bushman with no care) new and medically inferior options are (or will become) good enough.
In closing, I apologize for pissing in your Cheerios and thank you for both the well informed perspective and doing eye exams for third world people.
Even the conditions to which the Jessica alluded will become assessible by robotic means, and on balance there will be fewer failure to diagnose issues. My concern, as with all technology, is the loss of human skills in this area as automation takes over. How far back will we fall if we suffer a significant breakdown; EMP, social unrest etc. How do you retain the knowledge and avoid a dark age?
Professional quality care can’t be beat! No care at all really sucks… be it eye care, dentistry or medical. Generally speaking you cough up the bucks or do without….
Keep in mind that the AMA is basically a guild, I suspect the other related occupations have similar. Robots, the internet & smart phone apps may not do as good a job as the professional but they can compete with them and the guild is there to prevent that.
Individuals in the different professions can & will take that extra step, but that is that individual’s action & it’s taken within the bounds of the guild.
The next 20 years are going to be interesting.