Medically reviewed by Dr. Michael Nodland, OD · Updated August 2026
Call (561) 799-3932 or book an appointment.
Medical eye care is the diagnosis, monitoring and treatment of conditions affecting the health of the eye — glaucoma, cataracts, macular degeneration, diabetic eye disease — rather than the measurement of your glasses prescription. It is billed to your medical insurance or to Medicare, not to a vision plan, because it addresses a health condition rather than a refractive one. Dr. Michael Nodland has practiced at this address since 2010 and describes his focus as the diagnosis and treatment of ocular disease. Medical eye care is one of the services at Eye Expressions, and it is a different appointment from a routine eye exam, though the two are often handled at one visit.
Why do most eye diseases have no early symptoms?
Most eye disease is silent early on because the eye compensates well. The retina has no pain fibers, and when one eye starts to lose ground the other fills in the gap, so your vision can feel completely normal while a condition is already underway.
That is why these conditions are almost always found by someone looking for them rather than because you noticed something. By the time a change is obvious to you, it is usually not an early change.
The most useful thing an exam can do is photograph the retina. At Eye Expressions that photograph is taken with optomap ultra-widefield imaging, which reaches far enough out toward the edge of the retina to catch early disease that a central view would miss, and which for most patients means a disease check without dilating drops — dilation is still used when a closer look is needed, and Dr. Nodland will tell you beforehand. That imaging is included in your exam rather than sold as an add-on, and if you are using insurance the copay is never more than $39. How far the image actually reaches, and when drops are still the right call, is set out in full on the eye exam page.
| Condition | Who is most at risk | What you notice early |
|---|---|---|
| Glaucoma | Age 60+, family history, elevated eye pressure, African American or Hispanic ancestry | Usually nothing |
| Cataracts | Age, years of sun exposure, diabetes, some medications | Glare at night, colors dulling, gradual haze |
| Macular degeneration | Age 50+, smoking, family history | Usually nothing; later, distortion in central vision |
| Diabetic eye disease | Anyone with type 1 or type 2 diabetes | Usually nothing until advanced |
What are the symptoms of glaucoma?
Glaucoma usually has no symptoms at all until it is advanced. It is damage to the optic nerve, often but not always linked to raised pressure inside the eye, and it takes peripheral vision first — the edges of your field, where you are least likely to notice a loss.
Monitoring uses eye pressure, the appearance of the optic nerve, and visual field testing, which is done here in the office. Where an OCT scan is needed, Dr. Nodland refers you for it and stays involved in the follow-up. A single reading rarely settles the question; glaucoma is diagnosed and followed by comparing measurements across visits, which is why records and repeat testing matter more here than in almost any other condition.
Optic nerve damage from glaucoma is not reversible. What treatment can do is lower pressure to slow further loss, which is why finding it early changes the outcome so much.
Dr. Nodland screens for glaucoma and macular degeneration and treats them when he can, or refers you for more testing if he judges it necessary.
When do cataracts need surgery?
A cataract is a clouding of the eye’s natural lens, and it is a normal part of aging. Nearly everyone develops one eventually; having one does not mean you need surgery.
Surgery is considered when the cataract interferes with the things you actually do — driving at night, reading, golf, recognizing faces. That is a conversation about your daily life, not only about what the exam finds. Many people are monitored for years first, with a change in glasses doing the work in the meantime.
When surgery does make sense, an optometrist’s role is co-management: the evaluation and referral beforehand, and the post-operative visits afterward while the eye settles and the final prescription is determined.
What are the risk factors for macular degeneration?
Age-related macular degeneration affects the macula, the small central part of the retina you read and recognize faces with. The main risk factors are age over 50, smoking, and a family history of the condition.
Monitoring is the core of care. Between visits, many patients use an Amsler grid — a printed square of lines you look at one eye at a time, checking whether any lines appear wavy, broken or missing. New distortion, or a blurred or blank patch in your central vision, is a reason to call promptly rather than wait for your next appointment — that is urgent eye care, not a routine booking.
There are established treatments for the less common “wet” form, delivered by a retina specialist. They are most effective when started early, which is the whole argument for regular imaging.
How does diabetes affect the eyes?
Diabetes damages the small blood vessels of the retina, and the eye is one of the first places that damage becomes visible. Anyone with type 1 or type 2 diabetes should have a retinal examination at least once a year, whether or not vision has changed.
The exam looks for the earliest visible signs — tiny bulges and bleeds in the retinal vessels, deposits leaking from them, swelling in the center of the retina, and fragile new vessels growing where they should not — and, just as much, for what has changed since the year before. One image is a snapshot; a series is information.
Retinopathy staging, the case for annual screening and what Medicare covers are set out in full on our diabetic eye exams page. Your results can be shared with the physician managing your diabetes, since eye findings often reflect overall control.
What gets referred to a surgeon?
Anything requiring surgery or intraocular injections is referred out — cataract surgery, treatment for wet macular degeneration, retinal tears and detachments, and glaucoma needing a laser or surgical procedure. Optometrists diagnose, monitor and medically manage; they do not operate.
A referral is not a handoff. Dr. Nodland stays involved in the follow-up, sees you for post-operative and interval visits, and keeps the long-term record of your eye in one place. Sole-practitioner care means the same doctor is comparing this year’s images to last year’s.
Does Medicare cover this?
Yes — medical eye care is billed to Medicare Part B or to your medical insurance, not to a vision plan. Medicare covers medically necessary eye care including cataract evaluation and post-operative care, annual diabetic eye exams, and glaucoma testing for people at higher risk. It does not cover routine refraction for glasses.
Eye Expressions accepts Medicare, VSP, EyeMed, Humana, Aetna, Anthem, Blue View Vision, MetLife, Superior Vision, Davis Vision and Advantica. Monitoring visits are scheduled ahead, so there is normally time to verify your benefits and send you an estimated copay before the day — and for a condition followed over years, that is a number you will see more than once.
Plan networks vary — being covered by a carrier does not always mean your specific plan is one we are contracted with. Call (561) 799-3932 with your card and we will check before you come in. The difference between a vision plan and medical coverage, and which one pays for what, is set out on our insurance page.
Frequently asked questions
Will I see the same doctor each time? Yes. Dr. Nodland is the only optometrist at Eye Expressions, so the person reading this year’s images is the person who took last year’s. For a condition followed over years, that continuity is the substance of the monitoring.
I have no symptoms. Do I still need to be seen? Yes, and that is exactly the point. Glaucoma, early macular degeneration and diabetic retinopathy are typically found in people who feel fine.
Can I use my vision plan for this? No. Vision plans cover routine exams and eyewear. Once there is a condition to diagnose or treat, that part of the visit is a medical claim. We will always tell you before that happens.
How often should I be seen if I have one of these conditions? It depends on the condition and how stable it is — some people are seen annually, others more often. Dr. Nodland will set the interval and explain why.
Book a medical eye exam
Call (561) 799-3932 or book online. The optical is open Saturday 9am–2pm for frames, collections and adjustments, but Dr. Nodland does not hold regular Saturday exam hours and the online scheduler does not offer Saturday, so a Saturday appointment has to be requested by phone.
Eye Expressions · 7100 Fairway Drive, Suite 39, Palm Beach Gardens, FL 33418 — on Fairway Drive just off PGA Boulevard, with parking at the door. Monday–Friday 10am–6pm · Saturday 9am–2pm (optical; exams by phone request) · Family-owned since 2010 · 5.0 stars from around 500 Google reviews