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Routine Eye Exams
A routine exam is designed to check your overall eye health, determine your glasses or contact lens prescription, and ensure your vision is clear and comfortable.
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Purpose: Refractive care (nearsightedness, farsightedness, astigmatism, presbyopia)
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Billed to vision insurance (if you have it)
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Example reasons:
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Updating your glasses or contact lens prescription
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Annual vision checkup with no medical eye concerns
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Preventive screenings for healthy eyes
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Think of it like a dental cleaning—you’re here for preventive maintenance and vision correction.
Medical Eye Exams
A medical eye exam focuses on diagnosing, managing, or treating an eye health problem or disease.
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Purpose: Medical evaluation and treatment of eye conditions
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Billed to medical insurance (if you have it)
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Example reasons:
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Corneal conditions/diseases
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Retinal conditions/diseases
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Eye infections (“pink eye”)
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Glaucoma
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Diabetic eye disease
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Dry eye syndrome
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Flashes, floaters, or sudden vision changes
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Allergic or inflammatory eye conditions
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Think of it like going to your primary care physician—you’re here because something’s wrong and needs evaluation or treatment.
When a Routine Exam Becomes a Medical Exam
Sometimes a patient comes in for a routine vision check but mentions a medical concern—for example:
“I’m here for my glasses prescription, but my right eye has been red and itchy.”
In that case, your exam will need to be billed to medical insurance instead of vision insurance, because the reason for your visit requires a medical diagnosis and treatment.
We will always attempt to explain this change to you before proceeding, so you’re aware and can make the best decision for your care.
Why We Follow This Process
1. Insurance rules require us to bill based on the reason for your visit and what is found during the exam.
2. Medical conditions must be documented and billed appropriately for continuity of care with your primary care provider or specialist.
3. Your safety—accurate medical documentation ensures the right follow-up and treatment.