The largest lens maker (Essilor) has merged with the largest frame maker (Luxxotica) and they also own online retailer FramesDirect. A former executive of Essilor runs a Canadian company that is acquring independent opticians. Japanese lens makers (Hoya and Seiko) have merged in response.
Essilor, Zeiss and others are asking opticians to spend thousands of dollars on equipment [1] that measures patient’s eyes for lens personalization. This data (including auto-refraction [2]) then gets aggregated with optometerist prescription data (subjective refraction = which is better, 1 or 2), providing Google captcha-style human input to improve the software algorithms used in measurement. Opticians are funding their robot replacements.
Today, online retailers like FramesDirect use average values for some fitting measurements (e.g. pupil/fitting height in frame for optical center of single vision lens). There are mobile eye measurement apps that take a photo of your face with a credit-card sized object to adjust for scale, but they are not too accurate. At some point, self-service [3] optical measurement devices and lens customization algorithms will enable optical telemedicine globally.
[1] Optical dispensing goes digital, http://visionmonday.com/article/cover-story-dispensing-goes-...
[2] Wavefront aberrometer, https://www.fastcompany.com/3049271/this-iphone-accessory-re...
[3] Vision test with remote opticians, http://www.mobihealthnews.com/content/smart-vision-labs-laun...