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Eye Care - Exam Information
Eyeglass Examinations
The standard examination procedure
for a patient who wants to wear eyeglasses includes at least the following:
- Case history; reason for examination, patient medical and eye history,
current medications, etc.
- Recording of monocular (one eye) and binocular (both eyes) visual acuities
at far and near, with and without present correction
- Pupil responses (Neurological Integrity)
- External examination findings (Biomicroscopy)
- Internal examination findings (Ophthalmoscopy)
- Present prescription (when applicable)
- Retinoscopy (when applicable)
- Subjective refraction
- Phorometry/Binocular testing at far and near
- Tonometry
- Diagnosis/Prognosis
- Specific recommendations
Contact lens
examination
Examination requirements for patients who wish to wear
contact lenses include all of the standard eyeglass examination procedures as
well as the following:
- Keratometry
- Diagnostic lens testing (when applicable)
- Additional external examination (biomicroscopy) with and without contact
lenses
- Series of follow-up visits to ensure compliance with maintenance and wearing
schedules.
Providers generally assess higher charges for contact lens
examinations than for eyeglass examinations. Some CMV benefit plans may require
members to pay the difference between the usual and customary price for an
eyeglass examination and the usual and customary price for a contact lens
examination.
Dilation
Dilation is the enlargement of the pupil diameter, which
allows the doctor to observe the internal eye more completely. It is not always
part of a provider's standard examination procedure, but providers may perform
dilation if any of the following conditions exist:
- Diabetes
- Myopia (nearsightedness) over 6 diopters
- Hypertension (high blood pressure)
- Retinal disease
- Sudden changes in vision
- Flashes or floaters
- Family or personal health history that predicts future ocular complications
- State law requiring dilation
Disease detection
During the
course of an examination, an optometrist or ophthalmologist may detect
abnormalities in the eye that are symptomatic of certain diseases that require
treatment from another health care provider, such as diabetes or hypertension.
In this case, the member will be referred to the appropriate medical provider
based on their health plan.
Prescription
Prescriptions are often written following an
examination to correct one of the following conditions:
- Myopia
Myopia ("nearsightedness") is a condition in which light
refracted into the eye focuses at a point in front of the retina. Myopic
individuals can see objects clearly at near and have trouble seeing at far.
Myopia is correctable with eyeglasses or contact lenses. Myopic correcting
lenses are concave, or thinner in the center than on the edge.
- Hyperopia
Hyperopia ("farsightedness") is a condition in which
light refracted into the eye focuses at a point behind the retina. Hyperopic
individuals can see objects clearly at far and have trouble seeing at near.
Hyperopia is correctable with eyeglasses or contact lenses. Hyperopic correcting
lenses are convex, or thicker in the center than on the edge.
- Presbyopia
Presbyopia is the loss of focus ability due to the
natural aging process. It is correctable with bifocal or trifocal lenses that
reduce the need for the eye to focus when changing from far to near vision.
- Astigmatism
Astigmatism is a condition in which an asymmetric
cornea results in different visual irregularities in different parts of the eye.
It is correctable with eyeglass lenses that are ground to a different thickness
and curvature. Toric soft contact lenses or rigid contact lenses can also
correct some cases of astigmatism.
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