Medical Eye Exams

A medical eye exam is defined as an exam to diagnose and determine a treatment plan for a disease or complication with the eyes. This type of exam is scheduled as a follow-up to a routine exam in which an eyeglasses prescription is determined but a medical condition is also found. A medical eye exam/visit may also include filling out forms or insurance paperwork or possibly correspondence with specialists.

A routine eye exam may be converted to a medical eye exam after discussing the options with the doctor, especially if the condition found is serious and requires immediate attention. If converted to a medical visit, regular medical insurance will need to be billed instead of a vision plan.

The medical eye exam/visit could be recommended for problems with:

• Moderate-to-severe dry eyes

• Eye pain

• Eye injuries

• Eye infections

• Diabetic complications

• Cataracts

• Foreign bodies

• Glaucoma

• Floaters

• Light flashes

A medical treatment plan could include testing or procedure planning. Accurate insurance information will be needed to determine if all tests, exams, and procedures are covered by the patient’s insurance policy.

Both routine and medical exams can contain some of the same components (dilation, refraction, intraocular pressure test), but the diagnosis will determine if it is medical or routine. A routine exam would find something like nearsightedness or myopia. A medical exam would produce a diagnosis such as pink eye, glaucoma, or cataracts. A routine exam may result in eyeglasses being purchased. A medical exam may result in a medication prescription or a procedure.