Brick-and-mortar stores must deal with online competition. Even health clinics face disruption from telemedicine. Yet optometrists have special protection in South Carolina.
When a telehealth company invented a safe and effective way for doctors to renew vision prescriptions remotely, political insiders rallied in Columbia to ban the service in South Carolina. Now, nine years later, the state-sponsored favoritism could end.
The South Carolina Supreme Court, which already rejected an attempt to dismiss the case in 2022, will finally decide whether the protectionist ban is unconstitutional.
Oral arguments—available online like just about everything else in the modern economy—occurred on June 3, 2025. The case started much earlier in 2016, when established providers got fed up with Chicago-based Visibly operating in their market.
The startup, then called Opternative, had been safely operating in South Carolina for nearly two years. Even today, nobody can point to any problems. Visibly is FDA cleared, and doctors safely use it to expand access to care in dozens of states.
The South Carolina Optometric Physicians Association (SCOPA) did not care. The trade group, whose members make much of their money selling glasses in their shops, wanted the economic threat removed. So it drafted a bill, recruited legislative sponsors, and celebrated when a supermajority of state lawmakers overrode then-Gov. Nikki Haley’s veto.
“Take that Opternative!!!!!!,” SCOPA wrote in an email to its members.
It pays to have friends in high places. If booksellers had the same clout, they could have stopped Amazon in 1994. Travel agencies could have stopped Expedia in 1996. And video rental chains could have stopped Netflix in 1997.
Consumers would have suffered in terms of convenience, quality, and cost. But established providers have different priorities. Adapting to innovation can be a hassle when they already have familiar ways of doing things.
South Carolina optometrists have an especially comfortable arrangement. Most states allow two-year prescriptions for corrective lenses. The duration is three years in North Dakota and five years in Florida. But optometrists convinced lawmakers to adopt annual expirations in South Carolina.
This short window maximizes visits to eye specialists, which is great for business if you happen to sell lenses and frames. Online renewals could cut into this racket, which is why the backlash against Visibly was so visceral.
What the company’s opponents overlooked was that the South Carolina Constitution guarantees due process and equal protection, which means laws must meaningfully benefit the public. Reducing access to care does not benefit the public—it merely protects an outdated business model from competition.
Visibly made this argument when it filed its lawsuit. Our public interest law firm, the Institute for Justice, represents the company. A key fact we pointed out, and that state Supreme Court will now have to grapple with, is that South Carolina broadly embraces telemedicine.
State law trusts and empowers doctors to use online tools just like Visibly to prescribe nearly anything—eye drops, skin creams, antibiotics, and anything else doctors conclude would benefit a patient—except lenses. The only other prescriptions treated as harshly as lenses are opioids-inducing drugs. Needless to say, eyeglasses are not like opioids.
South Carolina does not treat lenses differently because they are uniquely dangerous. Indeed, about two-thirds of U.S. adults use prescription eyewear, and most renewals are routine. Instead, lenses are being treated differently because a trade group wrote a law to protect its bottom line and managed to scare the Legislature into adopting it.
That is unconstitutional. SCOPA can pretend that the internet does not exist. The group can live in the 1980s if it wants. But the South Carolina Constitution does not require courts to play along. The state trusts doctors to treat patients online and should not single out eyeglasses just because some people fear competition.
Political insiders must deal with reality, just like everyone else.
Joshua Windham is an attorney. Daryl James is a writer.
