UNITED STATES OF AMERICA 

BEFORE THE FEDERAL TRADE COMMISSION 

COMMISSIONERS: Lina M. Khan, Chair 

Rebecca Kelly Slaughter 

Christine S. Wilson 

Alvaro M. Bedoya 

192-3157 

In the Matter of 

DECISION AND ORDER 

LCA-VISION, a corporation, d/b/a 

LASIKPLUS, also d/b/a JOFFE DOCKET NO. CMEDICENTER 

DECISION 

The Federal Trade Commission (“Commission”) initiated an investigation of certain acts and 

practices of the Respondent named in the caption. The Commission’s Bureau of Consumer 

Protection (“BCP”) prepared and furnished to Respondent a draft Complaint. BCP proposed to 

present the draft Complaint to the Commission for its consideration. If issued by the 

Commission, the draft Complaint would charge the Respondent with violations of the Federal 

Trade Commission Act. 

Respondent and BCP thereafter executed an Agreement Containing Consent Order (“Consent 

Agreement”). The Consent Agreement includes: 1) statements by Respondent that it neither 

admits nor denies any of the allegations in the draft Complaint, except as specifically stated in 

this Decision and Order, and that only and solely for purposes of this action, it admits the facts 
 

 

 

necessary to establish jurisdiction; and 2) waivers and other provisions as required by the 

Commission’s Rules. 

The Commission considered the matter and determined that it had reason to believe that 

Respondent has violated the Federal Trade Commission Act, and that a Complaint should issue 

stating its charges in that respect. The Commission accepted the executed Consent Agreement 

and placed it on the public record for a period of 30 business days for the receipt and 

consideration of public comments. The Commission duly considered any comments received 

from interested persons pursuant to Section 2.34 of its Rules, 16 C.F.R. § 2.34. Now, in further 

conformity with the procedure prescribed in Rule 2.34, the Commission issues its Complaint, 

makes the following Findings, and issues the following Order: 

Findings 

1. The Respondent is LCA-Vision, doing business as LasikPlus and Joffe MediCenter, an 

Ohio corporation with its principal place of business at 7840 Montgomery Road, 

Cincinnati, OH 45326. 

2. The Commission has jurisdiction over the subject matter of this proceeding and over the 

Respondent, and the proceeding is in the public interest. 

ORDER 

Definitions 

For the purposes of this Order, the following definitions apply: 

A. “Clearly and conspicuously” means that a required disclosure is difficult to miss (i.e., 

easily noticeable) and easily understandable by ordinary consumers, including in all of 

the following ways: 

1. In any communication that is solely visual or solely audible, the disclosure must be 

made through the same means through which the communication is presented. In any 

communication made through both visual and audible means, such as a television 

advertisement, the disclosure must be presented simultaneously in both the visual and 

audible portions of the communication even if the representation requiring the 

disclosure (“triggering representation”) is made through only one means. 

2. A visual disclosure, by its size, contrast, location, the length of time it appears, and 

other characteristics, must stand out from any accompanying text or other visual 

elements so that it is easily noticed, read, and understood. 

3. An audible disclosure, including by telephone or streaming video, must be delivered 

in a volume, speed, and cadence sufficient for ordinary consumers to easily hear and 

understand it. 

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4. In any communication using an interactive electronic medium, such as the Internet or 

software, the disclosure must be unavoidable. 

5. The disclosure must use diction and syntax understandable to ordinary consumers and 

must appear in each language in which the triggering representation appears. 

6. The disclosure must comply with these requirements in each medium through which 

it is received, including all electronic devices and face-to-face communications. 

7. The disclosure must not be contradicted or mitigated by, or inconsistent with, 

anything else in the communication. 

8. When the representation or sales practice targets a specific audience, such as children, 

the elderly, or the terminally ill, “ordinary consumers” includes reasonable members 

of that group. 

B. “Close proximity” means that the disclosure is very near the triggering representation. 

For example, a disclosure made through a hyperlink, pop-up, interstitial, or other similar 

technique is not in close proximity to the triggering representation. 

C. “LASIK” means both laser-assisted in situ keratomileusis, commonly called LASIK, and 

photorefractive keratectomy, or PRK, another form of laser eye surgery. 

D. “The price most consumers pay per eye for Respondent’s LASIK” means the price 

range from the 25th to 75th percentile of prices paid per eye by consumers during the 

previous calendar year, or the second previous calendar year during the first calendar 

quarter of a then-current year, such as “most consumers paid between $X and $Y per eye 

in 2021.” 

