A new federal law gives contact lens wearers something eyeglasses wearers have had for 25 years — the legal right to a copy of their prescription so they can shop around for lenses. Lacking that right, patients in some states have been forced to buy their lenses from the doctor who prescribed them.  That has gradually changed in recent years as more than 30 states — including Kentucky this year — have passed laws requiring eye doctors to give patients a copy of their lens prescription.

Eye doctors in Kentucky say they support that principle. And they say that the Kentucky and federal laws will advance eye health by pushing lens wearers to get more frequent eye exams.  But they aren't happy the new federal law will partly pre-empt Kentucky's measure, which they say imposes a stronger prescription-verification requirement on lens retailers.  "We already had a good law here in Kentucky," said Darlene Eakin, executive director of the Kentucky Optometric Association.

Kentucky's law was passed unanimously last spring and took effect in June.  The federal measure, known as the Fairness to Contact Lens Consumers Act, was passed last month and signed into law Dec. 6 by President Bush. It will take effect Feb. 4.  Both laws have a dual objective: to guarantee consumers shopping choices, while preventing retailers from filling invalid or out-of-date prescriptions for lenses.

The federal law forbids eye doctors from requiring patients to buy contact lenses from them. It requires eye doctors to give a patient a copy of his or her lens prescription whether or not the patient requests it.  It also sets guidelines on prescription expiration dates and how retailers must verify prescriptions before filling them.

U.S. Rep. Richard Burr, R.-N.C., said he sponsored the legislation because "optometrists throughout the country were not all providing prescriptions to their patients." That left customers captive to buying lenses from their eye doctor, with "no ability to price-shop," Burr said.  "This is one of the few medical fields that we still allow ... for a doctor to provide a product that they can market to the patient," he said.

Brian Bethers, chief financial officer of 1-800 Contacts, made the same point. The company, the nation's largest online and mail seller of contacts, testified in favor of Burr's bill and stands to benefit from it.  Eye doctors who both prescribe and sell lenses have "an inherent conflict of interest," Bethers said.

But Eakin, of the Kentucky optometrists' group, said it's not uncommon for doctors to sell products they prescribe.  Podiatrists sell foot braces and orthotic shoes, and dentists sell tooth-whitening products and false teeth, she said. And some health-care clinics sell medications on-site.  "So I don't think that this is anything that you don't see commonly in the health-care industry, where the prescriber of a product (sells it) as an option," she said.  Eakin said Kentucky optometrists generally haven't refused to release prescriptions, and the optometric association supported Kentucky's bill.

The notion that consumers have a right to their own prescription isn't new. In 1978, the federal government required eye doctors to give eyeglasses wearers a copy of their prescriptions.  But that requirement didn't extent to contact lenses.  That began to change in the 1990s as states began passing their own contact lens laws.

The laws have helped fuel the growth of online lens sellers, and today many of the nation's 36 million contact lens wearers buy lenses online or at discount retailers like Wal-Mart.  But many states still lack laws guaranteeing consumers a copy of their lens prescription, and existing state laws have differing legal provisions.  For example, Indiana's law says a lens prescription must be released to a patient no more than six months after an initial fitting, a time period not included in Kentucky's law.

Burr said the federal law was aimed at creating "a seamless marketplace" for contacts.  He said that after initial reservations, eye doctors warmed to the bill because it could mean their patients would come in more frequently for exams.  That's because it makes it illegal for retailers to fill an expired prescription.

In Kentucky and Indiana, lens prescriptions generally are valid for one year. But many people ask online and other retailers to fill much older ones.  "I've had requests from Internet vendors (to verify prescriptions) for patients that I haven't seen in four or five years," said Dr. Elliott Rosengarten, a Louisville optometrist.

Dr. Ben Gaddie, an optometrist with Gaddie Eye Centers, said Kentucky's months-old law already has resulted in more patients coming in to get new prescriptions.  "We're uncovering a lot of patients that have just been year after year ordering their contact lenses online without having an eye examination," he said.  He added that patients "don't necessarily see it as a protection" when they can no longer get an old prescription refilled.

A key difference between the federal law and Kentucky's involves what retailers must do to verify a prescription is valid and up to date before filling it.  Vendors typically call or fax optometrists' offices to seek such verification — but if they don't get an answer within a stated time, they assume the prescription is valid and sell the lenses, a practice known as "passive verification." Kentucky's law is stricter: It forbids vendors from dispensing contacts without confirming a prescription is good.

Vendors argue that Kentucky's requirement is not fair, because eye doctors can thwart online sales by delaying verification.  Burr's bill, like laws in some states, allows passive verification, but gives eye doctors up to eight business hours to answer an inquiry.  That's longer than some online sellers wait. Bethers said 1-800 Contacts gives eye doctors between two and eight business hours, depending on the type of order.

Kentucky optometrists say eight hours sometimes isn't enough, especially in a rural state where some branch offices may not be open every day.  They say they aren't out to keep lens sales to themselves, but want to make sure people aren't harming their eyes.

Gaddie said some patients have come in after several years' absence for treatment of an eye ulcer, which ill-fitting lenses can cause.  "You ask them how they're getting their contact lenses, and they say, `Well, we just order them on the Internet,'" he said.

In addition to providing the right level of correction, eye doctors say, lenses must have the right fit for an eye's contours, charted with sophisticated equipment. The shape of the eye can change over time, requiring a new fitting.  But lens wearers don't always come in regularly. Rosengarten said perhaps half his patients get a yearly exam.

Despite their expanded freedoms, not all patients are comfortable with the idea of buying lenses online.  Peter Pritchard, a patient of Rosengarten, said he has never considered an online purchase because he has had difficulty getting the right fit. He prefers to get lenses from Rosengarten.