Should I see an opthamologist or an optometrist?

November 10, 2009 12:00 PM

Probably need my first pair of glasses. Haven't had my eyes checked in years. Should I see an opthamologist or an optometrist?

My vision is not what it used to be. I look at a computer all day and I'm starting to get eyestrain. Night driving is also more difficult. Should I see an opthamologist just because I haven't had a checkup in awhile? Or is that overkill?

What fun stuff should I know about getting my first pair of glasses? (I'm sure I don't want contacts.)

I'm 35, no known health conditions that would affect vision. I have health/vision insurance.

posted by desjardins to health & fitness (25 comments total)

You want an optometrist. If they think you need one, they'll refer you to an opthalmologist.

What fun stuff should I know about getting my first pair of glasses?

If you end up with ones with plastic frames, ask to see the heating box full of glass beads they use to expand the rims to get the lenses in. It's cooler than it sounds.
posted by Fiasco da Gama at 12:06 PM on November 10, 2009 [2 favorites]

Optometrists are specialists in measuring your vision for corrective lenses, and they also do some basic screening stuff; opthamologists are medical doctors with a specialty in diseases and conditions of the eye.

Get your vision checked by an optometrist, and if there is anything serious they will refer you to an opthamologist. Most people never go to an opthamologist until they get some condition, like iritis or glaucoma, which requires treatment. You may even have trouble getting an appointment with an opthamologist without a referral.

As someone wearing glasses for the first time, you will probably be more sensitive to the weight of them than someone who is used to it. So you might like very thin, light frames.

But as someone who has worn glasses for 16-20 hours a day since I was 8, the most important piece of advice I can give is to never, ever wipe your glasses with tissue paper. It will scratch them horribly. Get a proper cleaning cloth; a cotton hankerchief or tea-towel also does just fine. Dish-soap is also excellent for getting them very clean from the bits of oils that get on them from your eyelashes.
posted by jb at 12:09 PM on November 10, 2009 [1 favorite]

Glasses are fun. I feel better knowing that some tree branch, wind-borne debris, or spattering cooking oil won't be going in my eye. Get nice prescription sunglasses, too, and you'll be even cooler than you started out.
posted by StickyCarpet at 12:22 PM on November 10, 2009

Optometrists often charge ALOT for a pair of glasses. Even if you have vision coverage on your insurance, you'll usually end up spending a lot, especially if you're picky about your frames. Don't feel bad about asking for your prescription and shopping around. Try on frames at the optometrist's office, get the info for them, and see if you can find them elsewhere cheaper, even online.

Good luck!
posted by fresh-rn at 12:25 PM on November 10, 2009

If you do get glasses, your eyes/head may feel wonky for the first couple of days as the muscles that have been straining to compensate learn to relax. I remember it was a weird sensation, because the glasses were definitely an improvement, but my brain hadn't caught up with my new optics yet.

Also, you might want to ask for a complete copy of your prescription and get your pupillary distance so that you can order cheap glasses online in the future and avoid getting gouged on frames. I'm having an eye exam next week and I'm planning on going the online route.
posted by usonian at 12:25 PM on November 10, 2009 [1 favorite]

If driving is an issue, think about actually getting the anti-glare coating that they'll try to upsell you on. I did on my first pair but not the second...and I notice the difference. (Con: Anti-glare coating is also a smudge magnet...which is why I passed the second time.)

Ask for a copy of your prescription from your optometrist at that visit, and tuck it away somewhere. Even if your insurance covers a pair of eyeglasses, it probably does not cover breakage -- and it will likely be much cheaper to buy replacement ones online. Prescription sunglasses will be much cheaper online as well.
posted by gnomeloaf at 12:26 PM on November 10, 2009

Nth the recommendation of an optometrist.

Also, with your vision insurance, if it turns out that you do need glasses, it's worth it to shop around and look at different frames at different places. I ended up getting a pair of Koali designer purple and blue glasses for my latest pair, because my insurance could be used at a hole in the wall glasses shop that had a designer frames section.

