Eyeglass prescriptions expire after 1-2 years even when vision has not changed

Most US states mandate that eyeglass prescriptions expire after 1-2 years, requiring a new exam ($200-$400 without insurance) before a patient can order replacement glasses. For the roughly 70% of adults whose prescriptions remain stable year over year, this is a forced expenditure that provides no clinical value. If your glasses break at month 13, you cannot simply reorder the same prescription -- you must schedule an appointment, take time off work, sit through a 20-minute refraction, and pay for an exam that confirms what you already knew: your eyes have not changed. The real pain is felt by people without easy access to eye care. In rural areas, the nearest optometrist may be 50+ miles away. For hourly workers, taking a half-day off for an eye exam means lost wages on top of the exam cost. For uninsured adults (about 35% of the US population lacks vision coverage), the $200-$400 exam fee is the barrier that keeps them wearing a scratched, bent, outdated pair rather than ordering a fresh $30 pair online. The prescription expiration does not protect these people's health -- it blocks their access to affordable vision correction. This persists because mandatory annual exams are the financial backbone of optometric practices. The exam generates revenue directly and creates a captive audience for optical sales. State optometry boards set expiration periods, and these boards are composed of practicing optometrists with a direct financial interest in short expiration windows. The American Optometric Association frames this as patient safety -- claiming annual exams catch glaucoma and other conditions early -- but comprehensive eye health screenings and refractive exams are different services. You could screen for glaucoma without redoing the refraction, but unbundling these services would reduce the optometrist's ability to sell glasses at the point of care.