Routine eye care generally consists of an exam to determine the refractive state ( i.e. nearsightedness, farsightedness, astigmatism) of the eyes and to look at the overall eye health. Most vision plans pay for routine eye exams. A patient seeking routine care is typically healthy and just needs glasses or contact lenses to solve their visual problem.
The chief complaint and the findings during an exam determine whether an eye exam is considered routine or medical. Many people think they just need new glasses to fix their vision problem, and if that is so then the exam is routine. If the patient has other underlying conditions( i.e. diabetes, cataracts, glaucoma) or the doctor uncovers other problems during a routine exam, the exam may be filed under his/her medical insurance. Routine and medical exams may seem the same to the patient, but the doctor will look for different things based on whether there is a medical problem or not.
Refraction: The refraction is the part of the eye exam that determines the prescription for eyeglasses. It is an important part of the exam because it lets the doctor know if there is a medical problem involved or not.
Medical eye care: When a patient has a medical eye condition (such as cataracts, glaucoma, or other conditions that can affect the eye, besides just needing glasses) then an eye exam is considered medical. Often people who have systemic conditions such as diabetes need eye exams to ensure there are no eye-related complications. A new symptom such as double vision or flashing lights also warrants a medical eye exam. Medical eye exams are billed under a patient's regular medical insurance and one does not need a vision plan to be examined.