What’s the difference between a medical eye exam and a vision exam?

For insurance purposes, eye examinations are divided into two categories;

1) vision exams, and 2) medical exams. It’s often difficult to understand the difference, since vision exams often contain the same elements as medical exams.

Vision exams are routine or “well-vision” exams for people who have no eye disease or symptoms of disease. Your eyes are examined for any needed correction (such as glasses or contact lenses) and any potential indicators of eye disease. Vision exams usually produce a final diagnosis such as nearsightedness (myopia), farsightedness (hyperopia), or normal astigmatism.

Medical exams are medically necessary for the diagnosis and treatment of diseases and conditions of the eye. Your eye care professional evaluates the reasons for the symptoms and assesses any treatment needed. Medical eye exams produce diagnoses such as cataracts, glaucoma, diabetic retinopathy, macular degeneration, and many other potentially sight-threatening diseases. A refraction, which is the determination of your eyeglass prescription, is sometimes a necessary part of a medical exam.  There are times that your eye doctor may not determine that you have a medical condition causing your vision difficulty until you are thoroughly examined.  If we do file the exam with your medical insurance, you can still use your vision plan benefits towards the purchase of glasses or contact lenses based on your plans allowances.

What does my vision plan cover?

Usually, vision plans cover a thorough screening for eye diseases/disorders, and a refraction to determine your eyeglass prescription. Many vision plans also provide coverage or discounts for glasses and contact lenses. Vision plans do not cover medical eye exams.

What does my health insurance cover?

Medical eye exams are covered by your major medical insurance, subject to copays, coinsurance, and plan deductibles. Some medical insurance plans will cover one routine vision eye exam every two years in addition to covering eye exams for medical eye problems. Be sure to check with your insurance company to determine coverage.

What else do I need to know?

It is important to know that we are not able to bill both your vision insurance and medical insurance on the same day.  Dr. Price may find that it is best to bill your medical insurance for your initial visit.  However, if Dr. Price determines that you also have a medical condition that needs further treatment, evaluation, or monitoring, she may recommend that your return at a later visit at which time we may bill your medical insurance.  Even if your eye exam is billed to your medical insurance, you may still use a vision plan to purchase eyeglasses or contacts.

Contact Lens Exams

What happens during a contact lens fitting?

Your corneas (the front of the eye) will be examined to ensure that they are healthy enough for wearing contact lenses. The next step will be to take careful measurements of your eye using a special instrument called a keratometer.  Price Eye Care uses an automated keratometer that  measures the curvature of the surface of your eye.  These dimensions will then help Dr. Price to determine the shape and size of your lenses. In addition, a contact lens fitting also includes a test to evaluate the vision, centration, and comfort of the lens.  Dr. Price will be looking at how well each contact lens works with your eyes.  All of this information will help to ensure that the best contact lens brand and type is selected for you and your needs. Improper brands or solutions can often cause dry eye or allergy symptoms.

If you have worn contact lenses before, you will still need a contact lens fitting each time you would like a new contact lens prescription. The reason is your ocular health can deteriorate from wearing contact lenses. Improper use of contact lenses can lead to corneal scarring and in some cases blindness.

Pediatrics Exam

Infant Vision

Your baby has a whole lifetime to see and learn. But did you know your baby also has to learn to see? As a parent, there are many things that you can do to help your baby’s vision develop.

At about six months of age, you should take your baby to your eye doctor for his or her first thorough eye examination. Things that the optometrist will test for include excessive or unequal amounts of nearsightedness, farsightedness, or astigmatism.

The doctor will also test eye movement ability as well as check for eye health problems. These problems are not common, but it is important to identify children who have them at this stage. Vision development and eye health problems can be more easily corrected if treatment is begun early.

Unless you notice a need, or your eye doctor advises you otherwise, your child’s next examination should be around age three and then again before he or she enters school.

During the first four months of life, your baby should begin to follow moving objects with their eyes and reach for things, first by chance and later more accurately as hand-eye coordination and depth perception begin to develop.

To help, use a nightlight or other dim lamp in your baby’s room; change the crib’s position frequently and your child’s position in it. Keep reach-and-touch toys within your baby’s focus, about eight to twelve inches. Also talk to your baby as you walk around the room; alternate right and left sides with each feeding; and hang a mobile above and outside the crib.

