What’s that like: Routine eye exam

I did this just last week, so let’s get the “What’s that like?” series started with a routine eye exam.

Most posts in this series are going to be very long, so I’m going to put most of it under a little bit of a “fold” to try to keep it from being really long on the page in case you wanted to scroll past it.

A little background – I am nearsighted and I don’t even know how long I’ve been going in for eye exams. I think I’ve been wearing contacts since I was 13, when Mom said I was old enough for that responsibility. I was wearing glasses a least a few years before that. My prescription isn’t that severe, but it’s serious enough that I need corrective lenses in order to drive. I wear soft contacts most of the time, but I have glasses and prescription sunglasses for when my contacts aren’t agreeing with my eyes, typically in the spring when my allergies are flaring up.

Justin and I are covered by insurance through my work that covers most of the yearly eye exams and a certain dollar amount to put toward glasses frames, glasses lenses, and contact lenses.

So the framing of this experience is someone who has a slight visual impairment and is covered by pretty decent insurance. I don’t know what it’s like to go to the doctor while having perfect vision or without insurance.

There are a couple terms that you might run into during this process that I’ll go over first because they sound very similar: Optometrist, ophthalmologist, and optician. (Reference: Healthline.com.) Optometrists are most likely the person who will be the doctor at your routine eye appointment. Ophthalmologist is who you would see if you needed surgery. And an optician is someone who works for the eye doctor helping the patients with glasses and stuff – not everybody there will be one, but the person fitting your glasses should be.

Eye doctor appointments should be scheduled ahead of time – there might be some that accept walk-in patients, but my recommendation is to set up an appointment with the office ahead of time. If you have insurance, follow the information from your provider to make sure that the doctor you would like to see is actually covered by your insurance – with my insurance, I can look up local doctor’s offices through the insurance website to check or I can call the insurance and ask someone over the phone to look it up. My eye coverage is separate from my medical coverage, so when contacting my insurance about eye care, I have to contact a different provider than I do for most of my other stuff. Make sure you know who you need to talk with about your eye care insurance coverage, if you have it. And be aware that some providers are specific about the location where the doctor is working – so a doctor could be covered by insurance at one location but that exact same doctor could be considered “out of network” at another location, which will mean that your insurance coverage will be very different. It’s a stupid insurance thing, so make sure to check ahead of time.

I don’t have any advice about finding a good eye doctor other than looking at reviews and asking around to see if anyone has any recommendations about who to go see. What I can say is that if you get to the end of the exam and really didn’t like the doctor or the people working there, you don’t have to go back there again. Just find a different doctor next time and try again. Don’t feel obligated to go back to someone you didn’t like.

Okay, so you’ve found an eye doctor and set up an appointment. You’ve checked with your insurance to make sure that you’re covered to see this doctor at this exact location. And now you’re ready to go to the appointment.

If you have corrective eyewear, you should wear/bring that to your appointment. (Also, I’m not sure why you’d be reading this post because how did you get that without having an eye exam?!)

There is going to be paperwork to fill out – you might get this ahead of time if the doctor’s office sends it or they might send you to their website to find it or you might have to do it when you get their office. You should plan to get there with some extra time before your appointment to give time to complete it. The paperwork will ask about your personal information like your name, address, age, etc. It will also ask for your insurance information. They will probably want a copy of your state ID and your insurance card for their records – they’ll make a scan/photocopy at the office so make sure to have these two cards with you when you get to the office. The paperwork might also include questions about family medical history and payment information and HIPAA (Health Insurance Portability and Accountability Act) release forms. (If you’re not familiar with HIPAA, your health information provided to doctors is protected by law and if you have anyone who you would like the doctor to talk with about your information, the doctor’s office needs a signed form that says that they’re allowed to release that information. More information about HIPAA here. As a side note, please don’t share private health information with groups who are not covered by the HIPAA laws, like something in Ye Olde Book of Faces. They are not required to keep your information private.)

At future appointments, you won’t have as much paperwork to complete. You’ll need to review that the previous information is still accurate and provide updates, but it won’t take so long.

