Medically Necessary Diabetic Eye Health Exam
What is a diabetic eye health exam, and how does it differ from a routine eye exam?
The first difference is that Alberta Health does NOT cover routine eye exams. Routine eye exams generally include services and tests that may not be necessary in a diabetic eye health exam, such as a refraction. A refraction is the test that determines what strength of a prescription you need, and is necessary for acquiring new glasses or contact lenses.
It is very important to note that unless your vision is fluctuating as a result of your diabetes, a refraction will NOT be included in the diabetic eye health exam. Alberta Health does not cover refractions for the purpose of obtaining a prescription. This cost remains the responsibility of you, the patient.
What this means in a practical sense is that you will need to have your diabetic eye health exam and your routine exam on different days. Otherwise, you are responsible for the cost of the entire examination.
So what is a diabetic eye health exam?
This exam will test all areas of vision that may be affected by your diabetes and may include:
- acuity measurement,
- eye pressure measurement,
- dilated fundus exam, and
- slit lamp exam.
If there are other diabetic complications occurring, then additional testing may be done. If you're vision is fluctuating, then a refraction might be covered. Depending on when your last exam was, whether or not it is your first time visiting this particular optometrist, etc., the types of procedures done may vary, so be sure to talk with your doctor before the exam.
How do I get a diabetic eye health exam?
Just call your usual optometrist! All optometrists in Alberta are qualified and able to perform a medically necessary diabetic eye health exam. When you make your appointment, inform your doctor that you are a diabetic and would like to have a diabetic eye health exam.
Communication is vital in any relationship. Always confirm what procedures will be performed, and whether or not they are covered by Alberta Health, BEFORE entering the exam room.
Please note that if this is your first visit to a particular optometrist, or if it has been several years since your last routine eye exam, your optometrist may suggest that you have a full routine eye exam before the diabetic exam. This ensures that the optometrist has knowledge of your complete eye health situation.
If you don't currently have an optometrist, click here to find one near you.
Why should I get an eye exam?
Diabetics are at high risk for eye health complications such as diabetic retinopathy. A diabetic eye health exam once a year, and a complete routine eye exam every two years, is the recommended minimum standard of care. For more information on how diabetes effects the eyes and the importance of regular eye exams, click here.