Between four and eight months, your baby should begin to turn from side to side and use his or her arms and legs. Eye movement and eye/body coordination skills should develop further and both eyes should focus equally.

Enable your baby to explore different shapes and textures with his or her fingers; give your baby the freedom to crawl and explore; hang objects across the crib; and play “patty cake” and “peek-a-boo” with your baby.

From eight to twelve months, your baby should be mobile now, crawling and pulling himself or herself up. He or she will begin to use both eyes together and judge distances and grasp and throw objects with greater precision.

To support development don’t encourage early walking – crawling is important in developing eye-hand-foot-body coordination; give your baby stacking and take-apart toys; and provide objects your baby can touch, hold and see at the same time.

From one to two years, your child’s eye-hand coordination and depth perception will continue to develop and he or she will begin to understand abstract terms. Things you can do are encourage walking; provide building blocks, simple puzzles and balls; and provide opportunities to climb and explore indoors and out.

There are many other affectionate and loving ways in which you can aid your baby’s vision development. Use your creativity and imagination. Ask your eye doctor to suggest other specific activities.

Pre-School Vision

During the infant and toddler years, your child has been developing many vision skills and has been learning how to see. In the preschool years this process continues as your child develops visually guided eye-hand-body coordination, fine motor skills and the visual motor skills necessary to learn to read.

As a parent, you should watch for signs that may indicate a vision development problem, including a short attention span for the child’s age, difficulty with eye-hand-body coordination in ball play and bike riding or avoidance of coloring and puzzles and other detailed activities.

There are everyday things that you can do at home to help your preschooler’s vision develop as it should.

These activities include reading aloud to your child and letting him or her see what you are reading. Provide your child a chalkboard, finger paints and different shaped blocks and show your child how to use them in imaginative play. Provide safe opportunities to use playground equipment like a jungle gym and balance beam and allow them time for interacting with other children and for playing independently.

By age three, your child should have a thorough eye examination to make sure your preschooler’s vision is developing properly and there is no evidence of eye disease. If needed, your doctor can prescribe treatment including glasses and/or vision therapy to correct a vision development problem.

Tips to make your child’s optometric examination a positive experience:

  • Make an appointment early in the day and allow about one hour.
  • Talk about the examination in advance and encourage your child’s questions.
  • Explain the examination in your child’s terms, comparing the E chart to a puzzle and the instruments to tiny flashlights.

Unless recommended otherwise, your child’s next eye examination should be at age five. By comparing test results of the two examinations, your eye doctor can tell how well your child’s vision is developing for the next major step into the school years.

School-Age Vision

A good education for your child starts with good schools, good teachers and good vision. Your child’s eyes are constantly in use in the classroom and at play. When his or her vision is not functioning properly, learning and participation in recreational activities will also suffer.

The basic vision skills needed for school use are:

  • Near Vision. The ability to see clearly and comfortably at 10-13 inches.
  • Distance Vision. The ability to see clearly and comfortably beyond arm’s reach.
  • Binocular coordination. The ability to use both eyes together.
  • Eye movement skills. The ability to aim the eyes accurately, move smoothly and shift them quickly and accurately.
  • Focusing skills. The ability to keep both eyes accurately focused at the proper distance and to change focus quickly.
  • Peripheral awareness. The ability to be aware of things located to the side while looking straight ahead.
  • Eye/hand coordination. The ability to use the eyes and hands together.

If any of these or other vision skills are lacking or do not function properly, your child will have to work harder. This can lead to headaches, fatigue and other eyestrain problems. As a parent, be alert for symptoms that may indicate your child has a vision or visual processing problem.

Symptoms to watch for that may indicate your child has a vision or visual processing problem!
It is important to let us know if you notice your child frequently:

    • Loses their place while reading
    • Avoids close work
    • Holds reading material closer than normal
    • Tends to rub their eyes
    • Has headaches
    • Turns or tilts head to use one eye only
    • Makes frequent reversals when reading or writing
    • Uses finger to maintain place when reading
    • Omits or confuses small words when reading
    • Consistently performs below potential

Since vision changes can occur without you or your child noticing them, your child should visit the eye doctor at least once a year. If needed, the doctor can prescribe treatment including eyeglasses, contact lenses or vision therapy.