At the office where I got my exam, I kept my paperwork with me instead of handing it back to the person working at the desk. A different person then called me back to a room for pre-exam tests and ask about my current medications and current eyewear. There are a variety of different tests that this person will do and I don’t actually know what all of them are testing. Most of them require not wearing my contacts, so she provided a space for me to wash my hands and remove those. One of the tests was a handheld item (she held it) that puffed little bursts of air into my eyes and made my eyes water a lot. (I think that’s the glaucoma test and this is a whole lot better than the old one where I had to put my face into a thing and wait for the puff to make me jump.) There was another one where I looked into a machine to look at a picture of long road to a balloon that went in and out of focus. Another machine showed a green dot that then flashed bright white light, like a camera flash, first in one eye and then the other. (That one also made my eyes water. I don’t like bright lights.) She had me look at a book and tell her what number was written in all the dots. (I do know that this is a colorblindness test.  Here’s an example.) And then she had me put on 3D glasses and tell her which of the 4 dots in the diamond was standing forward of the others.

She also dilated my pupils by putting in eye drops that would have that effect. She had me look up at the ceiling and she put the drops into my eyes and then told me to blink until it stopped stinging. If you have trouble with your blink reflex being seriously strong, like Justin, then this is tricky – he tends to blink before the drops hit his eye. I think the work-around is to put the drops on the side of his nose where they run into his eye from the side. They do this dilation in order to get a really good look at the inside of your eye to look for a whole bunch of potential problems. It’s annoying, but it’s for your own good. And I do mean it’s annoying. Everything was so bright and I couldn’t focus on anything closer than arm’s length, so reading my phone or a book or a computer screen was completely out of the question. And the drops keep my eyes dilated for several hours – something like 4 to 6 hours. I was able to read before they completely got back to normal, but things were bright and sometimes one pupil was a different size than the other and I looked like I was having a stroke. I definitely would not plan to go back to work or do anything important for the rest of the afternoon.

If you get your eyes dilated, make sure to have sunglasses for the trip home. And it might be helpful to have someone else with you who can see to help with the payments and stuff at the end of the appointment. Justin seems to be able to see better than I am after getting this done, so maybe some people handle this better than others.

The first time coming to this doctor’s office, the person doing these pre-exam tasks also checked the prescription on my glasses so the doctor would have that information. They use a clever little machine that tells them that information, but I have no idea how it works.

After doing these tests, we walked to the exam room. The exam room will have a chair with a stand next to it and it might look intimidating. There are so many tools and machines that are used in eye exams that I haven’t seen anywhere else. It’s okay; you don’t have to know what they do or how they work because you won’t be expected to touch them. And they should always warn you before they use anything.

I was asked to sit in the chair and with a spoon-shaped paddle over one eye, read the letters on the eye chart shown on the wall ahead of me, and then swap and read the letters with the other eye covered. This is just a sort of baseline that was part of the pre-exam testing and once she was satisfied that I could read with both eyes, she excused herself from the room and told me the doctor would be in with me shortly.

I wonder what they do if they find out the person coming in for the eye exam can’t identify letters… Can’t illiterate people get eye exams? Hrm….

Anyway, after a short wait, during which I read the informational posters on the wall and admired my doctor’s wedding photos, she came in and we started the actual exam. She asked if I was experiencing any problems with my eyes or if I had any questions, and since I was good and just needed to get more contacts for the year, we started looking at the eye charts.

Because I wear corrective lenses and she already knows what that prescription is, she had me look at the eye chart on the wall through the big butterfly shaped thing that she placed in front of my face. This has lots of lenses and things so she can swap things around to see which lenses look more clear to me. So, she’ll set it up, and then, with one eye blocked and only looking with the other eye, ask if I like one set of lenses better than the second option. And then, based on the answer that I give, do I like this one better than the next one? And how about this other one? And what’s she’s doing is trying a lot of different lenses to see which of them are the ones that I should use to see. Sometimes the difference between the two options is really easy to say which one is better, but not always. Sometimes, it’s hard to really know – like they’re the same focus, but maybe one is a little smaller? Just be open to say what you’re seeing to the doctor and let them know. They want you to go home with the best possible vision that they can provide and that’s going to depend on your answers to these questions.

