People have lots of questions about eye exams, like how much they cost. (Learn More) They may also wonder if eye exams are covered by health insurance. (Learn More) The frequency at which to get your eyes examined is also a concern. (Learn More) And lots of people wonder what exactly happens in an eye doctor’s office. (Learn More)

We’ve outlined common questions and answers about eye exams below, so you’ll be prepared for your next visit.

How Much Is an Eye Exam?

The price of an eye exam differs on the basis of insurance (or lack thereof), as well as whether it is an initial visit or return visit. Other facts that influence price include the type of eye doctor conducting the exam, the location, and what range of services are performed.

In gneral, the average out-of-pocket (without insurance) cost of an eye exam can be up to $200 for a first visit. Recurring patients are rewarded by a reduced cost for their return visits, usually around $130 per visit.

Does My Insurance Plan Cover Eye Exams?

Vision coverage is usually done as an odd-on to regular health insurance, so this means there tends not to be a standard rubric for what benefits of eye exams are included in the coverage and what additional costs are present.

For insurance purposes, eye exams are split into two categories: medical visits and routine visits. Both are still considered to be full-on eye exams that cover the same basics, performed by either an optometrist or an ophthalmologist.

Where they are different is the reason for the visit, the symptoms or complaints that the patient has, and what results or diagnosis the doctor has at the end of the exam. These are what determines whether your insurance company considers the exam a routine visit or a medical visit and, in turn, what benefits may or may not apply.

In some cases, certain health insurance policies that have their own vision plans may offer some coverage for glasses and contact lenses. In other cases, even insurance companies that do cover routine exams will limit how many exams you can get in a year. Different plans may pay for all of your exams or only a certain number.

A standard vision insurance policy might mean you are responsible only for the copay, which could be up to $40. The rest of the routine exam will be covered. If you have no health insurance, or if you are underinsured (i.e., your plan does not cover vision care), you will have to pay the full cost of the exam out of pocket.

A medical eye exam, on the other hand, normally leads to a diagnosis of serious eye conditions, like cataracts, age-related macular degeneration, conjunctivitis, or glaucoma. Without further medical attention, these can lead to partial or complete vision loss.

Most health insurance policies will cover eye exams if you have symptoms of these conditions (or others like them).

We Promise Our Patients Peace of Mind
Consultation
Consultation

During the consultation, we will ask you about your eye health history and your medications, and perform some tests. You will then be examined by the surgeon who will discuss your treatment options. Your personal Patient Counselor will help you throughout the process.

Your Counselor can review payment options and schedule you for surgery and related appointments, such as pre- and post-operative exams. Prior to your procedure you will have a dilated eye exam, and you should discontinue wearing your contact lenses and begin taking eye drops as instructed.

Procedure
Procedure

Plan to be at the center for two to three hours the day of your procedure. ICL eye surgery is a fairly brief outpatient procedure. Your surgeon dilates your eyes, and gives you a local anesthetic to numb the area. A tiny incision is made, and the clear lens is slipped between your iris and your eye’s natural lens. The day of your procedure should be a day of rest.

Post Procedure
Post-Procedure

Your Patient Counselor will give you detailed post-operative instructions and eye drop regimen for your recovery. After ICL surgery, you’ll need several follow-ups with your eye doctor. Visual recovery is rapid, and you can expect noticeable improvement within a day or two. Most patients are generally able to return to their normal activities within two or three days following their procedure.

How Often Should I Get an Eye Exam?

Even if you think your eyesight is fine, it is important to get regular eye exams. The brain is very capable of adapting to worsening vision, such that many eye conditions start off with no noticeable symptoms.

Most eye doctors recommend eye exams every one or two years. You may have certain risk factors that make it advisable for you to get your eyes looked at every year.

Adults between the ages of 20 to 39 will likely be all right with an eye exam every other year because people in that age group are less likely to develop vision problems. However, African Americans have a higher risk of having eye problems, specifically glaucoma, so they should get their eyes checked more often. Hispanics and Latinx people are at similar risk.

