Thursday, August 04, 2005

Why isn't my Eyeglass Exam good for Contacts too?

Once again, thank you for all your comments on the last
“Do I really need that” post.
As I stated the comments brought forth some great questions,
and were going to address one of those in this post.

I hope the person that posted the comment doesn't mind me using it for this post.
But I think it is a question that a lot of people have, and that is why I wanted to use it as a basis for this post, it read like this:

“ This is useful considering I need a new pair of glasses. Actually, I prefer contacts, but I need a new pair of those as well, and the insurance won't cover the cost of the exam. Ridiculous. The insurance will pay for the lenses, will pay for the regular eye exam, and will pay for the glasses, but it won't pay for the measurement for contacts. Why is it a separate charge, anyway? Why isn’t it just part of the exam? Not fair.”

OK... Let's talk about this a moment, I am not going to say whether it is fair or not, but I am going to explain why they consider it too different types of eye exams.
In fact, there are actually three types of eye exams.

1. Eye exam for eyeglasses

2. Eye exam for contact lenses

(commonly know as a Contact lens fitting)

3. Eye exam for pathological problems

(usually given by a Ophthalmologist)

First off let's understand the difference between the three O’s.
An Ophthalmologist holds a doctorate of medicine (M.D.). These doctors have an intimate knowledge of all types of eye conditions and diseases, and can perform eye surgery when required.
They do more of a comprehensive exam looking for problems such as glaucoma, retinal detachment, cataracts etc. You can get an eyeglass prescription from these guys, but it is usually going to cost a lot more, and the doctor himself very rarely does the eyeglass exam, his technician does it and he signs off on it.

Optometrists hold a doctor of optometry degree (O.D.). Optometrists typically diagnose vision limitations, prescribe corrective lenses, and when vision disorders are present, refer patients to ophthalmologists.
These are the guys that are giving you either and eye exam for eyeglasses, or an eye exam with a contact lens fitting so they can give you a contact lens prescription.
Their eye exams are usually much less expensive than the ophthalmologists, and they do the eye exam their self rather than they're technicians doing the eye exam.

Opticians specialize in prescription eyeglasses. In certain geographical locations, they can distribute and fit contact lenses as well.
In some states it is mandatory for opticians to be licensed, and in some states it is not required. Opticians are like a pharmacist they fill the prescription.

That is what I am, I am an optician and licensed by the ABO.
That means I have passed a board exam to prove my competency set forth by the ABO.
ABO stands for “American board of opticianry”, so when I write my name it looks like this:
Ben Ramsey A.B.O.C. which means American board of opticianry certified.

Now, in my opinion if you are not having any pathological problems with your eyes, and all you want is eyeglasses or contact lenses then go to an optometrist.
The eye exam will be a lot less expensive and usually they're a little bit better at correcting your vision.
Please do not misunderstand I am not saying anything negative about ophthalmologists,
it's just that when they give you an eye exam they are looking at you from a surgeon’s point of view, and are looking more for pathological problems than just a refractive error.
And if you're not having any other problems besides just not seeing as well as you would like there is no sense in paying the extra money to go to an ophthalmologist versus the optometrist.

Back to the original question.
Why isn't my eye exam good for contacts too?
When you get an eye exam to correct your vision they put you in the chair and have you looked through the thing-a- majig , and say which is better number one or number two. Right?, then you tell them which one looks better to you.
This is called a subjective exam, you are making the choice of what looks better,
which in turn enables the doctor to diagnose what power your corrective lenses need to be.
But if you want contact lenses that power is going to be slightly different because instead of your corrective lenses being several millimeters away from your cornea suspended in a eyeglass frame, the corrective lenses are going to be laying directly on your cornea.
So that is going to change the power slightly. Plus, they also need to establish what size and what kind of contact lens is going to fit you.
They have to know what base curve you require how much liquid versus oxygen content your eye needs etc.
Unlike eyeglass lenses contact lenses are not standardized.
Because everybody's eye is not the same size or shape there are several different types of contact lenses, so the doctor must establish what size and shape and style of contact lens is best for you.
If you're a first-time wearer you may have to try a couple of different styles of contacts to find out which one is best for you, which may require a couple of follow-up visits.
So the point is, being fitted for contact lenses is more time-consuming than just a simple eye exam for glasses and that is why a contact lens fitting is more expensive than an exam just for eyeglasses.

Therefore most insurances don't what to pay the extra cost for the contact lens fitting.
They usually want the patient to pay a copayment to cover the extra charge.
I guess their philosophy is their job as an insurance company is to correct your vision with eyeglasses, but if you want contact lenses they consider that a luxury and do not want to
pay for it.
Again I'm not saying whether or not this is fair, I'm just saying that's the way it is.
I have heard of some insurance companies paying for contacts but then you have to buy your own eyeglasses.
It is very rare that I have ever seen an insurance company pay for eyeglasses and the contact lenses both.

As always I hope this has been helpful, feel free to post any comments or ask any questions that you may have regarding this post or any other optical questions.
You can also visit my web site, and go to the contact us page, there you will find my phone number and e-mail address feel free to contact me.

See you next time
Ben.... A.k.a. mobile eye Guy


  1. Anonymous1:36 PM

    I had bad lenses for the longest time, recently I got brand new ones, man, my wife is ugly.

  2. Thanks for answering my question on that. It makes sense. I just wish my insurance would pay for the contact exam- it's my money I'm paying them!


  3. Anonymous9:54 AM

    I bet the exam is all the same for both. However for the lenses they take an extra step in determining whether the eye size is a 8.4 or 8.6 or 8.8, which is pretty standard in most cases at 8.6. Money drain...

  4. Anonymous2:33 PM

    I do both the glasses and contact lens fittings and they are totally different exams. Especially if you have corneal problems such as Keratoconus or had a LASIK surgery gone bad. The lens placed on the eye itself MUST fit correctly otherwise the clarity of the vision will be affected and/or the comfort and health of the eye. Why sacrifice any of these?

  5. Chris1:07 AM

    Lasik is very dangerous if they accept you when you aren't really a good candidate! I had lasik surgery locally, which is really important!

  6. Different people should receive complete eye exams at different intervals. Children's eyes should be examined at six months of age, three years of age, and six or seven years of age and every two years during school days, since high vision problem rates are reported among both preschool and school-aged children. For children with risk factors of vision problems such as prematurity, developmental delays, turned eyes, family history of eye diseases and history of eye injury, more frequent eye exams are necessary.
    Opticians Eye Test

  7. It's a interesting point of view, but I disagree with you, because to many people doesn't have enough consideration about this striking difference. You know what is my point, specially in this hardly cases.

  8. I want lens (?) i don't need them but i just feel like having ones, at least during my work time in front of the pc all day hahah anyway I wonder why they are a lot of diseases like this, like a lot of errors in the human DNA.

  9. Thanks for this post. Know the top benefits of anti reflective glasses.