Mandatory annual contact lens exams cost US consumers $3.6 billion per year, with questionable medical necessity for stable-prescription wearers

The FDA classifies contact lenses as Class II or III medical devices, and 38 US states mandate contact lens prescriptions expire after just one year, forcing 45 million American contact lens wearers to pay $100-$250 annually for a mandatory exam before they can repurchase the same lenses they have been wearing without issues. Why it matters: 45 million wearers pay $100-$250 each per year for exams that frequently result in zero prescription changes, so the aggregate annual cost to consumers is $3.6-$7 billion including exam fees and lost work time, so cost-sensitive consumers stretch their lenses beyond recommended replacement schedules creating actual infection risk, so the mandatory exam becomes both the barrier that causes the very harm it claims to prevent and a profit center for optometrists, so patients in rural areas with long travel times to optometrists face disproportionate burdens. The structural root cause is that the Fairness to Contact Lens Consumers Act (15 U.S.C. ch. 102) sets a federal floor of one-year expiration and state optometry boards -- controlled by practicing optometrists who profit from mandatory exams -- have resisted extending prescription validity despite evidence from countries like the UK and Japan where longer prescription periods have not led to worse outcomes.