Amblyopia Vision

“Lazy eye” affects about four million people in the United States. It occurs when, for one of several reasons, one eye is used less than the other. If one eye is crossed or turns out, the individual sees double, so he or she learns to “shut off” or ignore that eye. If the two eyes are very different, one nearsighted and the other farsighted, the same thing can occur. After a while, vision in the unused eye is reduced.

For many years it was thought that amblyopia, or “lazy eye” – when one eye sees poorly and cannot be helped with corrective lenses – was a permanent condition unless it was detected and treated before the age of six. Many optometrists no longer accept this, believing that even adults can improve their sight – if not completely correct their lazy eye – through special therapy.

The American Optometric Association agrees that current research proves the old theory wrong. The success rate does drop off as one gets older, but the cut-off at age six is arbitrary. Age should not be a barrier, though the longer the condition has existed the more difficult it becomes to treat.

Treatment varies depending on the extent of the condition, the patients’ age and the optometrist. Small children often have their stronger eye patched for several hours a day. This stimulates the use of the weak eye while they perform exercises such as coloring, cutting things out and tracing.

Vision therapy – usually several hours a week, in the doctor’s office and at home – will often correct the underlying reason for the lazy eye. Very small children can improve in a month or two; older children may take several months to a year to respond.

With adults, treatment is basically the same, but it takes longer. Adults may not wear a patch at all if vision is very poor, or only for an hour or two at home while doing fine tasks such as coloring in the 0’s of a newspaper. Patients do exercises designed to improve focusing, tracking and spatial judgment.

Many times after treatment, 50 percent of the older children and adults see as well or almost as well with their lazy eye as with their normal eye, and four out of five of the rest at least show improvement. Results are permanent when both the amblyopia and the underlying problem are corrected. When the latter can’t be treated, patients should continue the exercises on a less-frequent basis and visit their optometrist periodically so that the eye does not weaken again.

Diabetic Exams

During your diabetic exam Dr. Price will look for several different changes. Diabetes can affect not only your ability to focus, but it can affect the health of your eyes. During your exam, Dr. Price will be looking for any signs of diabetic eye disease including changes in your blood vessels and macula. Diabetics also have a greater chance of developing glaucoma and cataracts, so we will also be looking for any signs of those ailments as well.

Unfortunately, Diabetic retinopathy is the number one cause of blindness in American adults. Fortunately, blindness caused by diabetes can be prevented with regular dilated eye exams.

Overtime, diabetes damages the blood vessels in the retina, the light-sensitive nerve tissue in your eye that sends visual images to your brain. The retina is often referred to as the “film in your camera”.

Retinal damage happens slowly. Your retinas have tiny blood vessels that are easy to damage. At first, you might not have any loss of sight from these changes. This is why you need to have a comprehensive eye exam once a year even if your sight seems fine.

Blurred vision or temporary blindness can occur when blood vessels weaken, bulge and leak fluid into surrounding tissue, causing swelling – a condition called macular edema. Abnormal new blood vessels may often, grow on the retina, where they can bleed into the eye and block vision. As the disease progresses, the retina can detach from the eye, resulting in permanent blindness. Irreversible vision loss can be prevented with early detection and treatment. This is just one of the reasons it is so important to have your eyes checked on a regular basis.

We encourage patients to call us right away if you are having any vision problems or if you have had a sudden change in your vision.

Retinal Photography

Price Eye Care pleased to offer retinal photography as a valuable addition to your comprehensive eye examination.  Retinal photos are recommended at your first visit to our office, and at least every 2-3 years afterwards.

Why does Dr. Price recommend retinal photos?

Retinal photos are high-resolution digital photographs of the interior portion of your eye called the retina.  These photos can assist us in diagnosing and documenting many diseases.  At future visits, Dr. Price can also refer back to these photos in order to detect changes in the retina which might indicate disease onset or progression.

What diseases can be documented using retinal photos?