It's worth it to shop around for frames that you absolutely love, instead of merely tolerate. It'll make the glasses wearing experience much less painful.
posted by spinifex23 at 12:26 PM on November 10, 2009

It is probably better (and cheaper) to see an optometrist than an ophthalmologist (correct spelling, not just because I'm a pedant but also to help future MeFi searches). However, ophthalmologists can measure you for a prescription. The last time I needed new glasses I ended up getting measured by an ophthalmologist simply because the optometrist in my small town was booked for a couple of weeks and the ophthalmologist could see me the same day.
posted by brianogilvie at 12:34 PM on November 10, 2009

Do absolutely get a copy of your prescription and (if your optometrist won't/can't do it) bribe an optician at an eyeglass store to measure your pupillary distance (I went the ruler-in-the-mirror route myself, and it's fine, but I will get an official measurement soon) so you can order online. You can go to a McGlasses kind of place to try stuff on (take someone with you for second opinions) and get a feel for size/shape/color/features, and then order something similar online. My mother just paid SIX HUNDRED DOLLARS for progressive-lens glasses from her small-town ripoff optician; I just paid $150 for four single-vision pair, including one with transition lenses (I don't like them, it turns out, so they'll live in the car for emergencies) and one with dark tint.

Make sure that you arrange for a ride and go ahead and do the full exam with dilation. Some people can walk out dilated and drive home, I found out the hard way that I cannot.
posted by Lyn Never at 12:35 PM on November 10, 2009

Committed glasses-wearer:

If you have extra FSA money, either extra "regular" glasses or prescription sunglasses can probably use it up. It's great to have backups. Also as someone above said, Rx sunglasses are the best thing ever.

Be aware that Transitions lenses frequently wind up making you look, inside, like you're wearing tinted lenses. Maybe they're fancier now, but I see a lot of people in bright indoor spaces who probably don't know that their Transitions are making them look goofy.

Try on a lot of frames! Depending on the shape of your face and eyes, certain frames (no matter how cool) won't be flattering; others will. After years you'll have a sense of what the right shapes are.

Have fun!
posted by chesty_a_arthur at 12:39 PM on November 10, 2009

Although you don't specifically mention it, has your vision suddenly gotten worse or has this been gradual? If it's been sudden, make sure you mention that to the optometrist along with the other issues you're having.
posted by tommasz at 12:41 PM on November 10, 2009

Depending on insurance, sometimes your best option is to buy frames and lenses at a shop owned by the doctor. VSP (one of the most popular) only works with doctor owned shops.
posted by Kimberly at 12:42 PM on November 10, 2009

Your health/vision insurance probably covers one visit to an optometrist or ophthamologist every few years, so there's likely not going to be (much of) a cost difference to you. If there's no difference or a small difference, I'd ask people on your health plan for recommended docs who are taking new patients and then go to whoever that might be, whether it's an ophthamologist or an optometrist.

If you've never worn glasses before, you might ask your doc what sorts of visual distortions you can expect with them so you don't freak out when things look funny. Unless your prescription is very weak, you can expect some pincushion (hyperopia) or barrel distortion (myopia).

Talk about different index plastics. Consider springing for the highest-index shit you can afford. Glass lenses are for masochists. People differ on this, but I've noticed obvious differences from antireflective coatings, and they also help other people see yer peepers.
posted by ROU_Xenophobe at 12:46 PM on November 10, 2009

I disagree about seeing an optometrist first.

Since you say you have not had your eyes checked in awhile, I would go the opthamologist route and ensure that there are no medical problems that you (or the optometrist) may have missed. The optometrist is not a medical doctor and so may miss some subtle thing that can have big repercussions down the road.
posted by dfriedman at 12:46 PM on November 10, 2009

Fun stuff for the first time glasses wearer: when you look at trees and realize that you can actually see the leaves....
posted by Lynsey at 12:47 PM on November 10, 2009 [1 favorite]

If you do end up getting glasses, be a little careful when driving with them initially. If you're like me, you might find yourself getting distracted by the amount of detail you can suddenly see. Like "Ooh, I can actually see each individual stone embedded in the road surface... oops, was that a red light?"
posted by FishBike at 1:09 PM on November 10, 2009

If your insurance covers them, buy a nice, comfortable, attractive pair of glasses at a brick and mortar store (so you can try them on, be sure they're good quality, etc.), BUT tell the salesperson you want to know your pupillary distance--it is much easier to persuade the person when you're already committed to buying a pair from them that day. Then, you can have your main pair of glasses, and buy as many $20 cheap-o pairs in whatever styles you want online.
posted by Meg_Murry at 1:28 PM on November 10, 2009

Unless you have a specific reason to think you have a medical problem beyond just needing glasses, there is no reason to skip ahead to an ophthalmologist. That'd be a bit like going to a surgeon instead of a family doctor for your regular medical checkup. Optometrists are trained to diagnose and in some cases treat medical issues; I'd trust one to do that job better than I'd trust an ophthalmologist to notice an issue that might be outside his area of surgical expertise.