Provisions 

I. Prohibited Misleading Representations 

IT IS ORDERED that Respondent, and Respondent’s officers, agents, employees, and 

attorneys, and all other persons in active concert or participation with any of them, who receive 

actual notice of this Order, whether acting directly or indirectly, in connection with the 

advertising, promotion, offering for sale, or sale, of a particular LASIK service offering must not 

misrepresent in any manner, expressly or by implication: 

A. the price of such LASIK service offering from Respondent, including but not limited to 

the total costs for such LASIK service offering; or 

B. the average price for all LASIK service offerings from Respondent or other providers; or 

C. any material restrictions, limitations, or conditions that affect the price consumers will 

pay for such LASIK service offering, other than restrictions, limitations, or conditions 

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resulting from clinical decisions made by Respondent’s affiliated independent medical 

professionals in their professional judgment in the course of their professional medical 

practice. 

II. Required Disclosure of Conditions and Requirements 

IT IS FURTHER ORDERED that: 

A. Respondent, and Respondent’s officers, agents, employees, and attorneys, and all other 

persons in active concert or participation with any of them, who receive actual notice of 

this Order, whether acting directly or indirectly, in connection with advertising, 

promoting, or offering for sale, or sale, of LASIK for a price or discount for which a 

majority of consumers, during the time the offer is valid, likely will not be able to meet 

the requirements or qualifications necessary to obtain such price or discount, must not 

make any representation, expressly or by implication, about such price or discount 

without disclosing, Clearly and Conspicuously, and in Close Proximity to that 

representation: 

1. If the price for LASIK is per eye; 

2. The price most consumers pay per eye for Respondent’s LASIK; 

3. The requirements or qualifications necessary to obtain the promoted price or discount, 

including, but not limited to, any restrictions on eligible prescriptions or eye 

conditions, such as that the promoted price or discount only applies for 

a) prescriptions with a diopter (or power) falling within a specified range; 

b) prescriptions with an astigmatism within a specified range; 

c) patients who are nearsighted (myopia), farsighted (hyperopia), need bi-focals 

(presbyopia), or are affected by any other medically recognized diagnosis; or 

d) patients who have or have not had LASIK surgery of any kind before, 

but not including requirements or qualifications resulting from clinical decisions made by 

Respondent’s affiliated independent medical professionals in their professional judgment 

in the course of their professional medical practice. 

B. Provided, however, that for a space-constrained advertisement, a disclosure will be 

deemed compliant with Paragraph A(3) of this Section as long as: (i) the disclosure 

specifies the types of requirements and medical conditions (e.g., prescriptions, 

nearsightedness) necessary to obtain the promoted price or discount; (ii) the disclosure is 

made Clearly and Conspicuously and in Close Proximity to at least one prominent 

representation of such promoted price or discount; (iii) the space-constrained 

advertisement includes a hyperlink in Close Proximity to the disclosure that leads to a 

webpage that Clearly and Conspicuously discloses all of the information required by this 

Section, including the disclosures required by Paragraph A(3); (iv) any other hyperlink 

contained in the space-constrained advertisement leads to a webpage that Clearly and 

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Conspicuously discloses all of the information required by this Section, including the 

disclosures required by Paragraph A(3); and (v) to the extent that any telephone number 

or short code/short number is included in such space-constrained advertisement, before 

any consumer who calls or sends a text message to such telephone number or short 

code/short number is scheduled for an appointment at Respondent’s vision centers, all of 

the information required by this Section, including the disclosures required by 

Paragraph A(3), is disclosed Clearly and Conspicuously to such consumer. 

C. Provided, however, that a price or discount offered (i) to a limited differentiated 

consumer group in which the offer Clearly and Conspicuously discloses the group 

limitation (e.g., that the offer is only available for recent graduates, managed-care 

members); (ii) on a redeemable coupon only available to the holder; or (iii) to an 

individual patient in-person or following their pre-operative consultation, is not subject to 

the disclosure requirement in Paragraph A(2) of this Section so long as the offer does not 

contain additional eligibility limitations or a representation of a “starting at,” “as low as,” 

or “from” price or similar representation. 

D. For purposes of this Section, “space-constrained advertisement” means any 

communication (including, but not limited to, Internet search results and banner ads) that 

has space, format, size, or technological restrictions (“Space Constraint”) that limit 

Respondent from being able to make the disclosures required by Paragraph A(3) of this 

Section. Respondent bears the burden of showing that there is a Space Constraint to 

make a required disclosure that is Clear and Conspicuous and in Close Proximity to the 

triggering representation. 

E. In determining whether a majority of consumers, during the time the offer is valid, likely 

will not be able to meet the requirements or qualifications necessary to obtain such price 

or discount, Respondent may rely upon generally-accepted industry data or reliable and 

relevant third-party analyses, research, and studies released during the preceding five 

years. For purposes of making this determination, “consumers” means all adults—either 

nationwide or in the applicable advertising target area of such price or discount—with a 

refractive error in one or both eyes. 

