用家用電腦檢查視力靠譜嗎 Take an Eye Exam on Your Laptop

I’ve just taken an eye exam — not in a spiffy doctor’s office with fancy contraptions, but in my living room with my smartphone and laptop.

我剛剛接受了一次視力檢查——不是在醫生辦公室裏，也沒有用什麼昂貴高級的奇妙玩意兒，整個檢查就在我的起居室裏進行，使用的是我的智能手機和筆記本電腦。

A new site called Opternative promises the high-tech, hands-off equivalent of a refraction test — one of the exams performed by an eye doctor to measure a prescription for eyeglasses or contact lenses — in the comfort of your own home.

通常，眼科醫生通過驗光（即屈光檢查）來爲患者開配鏡（普通或隱形眼鏡）處方。如今，一個名爲Opternative的新網站承諾，他們的新技術可以讓人們舒舒服服地在自己家裏完成類似的檢查過程。

To do the test, you need to have smartphone, a computer and at least 12 feet of space. You also have to be between the ages of 18 and 40. Unfortunately, I don’t make the cut, but for the purpose of experiencing this service first hand, I shaved an even 10 years off of my real age and did the test anyway. What’s a little white lie for science?

要進行這項檢測，需要有一部智能手機、一臺電腦和至少12英尺（約合3.65米）的空間。此外，受試者的年齡須在18歲至40歲之間。不幸的是，我並不符合這個要求，但爲了親身體驗這項服務，我把自己的真實年齡減去了10歲。出於探討科學的目的，撒個善意的小謊應該不要緊吧？

The actual exam is simple. You start by stepping 10 feet away from your computer — which Opternative calibrates and walks you through using a credit card and your own shoe size. Once you are set up, it’s an easy dive into the D.I.Y. exam. The test includes a series of visual tests, some with one eye covered, looking at various shapes, patterns, numbers and letters on the screen. You’re guided through the process with audio and video prompts, and respond to questions by clicking through multiple-choice questions using your smartphone as a remote control for the test.

實際的檢測過程非常簡單。首先，你需要走到距離電腦10英尺（約合3.0米）處——Opternative會藉助信用卡和你自己的鞋碼指導你準確把握這一距離。搞定這步之後，就可以輕鬆進入這一自助式(D.I.Y.)視力檢查的其餘步驟了。整個測試包括一系列的視力檢測（有的要求你遮住一隻眼睛），電腦屏幕上將出現各種各樣不同的形狀、圖案、數字和字母，你將在口述和書面提示的全程指導下，使用智能手機作爲遙控器，點擊多項選擇題的選項來回答問題。

At the end of the test, it asks you to fill out your medical and eye history, choose glasses or contacts ($40), or both ($60), and then wait for an ophthalmologist licensed in your state to review the exam and issue a prescription. Easy right? You’ll have a digital eye prescription within 24 hours.

在測試結束後，它會要求你填寫你的病史和眼科病史，並選擇想要配普通眼鏡還是隱形眼鏡（需支付40美元），又或者兩者皆要（需支付60美元）。之後，你只要等着你所在州的持證執業眼科醫生審覈檢查結果，並開出處方就行了。很容易對不對？24小時之內，一張數字化的眼科處方就到手了。

Except, that’s not what happened to me.

只不過，我的經歷卻並非如此。

Shortly after finishing the exam, I received a series of emails from someone at Opternative support, advising me to go see an eye doctor in person. The company promptly refunded my $40 and offered to help me find a trusted doctor in my area. They also helpfully recommended that I pick up a pair of +1.50 reading glasses.

在完成檢查後不久，我收到Opternative發來的多封電子郵件，勸告我親自去拜訪一下眼科醫生。公司迅速退還了我那40美元，並提出願意幫助我在我所在地區找一個值得信賴的醫生。此外，他們還周到地建議我配一副屈光度爲+1.50 D（150度）的老花鏡。

Wait. Rejection. What happened?

等等！先別忙。這是怎麼回事情？

With my permission, Aaron Dallek, the company’s co-founder, spoke with the California-based ophthalmologist who reviewed my exam to find out why he chose not to issue a prescription. There were apparently a few red flags from my medical history that kept me from fooling the system.

經我允許後，Opternative公司的聯合創始人阿龍·達萊克(Aaron Dallek)與常駐加州的一位眼科醫生進行了溝通，詢問他爲什麼在審覈我的檢查結果後選擇不出具處方。原來，是我的病史中存在危險信號(red flag)，害我沒能成功糊弄過這個系統。

First, I hadn’t ever seen an eye doctor in person, other than doing regular eye checks with my family physician. Second, I had mentioned some fuzziness around lights while driving at night, and some reading issues when my eyes are tired. While those symptoms are perfectly common for a 44-year-old (my real age), they are cause for concern for someone who reports their age as 34, which is what I did.

首先，除了接受家庭醫生的定期眼部檢查之外，我從來沒有親自拜訪過眼科醫生。第二，我曾提到在夜間開車時覺得燈光周圍有一圈模糊，當我眼睛疲勞時閱讀也會出現問題。雖然對於一個44歲（我的實際年齡）的人來說，這些症狀相當常見，可出現在一個34歲（我虛報的年齡）的人身上，就難怪醫生會擔心了。

Even though I fooled no one, in my quest to test Opternative, I still found the process to be straightforward and relatively hassle-free. Opternative is best suited for the person who finds themselves between eye exams and simply needs a new pair of glasses or wants to try a new brand of contact lenses. And the firm says it plans to expand its test to the over-40 crowd next year.

