A medical ocular consultation differs from a routine eye exam in the way that we are evaluating a patient for some sort of medical eye condition. This includes the diagnosis, treatment and/or follow up for any medical issues with the eyes such as moderate to severe dry eyes, eye or lid infections, eye pain or injury, flashes or floaters, foreign bodies, glaucoma, and red or irritated eyes.
Sometimes, you may come in for a comprehensive eye exam and find out that something is wrong, beyond your eyesight. If your optometrist communicates concern while examining you and gives you a medical diagnosis, then your visit has shifted to a medical eye exam. In other times, you might have a feeling that something is wrong with your eyes and schedule a medical ocular consultation. In this case, if the aim of the visit is for the optometrist to evaluate your symptoms of pain or other complaints, or to check in on existing medical conditions, this will also be considered a medical ocular consultation.
This type of exam is billed to your medical insurance company rather than your vision insurance plan. Medical ocular consultations often receive better insurance coverage than standard eye exams, as they’re seen as more essential to your overall health. However, because every insurance plan processes claims differently, the best thing that can be done is to be informed about what is and what is not covered by your insurance. Since your healthcare provider has no jurisdiction over what your insurance will or will not pay, being your own advocate by asking questions and communicating with your insurance will help you know what you can expect when it comes to paying for either medical or routine visits. If you’ve scheduled an appointment with us, we will ask for all your insurance information, so that we can verify your eligibility and benefits prior to your appointment. That way, if for some reason, you are not eligible or we do not participate with your particular insurance plan, we can let you know ahead of time.
The differences between the two types of eye exams might seem slight, but it’s still important to be aware of them. And most important of all, keep your eye health in tip-top shape by scheduling comprehensive eye exams yearly and a medical ocular consultation if you suspect something could be wrong with your eyes beyond mere vision issues.