Eye Exam and Vision Testing Guide

Eye exams and vision testing are an important part of having and maintaining good overall health. Exams test both your vision and your eye health.

Most people should receive an eye exam every year. People with certain eye or health conditions may need more frequent exams. If you are having difficulty paying for the care you need, free and low-cost eye exams are available through many businesses and organizations.

Many different tests may be performed during an eye exam depending on your needs. Your eye doctor will let you know which ones you need after a thorough preliminary exam and a detailed account of your family history.

What Does an Eye Exam and Vision Testing Entail?

Eye exams have two primary purposes:

• To assess how well you can see
• To evaluate the health of your eyes

Not all eye exams accomplish both goals. Doctors conduct some exams to check for specific eye health problems, such as glaucoma or diabetic retinopathy.

If your eye exam includes a test of your eyesight, your doctor may issue you a prescription for corrective eyewear when your exam is done. Exams that are limited to eye health never include a prescription.

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When Should You Have an Eye Exam?

The American Optometric Association recommends that everyone receive an annual eye exam that covers both visual acuity and eye health.

If you have a diagnosed eye condition, you will need more frequent eye exams. You may need only specific tests during your additional visits. If you are unsure of your eye care needs, ask your eye doctor what schedule they would recommend you follow.

Optometrist vs. Ophthalmologist: Who to See for an Eye Exam?

An optometrist is an eye care professional who has completed optometry school (four years of post-graduate study). They are not medical doctors. An optometrist can:

• Perform eye exams
• Prescribe corrective eyewear
• Identify eye abnormalities
• Prescribe medication for eye diseases

Ophthalmologists can do everything optometrists can do, and they can also perform eye surgeries and diagnose and treat multi-systemic diseases that involve the eyes.

If you were diagnosed with or have a family history of diseases like macular degeneration, glaucoma or diabetic retinopathy, it is best to see an ophthalmologist for more comprehensive eye care.

How to Prepare for an Eye Exam

When preparing for your eye exam, remember to bring:

• Your glasses, contact lenses, and any other prescription eyewear.
• A list of any medications or supplements you are currently taking. This includes any eyedrops that you use regularly.
• An account of your family’s medical history, including non-eye-related conditions. Certain health problems like diabetes run in families and may put you at higher risk of developing eye problems.
• The name of your primary care doctor. If your eye doctor finds any signs of disease during your exam, they will need to notify your primary care doctor so you can receive proper follow-up care.
• A copy of your insurance information if you have vision coverage.

What Do Eye Doctors Check for During Eye Exams?

Eye doctors check three things during eye exams:

• Your visual acuity (how well you can see, and how far)
• Your eye health
• Your eye pressure

 Increased eye pressure is an early sign of several eye diseases, including glaucoma.

Depending on your age, symptoms, family history, and when you last saw an eye doctor, you may not need all of these things to be checked during each exam.

What to Expect During Your Eye Exam

An eye exam takes between 15 minutes and an hour to complete depending on what tests you need to have done.

Over the course of your exam, your eye doctor will introduce each test one at a time. They will explain what each test is for as well as what they need you to do while they perform it.

At the end, you will receive your results. Depending on what was found, you may need further tests or more frequent screening exams. If your eye exam included visual acuity testing, you may receive a prescription for corrective eyewear. 

If your eyes are dilated as part of your exam, your vision will be extremely blurry for some time after your appointment. This effect will wear off over the next several hours. Most people’s vision returns to normal after four to 24 hours, but every case is different.

You should not drive after having a dilated eye exam. If you know you will receive one, plan for a friend or family member to drive you home afterwards.

You may also not be able to see well enough to work until the dilation effect wears off. Make sure that any pressing matters at work have been taken care of before you head to your eye exam.

What Tests are Performed During an Eye Exam?

Eye doctors and their technicians may conduct many tests as part of an eye exam. Two of the most common are:

• Visual acuity testing
• Visual field testing

Visual Acuity Testing

Visual acuity testing measures how well you can see up close and at a distance. During this test, your eye doctor will rotate a series of lenses in front of your eyes, then ask you to read letters off a chart posted in their office.

Depending on your responses, they may prescribe your corrective eyewear. Visual acuity testing can also be done using an autorefractor if a patient cannot participate in a traditional exam.