Some diseases that can affect the retina are glaucoma, macular degeneration, diabetes, and high blood pressure. Retinal photography can help screen for many of these diseases in your eyes. It can even help find a melanoma or retinal detachment in the eye.

But I have 20/20 Vision, why do I need Retinal Photography?

Patients often ask “my eyes are healthy; are retinal photos still recommended? The answer is yes.  First of all, we want to offer everything we can to detect a vision threatening problem. Secondly, by taking a retinal photo of a healthy eye, Dr. Price can refer back to this photo at your next exam.  This makes it easier for her to determine whether or not there are changes in your eye that might represent the onset of any disease.

Sports Vision

“Keep your eye on the ball!” “Focus on the finish line!” “Don’t lose sight of the green!”
If there’s one thing that seems to be a key to success in sports, it’s vision. But did you know you can improve your performance by improving some aspects of your vision? It’s easy to recognize problems, and even easier to solve them. The following are some aspects of vision which can be the difference between victory and defeat, and some exercises to improve performance.

DYNAMIC VISUAL ACUITY

Dynamic visual acuity is your ability to see objects when they are moving fast. This is important in sports like hockey, racquetball, and tennis. To improve dynamic visual acuity, cut out letters, stick them to a record turntable, and try to identify the letters at different speeds.

VISUAL CONCENTRATION

Visual concentration is your ability to ignore distractions happening around you. Your eyes naturally react to movement in the field of vision from spectators, other participants or the playing environment. To improve your visual concentration, have a friend stand nearby and wave their hands erratically while you practice.

EYE TRACKING

Eye tracking is following an object with your eyes without much head motion. It is important with any sport that involves a fast-moving ball. Good eye tracking will improve balance and reaction time. You can improve your eye tracking by watching the flight of a ball while keeping a book balanced on your head.

EYE-HAND-BODY COORDINATION

Eye-hand-body coordination is how your muscles and limbs react to the information gathered by your eyes. It affects timing and body control. To improve your eye-hand-body coordination, jump up and down on an old mattress while a friend tosses you a tennis ball from a variety of angles. Catch the ball and toss it back.

VISUAL MEMORY

Visual memory is the ability to process and remember a fast moving, complex picture of people and things. It is very important in basketball, hockey, and soccer, where the game quickly moves up the field. Visual memory helps you know where your teammates and opponents are positioned. To improve visual memory, look at a magazine page for a second, then turn the page. Try to reconstruct the images you just saw. When you have mastered the exercise, allow 5 seconds between seeing the image and reconstructing it.

PERIPHERAL VISION

Peripheral vision is the ability to see what is not directly in front of you, out of the corner of your eye. This allows you to see your teammate to your left or right while focusing on the goal in front of you. To make your peripheral vision more useful, try watching television with your head turned to one side or the other.

VISUAL REACTION TIME

Visual reaction time is what allows a batter to hit the ball or a tennis player to return a serve. It is the speed with which your brain interprets and reacts. To improve your visual reaction time, stand with your back to a friend. Have them toss a ball to you and yell, “Now!” When you hear the yell, turn around and try to catch the ball. By repeating this exercise, you can teach your brain to react more quickly.

FOCUS FLEXIBILITY

Focus flexibility allows a quarterback to quickly focus on his receivers even though they are at varying distances. To improve focus flexibility, post a magazine page on a wall about 15 feet away at eye level in front of you. Hold a similar page in your hand out in front of you, so that it is slightly to one side of your view of the page on the wall. Focus on an object or words on the page on the wall. Then quickly switch focus to the page in your hand. By switching focus back and forth, you will improve your focus flexibility.

DEPTH PERCEPTION

Depth perception lets you judge distance. This is especially important in basketball, golf, and other sports involving distance to the goal. To improve depth perception, have a friend point a straw at you, parallel to the ground, with the straw about two feet away from you. Practice quickly inserting a toothpick into the straw.

Glasses Repairs and Cleaning

Price Eye Care offers free adjustments and cleanings for your glasses to all of our patients. We can often repair your glasses in house at no cost as well. We want your looking your best, so feel free to stop in and have us clean your glasses or replace your nose-pads at no charge. We just ask that you call ahead if you think your adjustment our repair may take more individual attention. As always, we will do our best to accommodate your needs.