When most people think about eye exams, they picture a routine visit to update their prescription and check their vision. A typical appointment might go something like this: you read letters from a chart, your eye doctor examines your eyes for any signs of diseases, they determine your prescription by asking “Which is clearer, 1 or 2?”, and maybe you pick out a new pair of frames while considering your vision insurance benefits.
But did you know there’s another type of eye exam your eye doctor may recommend? A medical eye exam is just as important but serves a different purpose: diagnosing and treating specific eye conditions.
At Kristin L. Campbell, OD, in Delaware, OH, we offer both routine and medical eye exams to ensure that all aspects of your eye health are cared for. Let’s explore the key differences between these two types of exams and how insurance coverage works for each.
What is a routine eye exam?
A routine eye exam is a check-up designed to assess your vision and screen for any early signs of eye disease. Insurance providers define it as “an office visit to check vision, screen for eye disease, and/or update eyeglass or contact lens prescriptions.” These exams are essential for maintaining clear vision and catching potential issues early.
During a routine eye exam, an eye doctor will:
- Assess your visual acuity (how clearly you see at a distance)
- Perform a refraction test, which is when they ask, “Which is better, 1 or 2?” to determine the correct prescription strength for your glasses or contact lenses
- Check for early signs of eye diseases such as glaucoma, cataracts, or macular degeneration
- Evaluate the overall health of your eyes
Routine eye exams typically detect common vision problems like nearsightedness, farsightedness, and astigmatism. These exams are generally recommended annually or every two years, depending on your age, family health history, and whether you currently wear glasses or contact lenses.
What is a medical eye exam?
A medical eye exam is more in-depth and focuses on diagnosing, treating, or monitoring specific eye conditions. If you have eye pain, sudden vision changes, chronic dryness, or flashes of light, a medical exam is necessary.
Medical eye exams can diagnose and manage conditions such as:
- Dry eye syndrome
- Glaucoma
- Cataracts
- Diabetic retinopathy
- Macular degeneration
- Eye infections (e.g., pink eye)
If you visit an eye doctor for a routine eye exam and they discover signs of a medical condition, your visit may be reclassified as a medical eye exam. Alternatively, you may need a follow-up appointment for further testing and treatment.
Do vision plans cover both types of exams?
Insurance coverage depends on whether your exam is classified as routine or medical:
- Vision insurance covers routine eye exams, prescription updates, and discounts on glasses or contact lenses.
- Medical insurance covers exams and treatment related to eye diseases and medical conditions.
Since vision plans do not cover medical issues, patients must use their medical insurance for medical eye exams, treatments, and follow-up visits. Be sure to check your plan’s coverage before your appointment.
In conclusion
In summary, routine exams are for preventative and vision care, while medical exams focus on diagnosing and managing eye health concerns. Both play a crucial role in maintaining long-term eye health.
At Kristin L. Campbell OD, we provide comprehensive eye exams in Delaware, Ohio, and advanced care for various medical conditions. Contact us today to schedule your next appointment! We accept most major vision and medical insurance plans as well as other payment options. Before your appointment, be sure to visit our insurance page to confirm your coverage.