Visual Field Testing

Visual field testing measures how wide of an area you can see when you are focused on something in front of you. This test can be used to screen patients for glaucoma, multiple sclerosis, stroke, and other serious health conditions.

Several tests can only be performed with dilated eyes. These include:

• Ophthalmoscopy (or fundoscopy).
• Optical coherence tomography (OCT).

Ophthalmoscopy (or Fundoscopy)

Your eye doctor will shine a light in your eyes to get a better look at the structures inside it, including the cornea, lens, optic nerve, retina, and the blood vessels around all of these.

Optical Coherence Tomography (OCT)

Your eye doctor uses a computerized imaging system to obtain thousands of images of your eye’s retina, optic nerve, and other internal structures. These images are used to diagnose and document many eye health issues that affect these regions of the eye.

Other tests are used only when investigating specific eye problems, including:

• Tonometry.
• Corneal topography.
• Color vision testing.

Tonometry

After numbing your eye with special eye drops, your eye doctor will use a tool called a tonometer to blow air against the surface of your cornea and measure the resulting pressure change. This test can also be done using a special lamp and a small flat-tipped cone that is pressed against the eye. This version of the test is called applanation tonometry. Both versions measure the pressure in your eye to screen for glaucoma.

Corneal Topography

Your eye doctor uses a computerized device to map the surface of your eye. This test is used to measure the degree of astigmatism in a patient’s eyes to prepare them for upcoming eye surgeries.

Color Vision Testing

Several different tests are available to test your ability to see color. They typically require you to find a hidden number or letter in a collection of colored dots or to a selection of same-colored objects from darkest to lightest. These tests are not part of standard eye exams but are available if you ask for them.

Are Eye Exams Covered by Insurance?

Most health insurance plans do not cover eye exams. When they do, it is typically only for a percentage of the cost and not the full expense.

Vision insurance usually does cover the cost of routine annual eye exams in full. Depending on your policy, you may have to pay out of pocket for additional tests that are not considered to be part of a standard eye exam.

Be sure to check what type of coverage your health and vision insurance plans offer before making an eye exam appointment. You should also verify whether you need to book your eye exam with an in-network provider to use that coverage.

What Do Eye Exams Typically Cost?

The average cost of an eye exam nationally is around $114 without insurance. People with insurance can expect to pay significantly less depending on the type of plan they have.

Low-cost eye exams are available in many chain eyeglasses retailers like America’s Best and big-box stores like Walmart.

There are also some public health programs, charities, and non-profit organizations that offer free eye exams for people with low incomes. Most are run through social services, so be sure to ask your case worker about them if you are having difficulty covering the cost of your eye care.

Where Can You Get an Eye Exam?

There are four main places where you can get an eye exam:

• Eyeglasses retailers like Pearle Vision, Lenscrafters, and America’s Best.
• Online eyeglasses retailers like Warby Parker and Lens.com.
• Big box stores like Walmart, Target, and Costco.
• Independent optometrists’ and ophthalmologists’ offices.

Online eye exams tend to be inexpensive, but they are also limited in scope. They cannot identify signs of eye disease, and some may only be used to renew a prescription rather than to obtain a new one.

All eye exams that take place in an eye care professional’s office are equally thorough and reliable. If you are seeing a new eye doctor for the first time, let them know about any diagnosed eye conditions you have. This will allow them to make sure you receive all the tests you need to keep your eyes healthy.

References

1. Eye Exam Cost. (2022). CostHelper.

2. Get Help Paying for Eye Care. (May 2021). National Eye Institute.

3. What should I bring to my eye exam? (2022). Canadian Association of Optometrists.

4. Access to Clinical Vision Services: Workforce and Coverage. (September 2016). Making Eye Health a Population Health Imperative: Vision for Tomorrow.

5. Eye Exam and Vision Testing Basics. (2022). American Academy of Ophthalmology.

6. Eye Exam: What to Expect. (December 2020). Cleveland Clinic.

7. Get a Dilated Eye Exam. (May 2021). National Eye Institute.

8. Eye exam. (April 2021). Mayo Clinic.

9. See the Full Picture of Your Health with an Annual Comprehensive Eye Exam. (2022). American Optometric Association.

10. Visual Field Test. (March 2021). American Academy of Ophthalmology.

11. The Three Types of Eye Doctors. (March 2021). American University of the Caribbean School of Medicine.