Going to optometry for routine checks?

[TheTruckGuy]

Hope this doesn't get flagged as asking for medical advice.

But my question is, how often should someone go to optometry to just get their comprehensively checked? Assuming they don't need glasses, and they're 20/20 at their annual PCP check, and have no other systemic disease that directly affect the eye, how often should they see an optometrist for a screening type check? Do you just ask for an eye check up appointment? And what kind of optometry clinics do this? Like do you need to go to a private practice type place? Or do the big franchise locations that seem focused on selling glasses also do these?

Thanks

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[FinnMac]

I'd go once a year. There's over 270 diseases that manifest in the eyes, some of them first. A eye exam is probably the cheapest form of Healthcare in the USA.

 

[TheTruckGuy]

I'd go once a year. There's over 270 diseases that manifest in the eyes, some of them first. A eye exam is probably the cheapest form of Healthcare in the USA.

Do you think there's a difference in a big corporate place like Lens Crafters vs a small shop at Walmart vs a completely private shop that is in its own building?

 

[wysdoc]

Do you think there's a difference in a big corporate place like Lens Crafters vs a small shop at Walmart vs a completely private shop that is in its own building?

The main thing to compare is whether an actual optometrist is examining you and whether they are examining your eye itself or just checking your visual acuity for glasses.
Some of the newer chains have only an auto-refractor machine and some salespeople or opticians.

 

[Mr.Smile12]

I thought the recommendation was annual, including as a young child.

 

[TheTruckGuy]

The main thing to compare is whether an actual optometrist is examining you and whether they are examining your eye itself or just checking your visual acuity for glasses.
Some of the newer chains have only an auto-refractor machine and some salespeople or opticians.

Good point, I always figured all these places had to have an optometrist. Do you think everyone needs a dilated eye exam? Or just slit lamp without dilation is enough?

 

[eyeeye_captain]

I ran into a very well respected pediatric ophthalmologist last year who told me that there’s really no reason for screening asymptomatic kids who are doing ok. Extrapolating to adults, if you’re 20/20 and checking in with your PCP, it’s pretty unlikely that you’ll find anything crazy before the age of 50.

It’s reasonable to check in every couple years with someone, which may be overkill if you don’t need glasses. I’ll never argue against preventive/proactive care. You’ll probably get more mileage out of a local private practice since they can set their own schedule and take their time as opposed to meeting metrics at a big box. If you’re not willing to be dilated, you could do wide field photos.

 

[percyeye]

I ran into a very well respected pediatric ophthalmologist last year who told me that there’s really no reason for screening asymptomatic kids who are doing ok. Extrapolating to adults, if you’re 20/20 and checking in with your PCP, it’s pretty unlikely that you’ll find anything crazy before the age of 50.

It’s reasonable to check in every couple years with someone, which may be overkill if you don’t need glasses. I’ll never argue against preventive/proactive care. You’ll probably get more mileage out of a local private practice since they can set their own schedule and take their time as opposed to meeting metrics at a big box. If you’re not willing to be dilated, you could do wide field photos.

Interesting hearing that perspective from a pediatric ophthalmologist, especially with kids. Our state mandates an eye exam on all kids before entering certain grades and it happens all the time where you ask a parent or the kid how are you seeing? They both say good, no problems. And then you cover an eye and one eye sees 20/20 and the other is 20/200 because it is hiding a +5.00 prescription and it is true they are seeing well, but really only out of one eye they just didn't realize it. Happens all the time with kiddos.

And I also think there is a little bit of different mentality of Ophthalmology vs Optometry. Where Ophthalmology is obviously more surgical oriented so those are the type of problems Ophtho is looking to fix, and because of the increased demand for surgery they have less time for just comprehensive exams. Kind of like asking a general surgeon when should someone go to a Doctor? And they'd probably say when something is hurting or not working well where your PCP would say lets try and prevent it first. I doubt many Ophthalmologists are looking for things like eye posture at near, dry eye and rosacea, and almost everyone has DM2 or HTN nowadays so always a chance of something going on posteriorly with no symptoms. Heck the Retina guys around me don't want care to see anything unless they are doing surgery or injections because they are just too busy.

