Hello and welcome to Case of the Day. I’m Dr Croley and today we’ve started shifting the way we do things. Instead of having a patient we’re gonna discuss about, we’re going to talk about a part of the eye exam.
And so a lot of people wonder what is a refraction. So we’re gonna go over what that is and then that way, we’ll have a better idea what we do when we’re trying to do a refraction in the office. So when you come in for just a regular exam, then typically we’re also gonna check to see if how your vision is, as far as what’s your best correctable vision is, because going by best correctable vision, we’re trying to know the health and status of your eye.
So how we determine your best correctable vision is we put you behind this machine. This machine has all the lenses in that we could prescribe as far as glasses go. And you get behind there and it’s pretty boring and you know, we say, “which is better, one or two or seven or eight or whatever, whichever way the technician or doctor likes to refract, but we give you an option of two different lenses and then you tell us which one is better and we keep changing this around to then provide you the sharpest, best vision we can get. And then we know that the health of your eye is well because if you see 20/20, then we’ll know your eye at least from one standpoint that it’s pretty healthy because you have a normal vision. And so we base a lot of what we do, on tests that we do, or how concerned I might be, about the health of your eye based on your best correctable vision.
Many years ago, maybe 25 years ago, Medicare decided that a refraction is not a medical part of an eye exam. And so therefore they came up with a separate refraction code and that refraction is not covered by insurance or Medicare. There are some insurances that do start to cover refraction occasionally but Medicare made the decision it isn’t medically necessary or part of the medical exam of your eyes, which is really wrong because it gives us valuable data on the health of your eye because if your vision isn’t normal then we gotta go find something why is your vision not 20/20, what in your eyes is causing your vision to be blurred, and also if you do have an eye disease. We follow the severity of that disease based on what your best correctable vision is. If you’re using glasses that are old and check on your vision, we don’t know whether your vision is blurred because the glasses are wrong or we don’t know whether your vision is blurred because you have an eye disease. So that is the reason why doctors always try to do this test of refraction. It’s because we wanna know what your best correctable vision is because that helps us monitor the health of your eye.
And so I guess, to be controversial with it because people can’t understand why am I paying for this refraction. That’s because many years ago, Medicare decided not to cover it. So, if your doctor wants to do a refraction, in most cases, a wise thing to do because we get that information. If your vision is 20/20 with your present glasses and you’re happy with your present glasses, then it’s not necessary that you have a refraction then. But if your vision is not 20/20, and we want to know what the best correctable vision is, then a refraction is really a medical refraction, not just a refraction for glasses; we use it as a diagnostic tool.
So this contraption has all these lenses in. It has lenses in here to correct astigmatism and lenses to correct the nearsighted and farsighted. And then we have also prisms in here that if someone has double vision or having trouble focusing eyes together, we can determine how much prism is need to correct their deviation. So this a pretty complicated little machine that provides us a lot of information.
So now that you know what a refraction is, you could just have a refraction solely because you want to get glasses or help with a contact lens prescription. But in many, many cases, it’s actually a medical refraction where which providing us with health information about the health of your eye. So if you have any questions about what a refraction is, or anything else about your eyes, you can always try to contact us through the website, we’ll be happy to try to answer those questions. And if not, may God bless you with healthy eyes and great vision.