South Carolina’s war against online eye exams might just be the front line in America’s battle between innovation, common sense access to care, and protectionist regulations that do nothing but pad the pockets of entrenched interests and keep everyday citizens paying more for less.

At a Glance

• South Carolina banned online eye exams, bucking the national trend toward embracing telemedicine and affordable care.
• The law was pushed through by optometrist lobbyists, overriding the governor’s veto—despite zero evidence of harm from online vision tests.
• This ban forces patients into costly, annual in-person visits, benefitting local optometrists at the expense of ordinary consumers.
• The state Supreme Court is now reviewing whether this protectionist law violates constitutional rights, with a decision pending that could set national precedent.

Optometrist Lobbyists Versus the People—And Technology

The rise of telemedicine has made everything from dermatology to mental health more accessible and affordable for millions. But not in South Carolina—at least not if you want to renew a glasses prescription. For nearly two years, Visibly (formerly Opternative), a Chicago-based startup, offered state residents the ability to renew their vision prescriptions online. The convenience and cost savings were obvious: no unnecessary doctor visits, no wasted time, and lower costs for everyone who just needed an updated prescription, not a full medical workup. But rather than celebrate this advance, the South Carolina Optometric Physicians Association (SCOPA) saw a threat to their business model. Their response? Lobby the legislature to ban online eye exams altogether, conveniently ensuring that patients would have to keep showing up—and paying up—every single year. The “Eye Care Consumer Protection Law” was rammed through in 2016, over the veto of then-Governor Nikki Haley, who rightly called out the bill as anti-competitive nonsense that would only hurt South Carolinians.

Watch: Test It: Opternative, the online eye exam

Let’s not kid ourselves about who wins and who loses. Traditional optometrists get a captive market, more foot traffic, and more copays. Patients get higher bills, longer drives, and the privilege of making an annual pilgrimage to an in-person office just to get a piece of paper—something residents of most other states can do with a few clicks and a smartphone. All this in a state otherwise happy to embrace telemedicine for everything else. Why single out vision care? Follow the money.

The Constitutional Challenge: Protectionism Disguised as “Safety”

After the ban became law, Visibly and their legal partners at the Institute for Justice took the fight to the courts. Their argument is straightforward: the ban is not about public health, it’s about economic protectionism. The law contradicts South Carolina’s broader policies that allow telemedicine and online prescriptions for almost every other kind of medical service. Worse, there’s no credible evidence that online vision exams are dangerous. Most states allow longer prescription durations—two years or more—while South Carolina forces an annual renewal. The only ones benefitting are local optometrists. The Institute for Justice has made it clear: singling out online eye exams is arbitrary, protectionist, and unconstitutional. The South Carolina Supreme Court heard oral arguments on June 3, 2025, after previously allowing the case to proceed. The decision now sits with the justices, who must choose between siding with entrenched economic interests or with the rights and wallets of every South Carolinian who needs affordable eye care.

Implications: What’s Really at Stake for Patients, Taxpayers, and Liberty

If the Supreme Court upholds the ban, South Carolinians will continue to suffer under a system that’s more about protectionism than protection. Those in rural communities, the elderly, or anyone with limited mobility will find eye care harder and more expensive to access—all because a special interest group decided their profits matter more than your convenience or your wallet. If, on the other hand, the court strikes down this ridiculous law, it could open the door to genuine competition, lower prices, and a wave of innovation across the state and even the nation. It would send a message to every trade group and entrenched interest: you don’t get to hide behind phony “public safety” arguments when the real motive is protecting your own bottom line.