Both professions have their place. Ophtho looking more to fix structure sometimes while Optometry is more keying in on function of the visual system. Just my thoughts, for the most part we all play a key role in keeping people seeing and I work closely with my Ophthalmology colleagues.

 

[eyeeye_captain]

Interesting hearing that perspective from a pediatric ophthalmologist, especially with kids. Our state mandates an eye exam on all kids before entering certain grades and it happens all the time where you ask a parent or the kid how are you seeing? They both say good, no problems. And then you cover an eye and one eye sees 20/20 and the other is 20/200 because it is hiding a +5.00 prescription and it is true they are seeing well, but really only out of one eye they just didn't realize it. Happens all the time with kiddos.

And I also think there is a little bit of different mentality of Ophthalmology vs Optometry. Where Ophthalmology is obviously more surgical oriented so those are the type of problems Ophtho is looking to fix, and because of the increased demand for surgery they have less time for just comprehensive exams. Kind of like asking a general surgeon when should someone go to a Doctor? And they'd probably say when something is hurting or not working well where your PCP would say lets try and prevent it first. I doubt many Ophthalmologists are looking for things like eye posture at near, dry eye and rosacea, and almost everyone has DM2 or HTN nowadays so always a chance of something going on posteriorly with no symptoms. Heck the Retina guys around me don't want care to see anything unless they are doing surgery or injections because they are just too busy.

Both professions have their place. Ophtho looking more to fix structure sometimes while Optometry is more keying in on function of the visual system. Just my thoughts, for the most part we all play a key role in keeping people seeing and I work closely with my Ophthalmology colleagues.

Said peds doc does a lot of amblyopia research so I was a little surprised as well. I suspect they feel school screenings are sufficient for most kids.

When you have a 20/20 adult in each eye on the chart, checking in with a PCP, and are healthy like the OP, I don’t know that you get a big return from frequent exams.

 

[Optogal]

If healthy, 20 to early 40s range. I'd say 2-3 years is certainly adequate. I don't tell anyone who is plano OU with no pathology and 28 yo that they have to come every year, because they don't. If you start telling them things that are clearly not true, then you start to lose credibility.

 

[dantt]

Interesting hearing that perspective from a pediatric ophthalmologist, especially with kids. Our state mandates an eye exam on all kids before entering certain grades and it happens all the time where you ask a parent or the kid how are you seeing? They both say good, no problems. And then you cover an eye and one eye sees 20/20 and the other is 20/200 because it is hiding a +5.00 prescription and it is true they are seeing well, but really only out of one eye they just didn't realize it. Happens all the time with kiddos.

And I also think there is a little bit of different mentality of Ophthalmology vs Optometry. Where Ophthalmology is obviously more surgical oriented so those are the type of problems Ophtho is looking to fix, and because of the increased demand for surgery they have less time for just comprehensive exams. Kind of like asking a general surgeon when should someone go to a Doctor? And they'd probably say when something is hurting or not working well where your PCP would say lets try and prevent it first. I doubt many Ophthalmologists are looking for things like eye posture at near, dry eye and rosacea, and almost everyone has DM2 or HTN nowadays so always a chance of something going on posteriorly with no symptoms. Heck the Retina guys around me don't want care to see anything unless they are doing surgery or injections because they are just too busy.

Both professions have their place. Ophtho looking more to fix structure sometimes while Optometry is more keying in on function of the visual system. Just my thoughts, for the most part we all play a key role in keeping people seeing and I work closely with my Ophthalmology colleagues.

You're right. Ophthalmologists are not looking for eye posture at near. Nor are most optometrists. I've worn glasses since 3rd grade and have never heard of such a thing.

What's the point of looking for dry eyes/rosacea if patients are asymptomatic? So you can put a prokera on it or charge for IPL? If the dry eyes are so bad that the asymptomatic patient needs treatment lest their cornea melts, don't you think the ophthalmologist would notice it?

 

[percyeye]

You're right. Ophthalmologists are not looking for eye posture at near. Nor are most optometrists. I've worn glasses since 3rd grade and have never heard of such a thing.

What's the point of looking for dry eyes/rosacea if patients are asymptomatic? So you can put a prokera on it or charge for IPL? If the dry eyes are so bad that the asymptomatic patient needs treatment lest their cornea melts, don't you think the ophthalmologist would notice it?

