Getting your eyes checked starts with choosing the right type of eye doctor, scheduling a comprehensive exam, and knowing what to bring. The process is straightforward, but a few details can make the difference between a routine visit and one that catches a problem early.
Optometrist or Ophthalmologist: Which One You Need
Two types of doctors perform eye exams, and for most people, either one works for a routine checkup. An optometrist completes a four-year optometry program after college and is trained to perform eye exams, prescribe glasses and contacts, and diagnose and treat many common eye conditions. An ophthalmologist goes through medical school plus a four-year surgical residency and can do everything an optometrist does, plus perform eye surgery.
If you just need a prescription update or a general checkup, an optometrist is a great choice and typically easier to get an appointment with. If you have a known condition like glaucoma, cataracts, or diabetic eye disease, or if you need surgery, you’ll want an ophthalmologist. Many people start with an optometrist and get referred to an ophthalmologist if something comes up that needs specialized care.
How to Find and Book an Appointment
If you have vision insurance, your plan’s website will list in-network providers near you. Without insurance, you can search the American Board of Medical Specialties directory at certificationmatters.org to verify that an ophthalmologist is board certified. For optometrists, the American Optometric Association has a similar locator tool. Large retail chains like Costco, Walmart, and LensCrafters also have optometrists on-site, often at lower prices.
When you call to book, mention whether you need a routine exam (general checkup, prescription update) or a medical visit (you’re having symptoms like blurry vision, floaters, or eye pain). This distinction matters for both scheduling and insurance billing.
What to Bring to Your Appointment
Show up with your current glasses or contacts, even if the prescription feels outdated. Your doctor will compare your old prescription to your new one to track changes over time. Bring a list of all medications you take, including over-the-counter supplements, since some drugs affect your eyes or vision. You should also know your family’s eye health history: whether parents or siblings have had glaucoma, macular degeneration, or other eye diseases. And bring your insurance cards, both your vision plan and your medical insurance, since different parts of the visit may bill to different plans.
What Happens During the Exam
A comprehensive eye exam takes about 30 to 60 minutes and includes several tests, most of them painless and quick.
The visual acuity test is the one everyone knows. You read letters on a wall chart, and your results are written as a fraction like 20/20 or 20/40. The top number is your distance from the chart (20 feet), and the bottom number represents the smallest line you could read clearly. If you score 20/40, it means you need to be 20 feet away to read what someone with normal vision reads at 40 feet.
Next comes refraction, where the doctor determines your exact prescription. You look through a device with interchangeable lenses and say which option looks sharper. This is the “one or two, two or three” part of the exam. If you need glasses or contacts, this test produces your prescription.
The doctor will also examine the front structures of your eye using a slit lamp, which is a microscope with a bright light. You rest your chin on a support while the doctor looks at your cornea, iris, and lens up close. This is how they spot cataracts, corneal damage, and signs of infection.
A tonometry test measures the pressure inside your eyes. The most common version uses a small puff of air or a gentle touch to the surface of your eye (after numbing drops). Elevated eye pressure is one of the key warning signs of glaucoma.
What to Know About Dilation
For a thorough look at the back of your eye, the doctor will likely dilate your pupils using eye drops. Dilation widens your pupil so the doctor can see the retina, optic nerve, and blood vessels in detail. This is how they detect retinal tears, diabetic damage, macular degeneration, and even eye cancers.
Dilation allows the doctor to see about 240 degrees of the interior of your eye, compared to roughly 200 degrees with advanced imaging cameras. One optometrist at Sanford Health has noted finding small retinal tears in young, otherwise healthy patients that would have been missed without full dilation. It remains the gold standard, and no current imaging technology fully replaces it.
The drops take about 20 to 30 minutes to kick in. Once dilated, your pupils can stay enlarged for four to 24 hours, with people who have lighter-colored eyes tending toward the longer end. During that time, you’ll be sensitive to bright light and your near vision will be blurry. Bring sunglasses, and plan for someone else to drive you home if you’re uncomfortable behind the wheel with dilated eyes.
How Often You Need an Exam
The schedule depends on your age and risk factors. Healthy adults under 40 with no vision complaints or family history of eye disease generally don’t need routine comprehensive exams, according to the American Academy of Ophthalmology. That changes at 40, when every adult should get a baseline comprehensive eye evaluation.
- Ages 40 to 54: every 2 to 4 years if no risk factors
- Ages 55 to 64: every 1 to 3 years
- Ages 65 and older: every 1 to 2 years
If you have diabetes, a family history of glaucoma, or other risk factors, you’ll need exams more frequently regardless of age. People who wear glasses or contacts often go yearly to keep their prescriptions current, even if that’s more frequent than the medical guidelines strictly require.
Children’s Eye Exams
Babies should have their first thorough eye exam around 6 months of age. This might sound early, but certain conditions like amblyopia (lazy eye) affect 2 to 3 percent of young children and can cause permanent vision loss if not caught early. After that initial exam, children should have their eyes assessed at each regular pediatric checkup, with formal vision screenings every one to two years during school age.
Any child who can’t be successfully tested for visual acuity by age 4 should be referred for a comprehensive exam. Between checkups, watch for signs that something needs attention sooner: an eye that turns inward or outward constantly, excessive tearing, crusted or red eyelids, extreme light sensitivity, or the appearance of a white spot in the pupil. Any of these warrants a prompt visit.
How Insurance and Cost Work
Eye exams fall into two billing categories, and the distinction trips up a lot of people. A routine exam, where the doctor checks your vision and finds no medical problems, is covered by your vision insurance plan. This is the type of visit that pays for the exam and typically includes an eyeglasses prescription.
A medical exam, where the doctor diagnoses or monitors a condition like dry eye, cataracts, glaucoma, or diabetic eye changes, gets billed to your regular health insurance. Your standard deductible and coinsurance apply. In most cases, a medical eye visit does not include coverage for an eyeglasses prescription, so you may need a separate routine visit for that.
Medicare does not cover routine eye exams for glasses or contact lens prescriptions. You pay 100 percent of the cost for those. However, Medicare does cover eye exams related to diabetes management and glaucoma screenings for high-risk individuals. If you’re on Medicare and want a routine vision check, expect to pay out of pocket or carry a supplemental vision plan.
Without any insurance, a routine eye exam typically costs between $75 and $250 depending on your location and provider. Retail optical chains tend to be on the lower end, while private practices and academic medical centers may charge more.