III. Monetary Relief 

IT IS FURTHER ORDERED that: 

A. Respondent must pay to the Commission One Million Two Hundred Fifty Thousand 

Dollars ($1,250,000.00), which Respondent stipulates its undersigned counsel holds in 

escrow for no purpose other than payment to the Commission. 

B. Such payment must be made within 8 business days of the effective date of this Order by 

electronic fund transfer in accordance with instructions provided by a representative of 

the Commission. 

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IV. Additional Monetary Provisions 

IT IS FURTHER ORDERED that: 

A. Respondent relinquishes dominion and all legal and equitable right, title, and interest in 

all assets transferred pursuant to this Order and may not seek the return of any assets. 

B. The facts alleged in the Complaint will be taken as true, without further proof, in any 

subsequent civil litigation by or on behalf of the Commission to enforce its rights to any 

payment pursuant to this Order, such as a nondischargeability complaint in any 

bankruptcy case. 

C. The facts alleged in the Complaint establish all elements necessary to sustain an action by 

or on behalf of the Commission pursuant to Section 523(a)(2)(A) of the Bankruptcy 

Code, 11 U.S.C. § 523(a)(2)(A), and this Order will have collateral estoppel effect for 

such purposes. 

D. All money paid to the Commission pursuant to this Order may be deposited into a fund 

administered by the Commission or its designee to be used for relief, including consumer 

redress and any attendant expenses for the administration of any redress fund. If a 

representative of the Commission decides that direct redress to consumers is wholly or 

partially impracticable or money remains after redress is completed, the Commission may 

apply any remaining money for such other relief (including consumer information 

remedies) as it determines to be reasonably related to Respondent’s practices alleged in 

the Complaint. Any money not used is to be deposited to the U.S. Treasury. Respondent 

has no right to challenge any activities pursuant to this Provision. 

E. In the event of default on any obligation to make payment under this Order, interest, 

computed as if pursuant to 28 U.S.C. § 1961(a), shall accrue from the date of default to 

the date of payment. In the event such default continues for 10 business days beyond the 

date that payment is due, the entire amount will immediately become due and payable. 

F. Each day of nonpayment is a violation through continuing failure to obey or neglect to 

obey a final order of the Commission and thus will be deemed a separate offense and 

violation for which a civil penalty shall accrue. 

G. Respondent acknowledges that its Taxpayer Identification Numbers (Social Security or 

Employer Identification Numbers), which Respondent has previously submitted to the 

Commission, may be used for collecting and reporting on any delinquent amount arising 

out of this Order, in accordance with 31 U.S.C. § 7701. 

V. Consumer Information 

IT IS FURTHER ORDERED that Respondent must directly or indirectly provide 

sufficient information to enable the Commission to efficiently administer consumer redress to 

consumers who (i) visited Respondent’ centers for a LASIK consultation from January 1, 2014, 

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to August 30, 2020, (ii) were found to be medically eligible for LASIK, and (iii) declined having 

LASIK. Respondent must supply such redress data within 8 days of the effective date of this 

Order. If a representative of the Commission requests in writing any information related to 

redress, Respondent must provide it, in the form prescribed by the Commission representative, 

within 14 business days. 

VI. Acknowledgments of the Order 

IT IS FURTHER ORDERED that Respondent obtain acknowledgments of receipt of 

this Order: 

A. Respondent, within 10 business days of entry of this Order, must submit to the 

Commission an acknowledgment of receipt of this Order sworn under penalty of perjury; 

B. For 10 years after the issuance date of this Order, Respondent must deliver a copy of this 

Order to: (1) all principals, officers, directors, and LLC managers and members; (2) all 

employees, agents, and representatives having managerial responsibilities for conduct 

related to the subject matter of this Order; and (3) any business entity resulting from any 

change in structure as set forth in the Section titled Compliance Reporting. Delivery must 

occur within 10 business days after the effective date of this Order for current personnel. 

For all others, delivery must occur before they assume their responsibilities. 

C. From each individual or entity to which a Respondent delivered a copy of this Order, that 

Respondent must obtain, within 30 business days, a signed and dated acknowledgment of 

receipt of this Order. 

VII. Compliance Reports and Notices 

IT IS FURTHER ORDERED that Respondent make timely submissions to the 

Commission: 

A. One year after the issuance date of this Order, Respondent must submit a compliance 

report, sworn under penalty of perjury, in which: 

1. Respondent must: (a) identify the primary physical, postal, and email address and 

telephone number, as designated points of contact, which representatives of the 

Commission, may use to communicate with Respondent; (b) identify all of that 

Respondent’s businesses by all of their names, telephone numbers, and physical, 

postal, email, and Internet addresses; (c) describe the activities of each business, 

including the goods and services offered, the means of advertising, marketing, and 

sales; (d) describe in detail whether and how Respondent is in compliance with each 

Provision of this Order, including a discussion of all of the changes the Respondent 

made to comply with this Order; and (e) provide a copy of each Acknowledgment of 

the Order obtained pursuant to this Order, unless previously submitted to the 

Commission. 

