For an individual in good health with no vision problems an eye exam every two or three years should be fine. Young children should have an eye exam every year as young eyes change and glasses prescriptions should be monitored for best vision. Young children should also be evaluated for early signs of myopia. New research is showing that early intervention may prevent myopic progression in children. Individuals with diabetes or other significant medical problems should have their eyes examined annually. Patients with medical eye conditions may need to have their eyes evaluated several times per year. If you’re a contact lens wearer having your eyes checked once a year is a very important way to make sure your eyes are healthy and not being compromised by contact lens over wear. Patients don’t often realize that contact lens wear can affect the thickness and clarity of the cornea and can also irritate the palpebral conjunctiva under the lids that come in contact with your contact lenses. An annual eye exam will catch these problems and suggest changes before they become more serious issues.
A routine eye examination is a good idea even if you see fine. An eyeglass prescription may be needed to avoid eye strain, tiredness or headaches. You may have small changes to your vision that may not be apparent, but over the course of several years these small changes lead to significant changes in your prescription that may make your new glasses very difficult to adapt to. Many medical problems that are often undiagnosed may be apparent in the course of an eye exam. These conditions may be sight threatening or even life threatening.
Eye exams for children are usually done at age six when they begin school. Children’s eyes can be examined at any age if there is any suspicion of eye disease or poor vision. While very young patients cannot answer questions, there is much that can be seen and measured in the eye doctor’s office. A objective refraction can be performed on very young children with very accurate results. Eyes can be measured and monitored for any eye turns, also known as strabismus. Amblyopia, or “lazy eye”, in young children should be addressed early so we have the best chance of achieving normal visual acuity as the child grows older.
A careful eye exam on a healthy patient should take about 30 minutes. If there is a significant medical history, ocular pathology, or a difficult refraction, the exam may take longer. An eye exam involves determining your visual acuity with and without glasses correction, determining your optimal glasses prescription and assessing the health of your eye by examining your eyes with a binocular microscope, checking your intraocular pressures and carefully looking at your retinas.
The air puff test, or non contact tonometry, is a quick and painless way to determine the pressure of the fluid inside your eye. A modern non contact tonometer will give a very small, almost imperceptible puff. Determining the pressure inside your eye is an important indicator of eye health and an important factor in determining if you have glaucoma. If you have a strong dislike to the air puff test, your eye pressure can still be measured with an applanation tonometer. This involves using a single eye drop to each eye and gently measuring your eye pressure with a Goldmann applanation probe. The procedure is very accurate and completely painless.
A refraction is that part of the eye exam that involves looking through many different lenses so that an optimal prescription can be determined for glasses or contact lenses. The refraction tells the doctor what your best visual acuity is and what lens prescription is needed to achieve it. It also provides the prescription that is the starting point for a contact lens fitting and evaluation. For routine eye exams with vision plans, the refraction is bundled together with the health evaluation part of the examination and billed together as one charge. When using medical insurance the refraction is considered a separate procedure and not part of the regular exam. It is almost never covered by medical insurance and is billed to the patient as an additional charge.
A regular eye exam involves no procedures or tests that should cause any eye pain. Some patients are sensitive to bright lights which may cause some discomfort during brief parts of the examination. Extreme sensitivity to bright lights should be evaluated by your doctor.
Dilation is a part of the exam where drops are instilled in the eye to cause the pupils to dilate, or open up very wide. This gives the doctor a much better view of the peripheral retina to detect any pathology. A dilated eye exam is important every few years to make sure there are no sight threatening retinal changes such as tears, tumors or bleeding . It is particularly important for diabetics to have their eyes dilated annually, as diabetes is a leading cause of bleeding in the retina which may lead to blindness. Patients with ongoing diabetic retinopathy or other retinal pathology may need to have their eyes dilated several times per year to monitor any progression.
An optometrist is a health professional who went to optometry school for four years after college for a specialized education in eye disease, optics, contact lens and glasses prescriptions. Optometrists excel at primary eye care with particular emphasis on eyeglass and contact lens prescriptions. Optometrists can prescribe medications for many eye conditions and will refer patients to the appropriate specialist for advanced testing and surgery. Ophthalmologists are medical doctors who complete four years of medical school followed by a two or three year program of study in eye disease often specializing in specific eye pathology such as corneal and retinal disease. Many are also trained as surgeons performing retinal surgery, cataract surgery, LASIK surgery and other advanced eye care treatments.
No. You do not need a referral to get a routine eye exam. Certain medical insurance plans will require a referral from your primary care physician to see an eye specialist or to obtain additional testing. Claims may be denied if the appropriate referral is not obtained. Contact your medical insurance company for more information.