(Optometrists do a lot more than "basic screening stuff" these days; I suspect some people above are actually thinking of "opticians" which is a whole nother animal.)
posted by ook at 1:33 PM on November 10, 2009

dfriedman: "I disagree about seeing an optometrist first.

Since you say you have not had your eyes checked in awhile, I would go the opthamologist route and ensure that there are no medical problems that you (or the optometrist) may have missed. The optometrist is not a medical doctor and so may miss some subtle thing that can have big repercussions down the road."

Seconding this. I wouldn't have known about my increased internal eye pressure (precursor to glaucoma) if I hadn't visited a qualified doctor. Even if you might get away with visiting "just" an optometrist later on I would recommend an intensive first check-up just to make sure there is nothing waiting in the wings.
posted by PontifexPrimus at 1:45 PM on November 10, 2009

I wouldn't have known about my increased internal eye pressure (precursor to glaucoma) if I hadn't visited a qualified doctor.

Don't most optometrists test this with the device that sends a puff of air into your eye, and refer you if necessary? That was my impression, at least.

If it's your first pair of glasses, it might be worth balancing lens size with the adjustment factor, especially if you need bifocals. Getting frames that take smaller lenses can throw you off a little at first since you're going to have a sweet spot where you have corrected vision with a blurry frame. Then again, you don't want to overcompensate by getting huge frames, unless that's the fashion you're after.
posted by mikeh at 2:59 PM on November 10, 2009

Every visit to an optometrist I've had in the past 20 years or so has included an eye pressure check.
posted by ROU_Xenophobe at 3:07 PM on November 10, 2009

You might want to check with your insurance to see what they will cover.

I have been to both optometrists and ophthalmologists. If you go to an optometrist, go to one that has a private practice, not one in an optical boutique.
posted by radioamy at 3:12 PM on November 10, 2009

I agree that you should see an ophthalmologist. Just because you haven't been in many, many years, and freaky stuff can happen to your eyes.

(I, for example, have a mole growing in the back of my left eye. Fun times!)

At my ophthalmologists' office, I get my contacts prescribed by an optometrist, but then the ophthalmologist looks at my mole and declares that it is unmoved since my last visit. Which I heartily appreciate.
posted by purpleclover at 3:19 PM on November 10, 2009

I was prepared to come in here and recommend an ophthalmologist for the reasons stated above, but then I went and checked my eye doctor's website. Turns out I've been seeing an optometrist for the last several years. So, uh, yeah.
Optometrists are doctors (O.D., not M.D. -- ophthalmologists are indeed M.D.s). Anybody checking your eyes will check you for glaucoma, even at the stupid one-hour places. Instead of dilating my eyes, my doc now has a machine that takes a picture of your retina. My sister also has a mole or something growing at the back of her eye, and our optometrist has been following it carefully (and can compare from year to year using the previous images saved on the computer). Any good optometrist will be able to recognize if and when something is beyond them to deal with, and will send you on to an ophthalmologist.
I don't think there's any reason not to see an optometrist, if that's easier/covered by your insurance/otherwise preferable. Of course, no reason not to see an ophthalmologist either -- your experience will be virtually identical unless there is something seriously wrong, in which case the optometrist would refer you to an ophthalmologist.
I'm quite fond of the photo of the retina, rather than getting my eyes dilated. It's cheap (about $40 above the cost of my eye exam, but my medical insurance will actually cover it) and it allows them to sit and look for as long as they want without me flinching away. Plus they've got the image from year to year so they don't have to refer back to their notes -- "Let's see, that mole on purpleclover's eye was 3 mm last time, now it's...3.3? Maybe the borders have changed?" Plus I get to avoid dilation, which was always the worst part of eye exams. I swear I'm not associated, just an ardent fan, but if you want to find out if someone near you offers the service it's called Optomap, and I think you can look up providers on their website.
posted by katemonster at 4:48 PM on November 10, 2009

I suggest an ophthalmologist because there might be a time when you'll need prescription drugs or surgery for an eye condition and it is always better to have a relationship with a physician before you really need them.

While refraction for a prescription is low on the fun things to do for an ophthalmologist (in fact, he/she might have an O.D. in their office to do these), it gets your foot in the door so you can be an existing patient and not a new patient.

Sad that one has to have a health care strategy in this country (US)

Disclaimer: I am a medical doctor.
posted by teg4rvn at 3:26 PM on November 16, 2009