Eye Exams vs Vision Screenings


It is vital that you understand the differences between vision screening and eye examinations for the sake of your optical health and that of your family members. This becomes especially important regarding school-age children because poor eyesight could hinder their scholastic performance.


What Are Vision Screenings?


If your child is currently enrolled in elementary school or has been recently, chances are good that you’ve heard of vision screenings. Most states mandate that children in public schools undergo vision screenings to detect any subtle issues that they may have that aren’t usually always clear until they’re old enough to attend school. The school nurse oversees vision screenings, which are usually done by checking the child’s distance vision from 20 feet away. That classic eye chart with the rows of letters should come to mind. By knowing this, you’ll understand the gist of what vision screenings are.


What Do Vision Screenings Examine?


This vision screening procedure is insufficient to detect deficiencies in near vision or color vision, so problems like farsightedness, color-blindness, and a lack of eye coordination will not be found. Additionally, these screenings may also overlook a lot of other problems. In fact, it’s been suggested that as many as 15-20% of vision problems have been missed in school-aged children because their parents rely solely on these school-mandated screenings for all of the information about the optical health of their children. This basic vision check only does the bare minimum, which makes it very likely to miss the more problematic issues. It’s actually quite common for a child to be able to pass the screening, but still have trouble doing mandated close work for school, such as looking at and reading a book or doing homework.


What Makes Eye Exams Different?


You need to get an eye exam from a Doctor of Optometry to cover all of the bases of your optical health.

This test takes into consideration both a person’s overall health and the health of the immediate family. The eye health professional will make a detailed account of your visual history, or begin a file on your history if you have never done so before, so he/she has a record of any changes that may occur.

The evaluation will commence with a look at your eyes, followed by an internal exam. Additional testing includes refraction, visual acuity, visual field testing, and a whole battery of other tests. This thorough, across-the-board exam can detect a variety of conditions and diagnose issues that the basic vision screening was too ill equipped to do.

It is highly advised that you find an experienced optometrist to monitor your family’s overall health. Schedule a trip to Couture Optical when you’re ready for an eye exam and a new pair of prescription glasses.


Routine Eye Exams


Standard eye care procedures generally consist of an exam that determines the refractive state (i.e. nearsightedness/myopia, farsightedness/hyperopia, astigmatism, etc.) of the eyes and examine the overall health of the eyes. Most vision plans cover the costs of regular eye exams. A patient who seeks routine care is usually healthy and simply needs glasses or contact lenses to solve his/her visual problem.

The chief complaint, coupled with findings during an exam, determine whether an eye exam is considered routine or medical. Many people believe that just by getting and wearing new glasses, they will solve their vision problems, If that is the case, then the exam is considered to be routine. If the patient has other underlying conditions (ex. diabetes, cataracts, glaucoma, etc.) or the doctor uncovers other problems during a routine exam, then the exam will be considered medical in nature and may be filed under the patient’s medical insurance. Routine and medical exams may seem the same to the patient, but this distinction informs the optometrist of different things to look for based on whether there is a medical problem or not.


How the Test is Performed


The refraction test is a key part of the eye exam that determines the prescription power needed for a pair of eyeglasses. It is this test that lets the doctor know if the patient’s problem is medical in nature or not.

The optometrist, AKA “the eye doctor,” performs this test.

You will sit in a chair that has a special device called a phoropter/refractor attached to it. You need to look through the device and focus on the standard eye chart from 20 feet away. The device will have lenses of different prescription strengths that can be moved into your view. The test is performed one eye at a time. The optometrist will ask if the chart appears more or less clear when one of a choice pair of lenses is in place and will repeat the process with multiple pairs until he/she has accurately determined your prescription power.


How to Prepare for the Test

If you wear contact lenses, ask the doctor if you will need to remove them before the test and for how long they should be kept off.

How the Test Will Feel

You will not experience any discomfort during any part of the examination.

Why the Test is Performed

This test is standard procedure in a comprehensive eye examination. Its purpose is to determine whether or not you have a refractive error and therefore, a need for glasses or contact lenses to correct that error.

For people over age 40 who have normal distance vision, but have difficulty with near vision, a refraction test is especially useful in determining the right power of reading glasses.

Normal Results

If your uncorrected vision (i.e. without glasses or contact lenses) is normal, then the refractive error is zero (plano), and your vision should be 20/20.

A value of 20/20 denotes normal vision and means that you can read 3/8-inch letters at 20 feet. A small type size is usually used to determine how normal your near vision is.

What Abnormal Results Mean

If you require a combination of lenses to see 20/20, then that constitutes a refractive error. Eyeglasses or contact lenses should give you good vision. If you have a refractive error, then you also have a “prescription.” Your prescription is a series of numbers that describe the powers of the lenses needed to make you see clearly.

If your final vision is less than 20/20, even when supplemented with lenses, then there is probably another, non-optical problem with your eye.

The vision level you achieve during the refraction test is called the best-corrected visual acuity (BCVA).

Abnormal results may be due to:

  • Astigmatism
  • Farsightedness (AKA hyperopia)
  • Nearsightedness (AKA myopia)
  • Presbyopia (i.e. the inability to focus on near objects that develops with age)

Other conditions under which the test may be performed:

  • Macular degeneration
  • Retinal detachment
  • Retinal vessel occlusion
  • Retinitis pigmentosa
  • Corneal ulcers and infections


There are no risks associated with this procedure.


