A Visit to the Eye Doctor

• How to choose an optometrist or ophthalmologist
• What will happen before, during, and after the appointment?
• What kind of tests and procedures will they do?
• How long will the visit take?
• When should you see a specialist?
• How often should you go to the eye doctor?
• Should people with eye diseases see their eye doctor more often?
• Does health insurance cover the cost of the appointment?

Because of the value of sight, it is important to be proactive in your eye health. Taking a role in maintaining your sight and preventing its loss includes choosing a health-care provider best suited for your needs -- one that has the right training and experience, can give proper diagnosis and treatment, is informative, promotes the best possible outcome, and guides their care through genuine concern.

Getting started: How to choose an optometrist or ophthalmologist

• Qualifications. Having a solid set of credentials is one quality indicator of a good health care provider. Making sure that the professional has the proper and adequate training to diagnose, treat, and prevent disease can help you decide which doctor will best serve your eye health needs. Both your optometrist, OD, and ophthalmologist, DO or MD, should be certified through an accredited medical institution and be licensed to practice through the respective state board of optometry or state medical board. Ophthalmologists should, in addition, have internship and residential experience. Certificates and licensures should be displayed in conspicuous areas. You may confirm their credentials through the appropriate state board prior to your visit.

• Experience. Having experience is also a quality indicator of a health-care provider. An optometrist or ophthalmologist who has more experience will probably be more able to detect eye disease and diagnose disorders simply because they have seen more patients. The second benefit of visiting a health-care provider with experience is the reassurance that they have maintained a practice of optometry or ophthalmology. Consumers are unforgiving to malpractice and bad service.

  You may also want to know if your eye examiner participates in medical research or medical education. An eye health professional that participates in and is current with the latest research and education of their field is more knowledgeable about the latest techniques in diagnosing and treating eye disease and visual disorders.

• Services offered. Choosing an eye health professional who is able to provide a wide range of services is beneficial, but you also should select your provider by what services you do need. One who provides fewer services may sometimes be able to provide more specialization with a service or certain diseases, such as glaucoma and cataracts. You should examine your eye health needs to determine which health-care provider you should see.

Patient satisfaction. Making patients happy is very important. There is a clich about the word of mouth being faster and far more effective than any form of advertising. Knowing that patients have consumer loyalty to their health-care provider, but also encourage others to see their own doctor, is a very good indicator of quality.

Once you've seen your provider, determine if you are satisfied and comfortable with the outcome of your visit. You should be able to answer "yes" to questions like: Were you seen in a timely manner? Was the examiner thorough? Did he/she address all of your concerns and follow up with any possible complications or questions you had? Will you return? Will you recommend him/her to others?

What Will Happen Before, During, and After the Appointment?

If you currently wear glasses or contact lenses, bring them with you to your appointment.

Depending on the size and type of the office, you will more than likely be greeted by a receptionist or an optician. They will then take your name and ask you to fill out a sheet of information about your medical and eye-health history. Once your paperwork has been completed, you will be shown to the examining room where the doctor will perform tests of your vision and also check for disease.

After a thorough examination has been completed, you will be asked to wait until your prescription has been written. If you need vision correction, usually an optician will work with you to find the glasses or contact lenses that are best suited to you. At that time, you will make payment arrangements and set up your appointment for next year.

What Kind of Tests and Procedures Will They Do?

Your eye assessment should be complete, including:

• An examination of the interior and exterior of your eye. The doctor will check for signs of eye disease or general health problems, such as diabetes or hardening of the arteries that may show up initially in the eyes. Adults will be checked for eye pressure and field of vision to help diagnose glaucoma.

• A test of your visual acuity or ability to see sharply and clearly at near and far distances. Various tests can be used to determine the visual acuity of infants, children, and adults. These are fairly simple and can be performed by an ophthalmologist, optometrist, technician, nurse, or optician. They do not, however, test for important functions of sight, such as depth perception or color blindness. These are noninvasive, painless, and reliable and can be performed in a doctor's office, at school, or at home. One common type of test used for children or adults who cannot yet read is the Random E's Visual Acuity Test. The patient is asked to identify the direction that the letter "E" opens to by holding out 4 fingers to mimic the letter "E." This test is safe, there are no risks involved, and it works just as well as most other tests.

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Tests to determine the presence of nearsightedness, farsightedness, astigmatism, depth perception problems, and, in people over age 40, presbyopia (an age-related condition affecting reading vision).

A test determining eye coordination and eye muscle function. This confirms that the eyes are working properly together.

A test of the ability to change focus easily from near to far, and then far to near.

The results will give your eye health professional information about your overall eye health, your sight, and what prescription you will need to correct your vision.

How Long Will the Visit Take?

For your first visit, allow two hours. That includes time to sign in, be examined by the doctor, and also be fitted for your prescription, if necessary. From then on, your visits may be shorter simply because you may want to use the same frames and your information will already be on file.

When Should You See a Specialist?

You should see a specialist when referred by your physician or eye health provider for specific eye concerns. There is a wealth of information about the eyes and visual system. Specialists, because of the scope of their focus, can better pinpoint disease-related problems.

How Often Should You Go to the Eye Doctor?

You should visit your eye health care provider at least once per year, or immediately if you have any degree of sudden vision loss, eye pain, or irritation.

Should People With Certain Diseases See Their Eye Doctor More Often?

• People with diabetes should see their doctor more frequently as recommended by their diabetes specialist. There are complications of diabetes associated with blindness, and early detection can prevent loss of sight, which may be irreversible.

• People with a family history of eye diseases such as glaucoma, macular degeneration, and corneal diseases should also see their doctor more frequently as they age.

As with any disorder, there is a higher risk of certain eye disorders if someone in your family has had that eye problem.

Does Health Insurance Cover the Cost of the Appointment?

Most vision health coverage plans will cover a portion or all of the expenses associated with vision care. It is best to check with your health insurance provider to determine the limits of your coverage. If you do not have vision health insurance, some doctors may work with you to set up an affordable payment plan.

Having a complete exam with an eye specialist every one to two years is important because most eye diseases can be treated when found in an early stage. If you have health problems such as diabetes, you may need to visit your eye doctor more frequently to detect any complications.

Reviewed by the doctors at The Cleveland Clinic Cole Eye Institute.

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Edited by Charlotte E. Grayson, MD, WebMD, October 2004.