不過，我的本意只是想體驗一下opternative，所以雖然沒能矇混過關，我仍然感覺這個檢查十分輕鬆簡單。Opternative最適合那些想配副新眼鏡，或想嘗試下某個新品牌的隱形眼鏡，不巧正趕上兩次眼科檢查的中間時段的人。該公司稱，他們計劃明年將該檢查的適宜受試者擴大到40歲以上人羣。

Now some bad news. You’ll need 25 uninterrupted minutes to take the test. Unfortunately, it’s also not covered by insurance, and it’s only available in 30 states so far. Most important, it’s not a comprehensive eye exam so it’s not a good option for people who have an unusual symptom or are worried about their eye health, including diseases such as glaucoma, cataracts and diabetes.

現在，我們再來說一些壞消息。這項檢查需要連續進行25分鐘。而且，不幸的是，目前只有30個州可以享受這項服務，費用還不能從醫保裏報銷。最重要的是，它並非全面的眼科檢查，如果存在異常症狀或者擔心自己患有青光眼、白內障或糖尿病等眼部疾病，它絕非你的明智選擇。

Even so, for people who are candidates for the service, the company says the results are statistically equivalent to a traditional in-person exam. The firm says data from a clinical trial showed that participants achieved at least 20/25 vision with the prescription generated by the Opternative self-test. Those results are statistically equivalent to a traditional in-person exam.

即便如此，該公司表示，對於適宜的受試者，檢查結果的準確性在統計上與傳統的當面檢查不相上下。他們還稱，臨牀試驗的數據顯示，參與者採用Opternative自助驗光生成的處方後，矯正視力至少可以達到20/25。從統計上來說，這些結果與傳統的面對面檢查相當。

Opternative does have a disclaimer at the bottom of its homepage: “Opternative’s service does not include any type of eye health exam. Our service only provides patients with a refractive eye exam, which measures a person’s prescription for glasses or contact lenses.”

Opternative還在其主頁底部做出瞭如下聲明：“Opternative的服務不包括任何類型的眼部健康檢查。我們僅爲患者提供驗光服務，以及依此開具的配製普通眼鏡或隱形眼鏡的處方。”

Even so, the American Optometric Association does not support online eye exams. The A.O.A. president, Dr. Steven Loomis, has said he’s concerned that eye patients may try to skip in-person appointments entirely once they get a taste of digital convenience.

即便如此，美國視光協會(American Optometric Association, A.O.A.)並不支持在線的眼科檢查。A.O.A.的主席史蒂文·盧米斯(Steven Loomis)博士表示，他擔心一旦眼疾患者嚐到了數字化檢查的方便之處，就會完全略過約見正規眼科醫生當面看診的“麻煩”。

“Opternative knows it’s not offering anyone an eye exam, yet they claim that they are,” Dr. Loomis said in an email. “We actively oppose inferior and outright bad patient care, and instances when technology can be abused in a way that leaves patients misled, misinformed or confused about the state of their own health.”

“Opternative明知自己無法爲任何人提供眼科檢查，卻聲稱自己做得到。”盧米斯博士在一封電子郵件中說。“我們強烈抵制水平低劣的患者醫護，反對濫用技術誤導患者，以致令他們搞不清自己的健康狀況。”

Adding to the criticism from the optometry community is a lawsuit alleging one of Opternative’s co-founders used proprietary information from the National Board of Examiners in Optometry for a different website business. The complaint, which isn’t related to Opternative’s online eye exams and has been settled, does seem to have created a public relations challenge for the firm.

除了上述來自眼科學界的批評之外，還有人提起訴訟，控告Opternative的創始人之一在另一項網站業務中使用了美國國家視力測定術考覈委員會(National Board of Examiners in Optometry)的專有信息。該投訴雖與Opternative的在線視力檢查無關，且已經達成了庭外和解，但它確實對該公司的公關能力提出了一大挑戰。

What does all of that have to do with the convenience of getting a prescription for glasses or contacts? Nothing for me. Heeding Opternative’s advice, I made an appointment with an eye doctor, and spent two hours in his office and more than $500 to end up back where I started: With a pair of reading glasses and the knowledge that my eyesight just isn’t what it used to be.

但比起可以便捷地獲得普通或隱形眼鏡處方，上述種種又有什麼大不了的？反正我是覺得沒什麼關係。我聽取Opternative的建議約見了眼科醫生，在他的辦公室待了兩個小時還花了500多美元，最後的結果也不過是回到了原地：配一副老花鏡，並承認自己的視力已經不如以往。

I personally did not feel misled by my online eye exam experience, but I am not surprised that eye doctors are wary about online services. Other medical professionals have expressed similar reservations about telemedicine, but a number of new digital services are now delivering online consultations anyway. It was only a matter of time before the eyes have it too.

我個人覺得並沒有被這次的在線驗光誤導，不過眼科醫生對在線服務持謹慎態度也並不令我感到驚訝。其他的醫學專業人士也對遠程醫療表示了類似的保留意見，但無論如何，目前有若干個新興的數字服務在提供在線諮詢。眼科出現此類服務只是個時間遲早的問題。