Couture Optical Eye Exams include the following services:

  1. Full patient case history
  2. Measuring the visual acuity of your distance vision with the usage of an eye chart
  3. Testing the balance in your eye muscles
  4. Testing for stereopsis
  5. Testing your color vision
  6. Pupillary reading from existing glasses
  7. Testing for signs of glaucoma
  8. Refraction and prescription power
  9. Evaluating the health of your eyes, both externally and internally
  10. Testing the pupils and fundi
  11. Dilated eye exams (when necessary) with the usage of dilating eye drops
  12. Patient consultation & planning for future care

How Often Should You Get Your Eyes Examined?



According to the American Optometric Association, infants up to 2 years old should have their eyes checked every six months and again once they reach the age of 3.

Some experts estimate that approximately 5 percent to 10 percent of pre-schoolers and 1 out of every 4 of school-aged children have vision problems. Therefore, school-age children should get another examination when they are about to enter kindergarten or 1st grade.

Those who don’t have any vision problems or are at risk for vision and/or eye problems should continue to get examined every 2 years thereafter up until they become adults at the age of 18.

It is recommended that children who wear eyeglasses or contact lenses should have their eyes examined at least on an annual basis or according to the instructions of their optometrist.

Children who have existing vision problems or risk factors should have their eyes examined more frequently. Common risk factors for vision problems include:

  • Premature birth
  • Developmental delays
  • Turned or crossed eyes (AKA strabismus)
  • Family history of eye disease
  • History of eye injury or injuries
  • Other physical illnesses or diseases


The AOA also recommends that any adult who wears eyeglasses or contacts get an annual eye exam. If you don’t normally need vision correction, you may still require an eye exam every 2 – 3 years up to the age of 40. The frequency with which you should schedule appointments for eye examinations is dependent on your rate of visual change and overall health. Doctors often recommend that those adults who unfortunately have diabetes, high blood pressure and other disorders get these exams done more frequently, because many of these diseases can affect vision and eye health for the worse.

If you are over 40, it’s a good idea to have your eyes examined every 1 – 2 years to check for common age-related eye problems such as macular degeneration, cataracts, and presbyopia.

Everyone over the age of 60 should be examined annually because the risk of eye disorders or diseases increases along with age.

Adults over the age of 60 should return to annual appointments specifically to screen for age-related eye issues, such as macular degeneration and glaucoma.

Individuals with vision impairment, no matter what their age group, need to see their optometrist annually to discover and monitor any changes in their vision.


What Information Should I Take With Me to My Eye Exam?


It’s important that you have some basic information on hand and ready at the time of your eye examination. Bring the following items to your exam:

  • All eyeglasses and contact lenses you routinely use, including reading glasses.
  • A list of any medications you take (including dosages).
  • A list of any nutritional supplements you take (including dosages).
  • A list of questions to ask the doctor, especially if you are interested in contact lenses or laser vision correction surgery.
  • Finally, also bring your medical or vision insurance card if you will be using it for a portion of your fees.

What Is The Optometrist Checking For?


In addition to evaluating whether you have myopia, hyperopia, or astigmatism, your eye doctor will check your eyes for eye diseases and other problems that could lead to vision loss. Here are some of the conditions that your eye doctor will be looking for:

  • Amblyopia: This occurs when there is a misalignment in the eyes due to strabismus (see below) or when one eye has a much different prescription power than the other. The brain will “shut off” the image from the affected eye. If left untreated, amblyopia can stunt the visual development of the afflicted eye, which could later on result in permanent vision impairment. Patching the stronger eye for periods of time often treats this condition.
  • Strabismus: This condition is also referred to as “crossed eyes” or “turned eyes.” The optometrist will check the alignment of your eyes to ascertain that they are working well together. Strabismus usually causes problems with depth perception and is a risk factor for the causation of amblyopia.
  • Eye Diseases: Many eye diseases, such as glaucoma and diabetic eye disease, have no obvious symptoms in their early stages. The optometrist will check the health of your eyes inside and out for any signs of early problems. In most cases, early detection and treatment of eye diseases can potentially help reduce your risk for permanent vision loss.
  • Other Diseases: Your eye doctor can detect early signs of some systemic conditions and diseases by examining your eye’s blood vessels, retina and so forth. They may be able to tell you if you are developing high blood pressure, high cholesterol or other problems.

For example, diabetes can cause small blood vessels to leak fluids into the eye, as well as swell the macula. Since the macula is the most sensitive part of the retina, this could eventually result in vision loss. It’s estimated that 1/3rd of Americans who have diabetes don’t know it; your optometrist may detect it before your primary care physician does, especially if you’re overdue for a physical.


Save Money at Couture Optical


If you are worried about the cost of an eye exam without insurance, you are in luck; Couture Optical offers FREE eye exams with a qualifying purchase of prescription eyeglasses.

Eye Doctors are Expert Eyecare Professionals
Heading to a meeting with the eye doctor means that you are working with an eye care professional. It’s important to make sure that you work with someone who not only knows his/her trade, but also excels in it.

Let an Optometrist Check Your Eyesight
Many people skip visiting their eye doctor if they haven’t experienced a change in vision, while others choose to assess their own eye health from home. In reality, this is a poor habit to get into and a somewhat dangerous practice. There are optometrists in the world for a reason, and it’s important that you allow a Doctor of Optometry to check your eyesight instead of doing it yourself.