What glaucoma screening involves and why it matters

Glaucoma screening is a straightforward test that measures the pressure inside your eye. High pressure can damage the optic nerve over time and cause vision loss. The test takes a few minutes, does not hurt, and often catches the problem before you notice any symptoms — which is why it matters. Once glaucoma causes vision loss, that damage cannot be reversed, so catching it early is the only way to prevent it.

Most people with glaucoma have no warning signs. You might feel fine and see clearly, but pressure inside your eye could still be building. A screening is the only way to know. If your eye doctor finds high pressure, they can start treatment to slow or stop the damage.

Medicare covers glaucoma screening once every 12 months if you have diabetes or a family history of glaucoma. Some states cover screening more often or for more people. Your primary care doctor can refer you, or you can go directly to an eye doctor.

Key Takeaways

  • Glaucoma screening measures eye pressure and takes only a few minutes, with no pain or recovery time.
  • Medicare covers one screening per year if you have diabetes or a family history of glaucoma, with no copay.
  • You do not need a referral to see an eye doctor for screening, though your primary care doctor can provide one.
  • Early detection prevents vision loss, because glaucoma damage cannot be reversed once it happens.
  • If screening finds high pressure, your eye doctor will discuss treatment options to protect your vision.

How the screening test works

The most common screening test is called tonometry, which measures the pressure inside your eye. Your eye doctor will put numbing drops in your eye so you do not feel anything. Then they use a small device that either touches the surface of your eye very gently or blows a puff of air at it — you choose which method you prefer. The whole test takes less than a minute per eye.

Your eye doctor may also look at your optic nerve using a special lens or camera. This helps them see whether high pressure has already caused any damage. If they see signs of glaucoma, they will talk with you about next steps, which usually means starting eye drops or other treatment to lower the pressure.

You will get your results the same day. If your pressure is normal and your optic nerve looks healthy, you are done. If pressure is high, your doctor will explain what that means and what to do next.

Who should get screened and how often

You should consider screening if you are over 60, have diabetes, have a family member with glaucoma, are African American or Hispanic (these groups have higher risk), or have had an eye injury. Even if none of these explore to you, many eye doctors recommend screening starting at age 40 as part of routine eye care.

Medicare covers screening once per year if you have diabetes or a family history of glaucoma. If you have neither, Medicare does not cover routine screening, though you can still have one done and pay out of pocket. Many community health centers offer low-cost or free eye screening. Your state health department or local Area Agency on Aging can tell you where to find them.

If your first screening shows normal pressure and a healthy optic nerve, your eye doctor will tell you when to come back — usually every one to two years. If pressure is high or borderline, you may need screening more often.

What to bring and how to prepare

Bring your insurance card and a photo ID. If you have Medicare, bring your Medicare card. If you see an eye doctor regularly, bring a list of any eye drops or other medications you use. You do not need to fast or stop taking any medications before screening.

Wear comfortable clothing and plan to spend 30 to 45 minutes at the office, though the screening itself takes only a few minutes. The numbing drops used during the test can make your vision blurry for a short time afterward, so you can drive home, but some people prefer not to. If you wear contact lenses, you can keep them in, but your eye doctor may ask you to remove them during the test.

If you have glaucoma or high eye pressure already, bring a list of all the eye drops you use, including the name and how often you use them. This helps your doctor track your treatment.

Where to get screened

You can get screened at an eye doctor's office — either an optometrist or an ophthalmologist. An ophthalmologist is a medical doctor who specializes in eye care and can also perform surgery if needed. An optometrist is trained to do screening and prescribe glasses and contacts. Both can do glaucoma screening.

Community health centers often offer screening at low cost or free. To find one near you, call 211 (a free helpline) or visit findahealthcenter.hrsa.gov. Your primary care doctor can also refer you to an eye doctor or tell you where screening is available in your area.

If you have Medicare, search for "eye doctor" or "ophthalmologist" on Medicare.gov to find doctors who accept Medicare. Call ahead to confirm they do glaucoma screening and that they accept your insurance.

What happens if screening shows high pressure

High eye pressure does not always mean you have glaucoma — some people have high pressure but never develop vision loss. However, high pressure is a risk factor, and your eye doctor will want to monitor you closely. They may recommend starting treatment right away or watching you more often to see if pressure stays high or if your optic nerve shows damage.

Treatment usually starts with eye drops that lower pressure by either reducing the amount of fluid your eye makes or helping it drain better. You use these drops once or twice a day, usually in the evening. If drops do not lower pressure enough, your doctor may add a second type of drop or recommend laser treatment or surgery.

Your eye doctor will schedule follow-up visits to check your pressure and optic nerve regularly. These visits are important because they show whether your treatment is working. Do not skip them, even if you feel fine.

Cost and insurance coverage

Medicare covers one glaucoma screening per year with no copay if you have diabetes or a family history of glaucoma. The screening must be done by an eye doctor who accepts Medicare. If you have a Medicare Advantage plan, coverage may differ — call your plan to ask.

If you do not have Medicare or do not meet the coverage rules, screening usually costs between $50 and $150 out of pocket, depending on where you go. Community health centers often charge less or use a sliding fee scale based on income. Some states cover screening for people over 65 even without diabetes or family history — call your state health department to ask.

If screening leads to a diagnosis of glaucoma, treatment with eye drops is usually covered by insurance. If your doctor recommends laser treatment or surgery, coverage depends on your plan — ask your insurance company before the procedure.

Frequently Asked Questions

Does glaucoma screening hurt?

No. Your eye doctor puts numbing drops in your eye first, so you feel nothing during the test. You may feel a slight pressure or see a puff of air, but there is no pain. Your eye may feel slightly irritated for a few minutes after the drops wear off, but that passes quickly.

Can I get screened without a referral from my doctor?

Yes. You can call an eye doctor directly and schedule a screening without a referral. However, if you want Medicare to cover it, you may need documentation that you have diabetes or a family history of glaucoma — your primary care doctor can provide that.

What if I have had glaucoma before or have a family member with it?

You should be screened at least once a year, and possibly more often depending on your eye doctor's recommendation. If you have a family member with glaucoma, tell your eye doctor — this increases your risk and may change how often you need screening.

Will screening find glaucoma if I already have vision loss?

Screening measures pressure and looks at your optic nerve, so it can show damage that has already happened. However, once glaucoma causes vision loss, that loss cannot be restored. This is why screening before you notice symptoms is so important.

What should I do if I cannot afford screening?

Call 211 or visit 211.org to find free or low-cost eye screening in your area. Many community health centers offer it on a sliding fee scale. Your state health department can also tell you about programs that cover screening for older adults with limited income.