42 CFR §435.531

1. (a)Except as specified in paragraph (b) of this section, in determining blindness—
   1. (1)A physician skilled in the diseases of the eye or an optometrist, whichever the individual selects, must examine him, unless both of the applicant's eyes are missing;
   2. (2)The examiner must submit a report of examination to the Medicaid agency; and
   3. (3)A physician skilled in the diseases of the eye (for example, an ophthalmologist or an eye, ear, nose, and throat specialist) must review the report and determine on behalf of the agency—
      1. (i)Whether the individual meets the definition of blindness; and
      2. (ii)Whether and when re-examinations are necessary for periodic redeterminations of eligibility, as required under § 435.916 of this part.
2. (b)If an agency provides Medicaid to individuals receiving SSI on the basis of blindness, this section does not apply for those individuals.