I don't know about "most" Optometrists aren't checking eye posture, probably in an Ophthalmology setting they aren't checking for posture, but in our office I know we check on almost everyone. Especially after the age of 65-70 those folks are going to start having decompensating phorias for sure. You can gain a patient for life just by putting in some 0.75BD prism in their Rx because their visual system will be working so much better at the end of a long day.

Are the Dry eye/Rosacea really asymptomatic? Sometimes. It happens all the time and you look at their lids and cornea and we will stop and ask, "have you had any tearing, fluctuating vision, burning, etc"? And they will say yeah, but that has been going on for years since I've been working on a computer 8 hours a day. A lot of the time they don't even realize they are symptomatic. And if they aren't symptomatic I can almost guarantee they will be in 2-3 years.

Again I see this as a surgeon is mostly keying in on surgery stuff and that is great. Everyone has their place, because if I had a family members and I sent them to any Ophthalmologist in our area for an "eye exam" they'd be pissed. You wait in the waiting room for 2 hours, get worked up and refracted by a tech, and then the Ophthalmologist takes a peak and says nothing is wrong, instead of explaining things about their visual system and how to make their vision more comfortable.

 

[VA Hopeful Dr]

I ran into a very well respected pediatric ophthalmologist last year who told me that there’s really no reason for screening asymptomatic kids who are doing ok. Extrapolating to adults, if you’re 20/20 and checking in with your PCP, it’s pretty unlikely that you’ll find anything crazy before the age of 50.

It’s reasonable to check in every couple years with someone, which may be overkill if you don’t need glasses. I’ll never argue against preventive/proactive care. You’ll probably get more mileage out of a local private practice since they can set their own schedule and take their time as opposed to meeting metrics at a big box. If you’re not willing to be dilated, you could do wide field photos.

PCP here. I don't disagree but I don't think most of us do VA all that often for what that's worth.

 

[eyeeye_captain]

PCP here. I don't disagree but I don't think most of us do VA all that often for what that's worth.

I meant mostly from a cardiovascular risk factor perspective. I see my significant share of delayed diagnosis diabetics who weren’t checking in with you folks.

 

[TheTruckGuy]

I don't know about "most" Optometrists aren't checking eye posture, probably in an Ophthalmology setting they aren't checking for posture, but in our office I know we check on almost everyone. Especially after the age of 65-70 those folks are going to start having decompensating phorias for sure. You can gain a patient for life just by putting in some 0.75BD prism in their Rx because their visual system will be working so much better at the end of a long day.

Are the Dry eye/Rosacea really asymptomatic? Sometimes. It happens all the time and you look at their lids and cornea and we will stop and ask, "have you had any tearing, fluctuating vision, burning, etc"? And they will say yeah, but that has been going on for years since I've been working on a computer 8 hours a day. A lot of the time they don't even realize they are symptomatic. And if they aren't symptomatic I can almost guarantee they will be in 2-3 years.

Again I see this as a surgeon is mostly keying in on surgery stuff and that is great. Everyone has their place, because if I had a family members and I sent them to any Ophthalmologist in our area for an "eye exam" they'd be pissed. You wait in the waiting room for 2 hours, get worked up and refracted by a tech, and then the Ophthalmologist takes a peak and says nothing is wrong, instead of explaining things about their visual system and how to make their vision more comfortable.

Never heard the term "eye posture" before. Is that just phorias. Sounds like, based off your post, that people tend develop phorias as they get older? Or is it tropias they develop?

Another question. Say I go to an optometrist for a general check up, and they don't do a slit lamp or anything, and just look at the data from the machines the techs run me through. Would you be like "umm... could you please do a slit lamp as well?" Or is a slit lamp overrated if everything else looks good and you're otherwise healthy?

 

[KHE]

Never heard the term "eye posture" before. Is that just phorias. Sounds like, based off your post, that people tend develop phorias as they get older? Or is it tropias they develop?

Another question. Say I go to an optometrist for a general check up, and they don't do a slit lamp or anything, and just look at the data from the machines the techs run me through. Would you be like "umm... could you please do a slit lamp as well?" Or is a slit lamp overrated if everything else looks good and you're otherwise healthy?

That would be highly unusual. Even the laziest optometrist out there is going to give you at least a cursory slit lamp exam. If they didn't, something is really wrong.