As this process was going on, flipping between different lenses, she was asking me to read smaller and smaller letters off the eye chart on the wall ahead of me. And when she got to a point where she was satisfied, she asked me to look one more time, with both eyes open, and make sure that I could still see clearly with both eyes.

My prescription changed very slightly this year, but not a concerning amount. She asked if the contacts I’ve been wearing are still working for me and how frequently I swap them with new ones (to check that I’m disposing of them in the right amount of time – I’m supposed to use new contact lenses every 2 weeks). And then she brought me a new pair to try on to make sure that the prescription would work. She had a sink in the corner where I could wash my hands again before putting them in, and then had me sit on the chair again and, this time without the butterfly-looking thing, read the eye chart to make sure I could still see it, which I could see just fine.

After that, she did a close-up eye exam. And this is why you need to feel comfortable with your eye doctor because they are going to seriously invade your space at this point. She had me put my chin on a little stand so she could look at my eye with a lens that lets her see inside my eye. She asked me to look at her ear and then up and down while she held the lens in front of one eye and then the other. There’s a bright white light stripe on the lens that made my eyes water, but she’s good and quick at this and it didn’t take her very long to check both eyes.

She’s looking for damage to the eye and different diseases that show up in there. She’s also looking to make sure that the contact lenses I’ve just put in are fitting my eyes nicely.

Once she was happy that my eyes are nice and healthy and that my contacts were going to work and updated my information in the computer, she asked if I had any questions or anything else I wanted to ask, and then walked me out to the front of the office, where she thanked me and told the optician what I would be ordering.

Since I’m an established patient at this office, they already know what I use for my contacts, but if I was new, I would have discussed with the doctor the different types of contacts available and the different length of use that are available. I use 2-week contacts, but I have used longer ones and there are options for ones that swap out daily. This length is good for me and I like this brand, so I’m not changing right now. But that is a conversation that would be held with the doctor before putting in the new contacts.

If I was in the market for new glasses, this in the point in the appointment when I’d be looking at the different options for that. There are a lot of frames on the walls of the office that they have available for sale. These are just samples to try on and see if you like how they fit your face. They should have a little price sticker on them, and with our insurance, we get a frame allowance every 2 years up to a certain amount. Anything over that amount comes out of our own pockets.

After trying on a bunch of frames and deciding which pair you’d like, the optician will help select the lenses to put into those frames. There are a lot of options for this, too. If your prescription is really bad (meaning you can’t see for squat) then your lenses might be really thick normally, but you can chose an option that makes them significantly thinner. You can get tinting, anti-glare (I really recommend this option if you work at a computer a lot), anti-scratch, and a bunch of other things, I’m sure. I don’t wear my glasses enough to know what’s available for this. Be aware that each option will increase the amount you pay for your lenses, and our insurance again has a cap of how much they will pay for these. So, you might have to decide to pay out of your own pocket or not choose all the bells and whistles that you’d like.

Also of note for insurance, if I recall correctly, my insurance will either pay for glasses or contacts, but not both. So be aware that you might face limitations there as well.

Once you’ve selected frames and the options for your lenses, they will need to take some measurements of your face to make sure that your glasses will fit your face correctly. And then they will order your glasses. (There might be places where you can walk out that same day with glasses, but I have no idea.) Once your glasses arrive, they will call you in to make sure that they got everything right and the glasses fit and the lenses are right. They can make some tweaks to the fit before sending you home with your new glasses, so let them know if they don’t feel right.

Some offices have better frames selections than others and some frames that you got from one location might not be able to get lenses fit at a different location. The glasses Justin got from the eye doctor in Bluffton couldn’t get lenses fit correctly by the eye doctor here in Savannah. Also, there are a lot of options to buy glasses from online companies, which isn’t something I have experience with yet, but I think Justin’s planning to do that in the near future. He just had to request a copy of his prescription to take home when he left his appointment.

And I think that covers it! Please let me know what you think!