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B. Respondent must submit a compliance notice, sworn under penalty of perjury, within 14 

business days of any change in the following: (a) any designated point of contact; or (b) 

the structure of Respondent that may affect compliance obligations arising under this 

Order, including: creation, merger, sale, or dissolution of the entity or any subsidiary, 

parent, or affiliate that engages in any acts or practices subject to this Order. 

C. Respondent must submit notice of the filing of any bankruptcy petition, insolvency 

proceeding, or similar proceeding by or against such Respondent within 14 business days 

of its filing. 

D. Any submission to the Commission required by this Order to be sworn under penalty of 

perjury must be true and accurate and comply with 28 U.S.C. § 1746, such as by 

concluding: “I declare under penalty of perjury under the laws of the United States of 

America that the foregoing is true and correct. Executed on: _____” and supplying the 

date, signatory’s full name, title (if applicable), and signature. 

E. Unless otherwise directed by a Commission representative in writing, all submissions to 

the Commission pursuant to this Order must be emailed to DEbrief@ftc.gov or sent by 

overnight courier (not the U.S. Postal Service) to: Associate Director for Enforcement, 

Bureau of Consumer Protection, Federal Trade Commission, 600 Pennsylvania Avenue 

NW, Washington, DC 20580. The subject line must begin: In re LCA-Vision. 

VIII. Recordkeeping 

IT IS FURTHER ORDERED that Respondent must create certain records for 20 years after 

the issuance date of this Order, and retain each such record for 5 years, unless otherwise 

specified below. Specifically, Respondent must create and retain the following records: 

A. accounting records showing the revenues from all goods or services sold, the costs 

incurred in generating those revenues, and resulting net profit or loss; 

B. personnel records showing, for each person providing services in relation to any aspect of 

this Order, whether as an employee or otherwise, that person’s: name; addresses; 

telephone numbers; job title or position; dates of service; and (if applicable) the reason 

for termination; 

C. copies or records of all consumer complaints and refund requests relating to pricing and 

advertising, whether received directly or indirectly, such as through a third party, and any 

response thereto; provided this requirement shall not impose a duty upon Respondent to 

actively monitor third parties or request complaints from parties who may receive such 

complaints; 

D. all records necessary to demonstrate full compliance with each provision of this Order, 

including all submissions to the Commission; and 

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E. a copy of each unique advertisement (or the full inventory of the variable elements of any 

dynamic advertisement campaign) or other marketing material making a representation 

subject to this Order. 

IX. Compliance Monitoring 

IT IS FURTHER ORDERED that, for the purpose of monitoring Respondent’s 

compliance with this Order: 

A. Within 10 business days of receipt of a written request from a representative of the 

Commission, Respondent must: submit additional compliance reports or other requested 

information, which must be sworn under penalty of perjury, and produce records for 

inspection and copying. 

B. For matters concerning this Order, representatives of the Commission are authorized to 

communicate directly with Respondent. Respondent must permit representatives of the 

Commission to interview anyone affiliated with Respondent who has agreed to such an 

interview. The interviewee may have counsel present. 

C. The Commission may use all other lawful means, including posing through its 

representatives as consumers, suppliers, or other individuals or entities, to Respondent or 

any individual or entity affiliated with Respondent, without the necessity of identification 

or prior notice. Nothing in this Order limits the Commission’s lawful use of compulsory 

process, pursuant to Sections 9 and 20 of the FTC Act, 15 U.S.C. §§ 49, 57b-1. 

X. Order Effective Dates 

IT IS FURTHER ORDERED that this Order is final and effective upon the date of its 

publication on the Commission’s website (ftc.gov) as a final order. This Order will terminate 20 

years from the date of its issuance (which date may be stated at the end of this Order, near the 

Commission’s seal), or 20 years from the most recent date that the United States or the 

Commission files a complaint (with or without an accompanying settlement) in federal court 

alleging any violation of this Order, whichever comes later; provided, however, that the filing of 

such a complaint will not affect the duration of: 

A. Any Provision in this Order that terminates in less than 20 years; and 

B. This Order if such complaint is filed after this Order has terminated pursuant to this 

Provision. 

Provided, further, that if such complaint is dismissed or a federal court rules that the Respondent 

did not violate any provision of this Order, and the dismissal or ruling is either not appealed or 

upheld on appeal, then this Order will terminate according to this Provision as though the 

complaint had never been filed, except that this Order will not terminate between the date such 

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complaint is filed and the later of the deadline for appealing such dismissal or ruling and the date 

such dismissal or ruling is upheld on appeal. 

By the Commission. 

April J. Tabor 

Secretary 

SEAL: 

ISSUED: 

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