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 five 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.

Children’s eyes should also be evaluated for early signs of myopia or nearsightedness. New research is showing that early intervention using one or more myopia control therapies can significantly reduce the risk of myopia progression.  

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.