Types of Eye Exams Explained: What Each Costs in 2026
Booking the right type of eye exam saves time and money. A basic screening and a comprehensive exam are not the same thing - and knowing the difference could mean catching a serious condition early.
Eye Exam Types at a Glance
| Exam Type | What It Checks | Duration | Cost Range | Who Needs It |
|---|---|---|---|---|
| Basic vision screening | Visual acuity only | 5-10 min | $5-$25 | School/work requirement, DMV |
| Routine eye exam | Acuity + refraction + basic eye health | 20-30 min | $50-$150 | Glasses/contacts wearers with stable prescription |
| Comprehensive eye exam | Full assessment: acuity, refraction, pressure, retina | 30-60 min | $100-$250 | Everyone (annually or biannually) |
| Dilated eye exam | Comprehensive + pupil dilation for better retinal view | 45-90 min (incl. dilation wait) | $150-$300 | Over 40, diabetes, family history of eye disease |
| Contact lens exam | Comprehensive + corneal measurements + lens fitting | 45-60 min | $150-$370 | Contact lens wearers |
| Medical eye exam | Disease diagnosis/management | 30-60 min | $150-$300+ | Eye disease patients, sudden symptoms |
| Retinal imaging (add-on) | Digital photograph/OCT map of retina | 5-15 min | $30-$75 extra | Over 40, glaucoma/macular degeneration risk |
| Paediatric eye exam | Age-adapted comprehensive assessment | 20-45 min | $50-$200 | Children from 6 months onward |
Screening vs Comprehensive: The Critical Difference
A basic vision screening only checks whether you can read an eye chart (visual acuity). It cannot detect glaucoma, cataracts, macular degeneration, diabetic retinopathy, or retinal detachment. These conditions can be present with perfectly normal visual acuity in their early stages. Only a comprehensive eye exam can detect them.
- Visual acuity (distance vision)
- Sometimes: near vision
- Sometimes: colour vision
- Refraction (exact prescription)
- Eye pressure (glaucoma screening)
- Retinal examination
- Optic nerve assessment
- Binocular vision and eye movement
- Lens clarity (cataract detection)
- Blood vessel health
When to See an Ophthalmologist Instead of an Optometrist
Routine vs medical: Optometrists handle routine eye exams and prescriptions. Ophthalmologists are medical doctors who treat eye diseases and perform surgery. Optometrist exam: $50-$250. Ophthalmologist exam: $150-$300+, and typically billed to medical insurance.
- Sudden vision loss or changes
- Eye pain
- New floaters or flashes of light
- Persistent redness or discharge
- Glaucoma, cataract, macular degeneration management
- Need for eye surgery (LASIK, cataract)
- Referral from your optometrist
- Routine comprehensive exams
- Glasses and contact lens prescriptions
- Myopia and presbyopia management
- Annual checkups (no symptoms)
- Contact lens fittings
- Dry eye management
- Monitoring stable chronic conditions
Detailed Breakdown by Exam Type
Basic vision screening
A pass/fail test measuring visual acuity at 20 feet. Used by schools, employers, and the DMV. It tells you if your vision meets a minimum standard but nothing about eye health. You can have 20/20 vision and still have glaucoma or early macular degeneration.
Routine eye exam
Checks visual acuity and provides a refraction (glasses prescription). May include a basic slit lamp examination and sometimes eye pressure. Suitable for young adults with stable vision who mainly need prescription updates.
Comprehensive eye exam
A full assessment of both vision and eye health. Includes refraction, eye pressure (tonometry), retinal examination (with or without dilation), binocular vision testing, and examination of all eye structures. Recommended for adults of all ages, and annually for those over 40 or with risk factors.
Dilated eye exam
A comprehensive exam with the addition of pupil-dilating eye drops. Dilation allows a much wider and more detailed view of the retina and optic nerve. Recommended for over-40s, diabetics, people with family history of retinal disease, and those with high myopia. Expect blurred near vision for 2-6 hours afterward.
Contact lens exam
A comprehensive exam plus additional measurements: keratometry (corneal curvature), tear film assessment, trial lens fitting, and a follow-up check. Required to obtain a contact lens prescription, which is separate from a glasses prescription.
Medical eye exam
An examination conducted by an ophthalmologist to diagnose or manage an eye disease. This is billed to medical (not vision) insurance. Examples include: monitoring diabetic retinopathy, managing glaucoma, evaluating cataracts for surgery, or investigating sudden vision changes.
FAQ: Eye Exam Types
What is the difference between a vision screening and a comprehensive eye exam?
A vision screening only checks visual acuity (can you read the eye chart). A comprehensive exam checks all aspects of vision and eye health including eye pressure, retinal health, and binocular function. A screening can miss glaucoma, cataracts, macular degeneration, and diabetic retinopathy.
Does dilation cost extra?
Dilation is often included in comprehensive exam pricing, but some providers charge an additional $20-$50. It is recommended for patients over 40, diabetics, and those with risk factors. Ask your provider upfront whether dilation is included.
What is retinal imaging and is it worth it?
Retinal imaging uses a digital camera or OCT scanner to photograph or map the retina. It costs $30-$75 in the US or £10-£20 in the UK as an add-on. It provides a permanent retinal health record for comparison over time and is worth considering for anyone over 40 or with risk factors.
When should I see an ophthalmologist instead of an optometrist?
See an ophthalmologist for: sudden vision changes, eye pain, new floaters or flashes, persistent redness, diagnosed eye disease management, or need for surgery. Routine exams and prescription updates are handled by optometrists.