People between the ages of 40 and 64 will start to experience continuous changes to their vision, so they should be more regular with their eye exams. The lens of the eye slowly starts to harden from about 35 years of age, affecting near vision. Additionally, visual acuity tends to diminish around this time, leading to a need for increasing lens prescriptions. This is why most adults over the age of 45 will need some form of corrective eyewear.

Furthermore, adults ages 40 to 64 are also more prone to developing health problems that can affect vision, even leading to vision loss, like type 2 diabetes and high blood pressure. Certain prescription medications can also cause side effects that lead to deteriorating vision, so people in this age range should see an optometrist at least once a year.

Risk Factors

Once a person reaches their 65th birthday, yearly eye exams are highly recommended. As much as vision continues to decline around this time, people around this age will start to develop cataracts, and the health conditions that can cause vision problems tend to become more pronounced with age.

Other risk factors that should give you reasons to schedule your eye exams include:

  • A family history of eye conditions, like macular degeneration and glaucoma, among others.
  • A past history of eye surgery or injuries to the eye.
  • The onset of heart disease, diabetes, and other health conditions that affect vision.

Anybody at risk for these conditions should have their eyes examined at least once a year.

What Happens in an Eye Exam?

At the start of the exam, the doctor will ask you for your medical history and if you’ve been experiencing any problems with your vision. If you have any corrective eyewear (glasses or contact lenses), bring them to the appointment so the doctor can see if you need a stronger prescription.

During the exam, the doctor will perform a number of different tests to see how strong your vision is and to assess if there are any problems with the shape of your eyeball, the pressure inside your eye, and the dimensions and features of your eye, all of which can affect your vision. These tests might include a glaucoma test, a refraction test, and a visual acuity test, among others. The doctor might use these tests based on your family history and the nature of the vision problems you’re having.

Based on what these tests show, the doctor will tell you that you need follow-up vision tests or that you need to get (stronger) contact lenses or glasses.

A comprehensive eye exam will check how well you can see and also if there are any problems with your eye, such as eye diseases and vision issues. A comprehensive exam can be done once a year or every two years based on the risk factors mentioned above. A health insurance plan that offers vision coverage will likely cover an annual comprehensive exam.

A diagnostic (or follow-up) exam is conducted if the doctor found anything of concern during the comprehensive exam. Diagnostic exams are effectively additional vision tests that look a little deeper than what the comprehensive exam is able to cover.

These are billed differently than comprehensive exams. You should check your medical and/or vision coverage plans to see if additional visits and tests are covered.

How Long Does an Eye Exam Take?

A comprehensive eye exam takes at least an hour. Follow-up exams will likely take longer, depending on the issue.

What Do the Letters on My Prescription Mean?

When you get your prescription, you will see a lot of different measurements. Two of the most important measurements are your OS and your OD. Both are Latin terms to refer to each eye.

The OS is “oculus sinister,” which is the Latin for “left eye.” The OD is “oculus dexter,” which is the Latin for “right eye.” Some prescriptions also have a measurement for OU, Latin for “oculus uterque,” or “both eyes.” Some doctors replace the Latin terms with RE for right eye and LE for left eye.

Other terms on your prescription might include SPH, an abbreviation for “sphere,” which refers to the power of the lens to correct your vision. Nearsighted people have a negative SPH, marked by a minus sign. Farsighted people have a positive SPH, marked by a plus sign.

CYL is an abbreviation of “cylinder,” the lens power to correct your astigmatism (if your doctor finds astigmatism).

Is My Eyeglass Prescription the Same as My Contact Lens Prescription?

No, they are not the same. Eyeglass prescriptions do not have all the information necessary for you to purchase contact lenses,

References

The Average Cost of an Eye Exam Without Insurance. (October 2017). Pocket Sense.

Is Vision Insurance Worth It? What You Should Know. (May 2021). Investopedia.

Glaucoma Makes African Americans 15 Times More Likely to Suffer From Vision Impairment. (August 2020). The Voice of Black Cincinnati.

Eye Health Among Hispanics/Latinos. (July 2019). National Eye Institute.

Get an Eye Disease Screening at 40. (March 2019). American Academy of Ophthalmology.

How to Read Your Eyeglass Prescription. (November 2020). WebMD.

Eye Exam and Vision Testing Basics. (January 2021). American Academy of Ophthalmology.

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