Pupils Wide Open

Prescription laws, generally regarded as a safeguard for the public, may be facilitating protectionism and price-fixing instead. Attorneys general in 33 states are suing the American Optometric Association for jacking up the price of contact lenses, which are worn by nearly 25 million Americans. They hope to prove that optometrists conspired to fix prices and to limit the release of contact lens prescriptions.

"Optometry is virtually the only form of health care where the care giver actually sells the items he prescribes," according to Consumers Research. Eye doctors had faced a considerable drop in income when technology moved the contact lens industry away from specialized lenses to disposables. This shift made mass production possible, taking distribution out of doctors' control. Through the AOA, optometrists fought back by pressuring manufacturers of disposables to sell lenses only to licensed optometrists, rather than directly to other retailers or patients.

When it comes to soft contacts, companies that mass-distribute the lenses are forced to buy more expensive lenses from wholesalers, instead of directly from manufacturers. And many optometrists won't write a patient a prescription unless he agrees to buy their lenses. Such practices allow eye doctors to mark up lenses between one and five times the cost.