How often should I have an eye exam?

Getting the best value for your money when it comes to eyeglasses, sunglasses, eye exams, and contact lenses.

Postby george » Sun Nov 21, 2010 12:19 am

<Updated November 11, 2012 to fix broken links>

In a thread about Lenscrafters limiting the amount of contacts you can receive at a time, someone suggested that Lenscrafters was doing this to try to make sure people pay for an eye exam each year. While that person's insurance only covers an exam every other year, my insurance pays for an exam each year. I figured this is a pretty basic question and I should be able to get a clear answer. After doing a bit of research, I realized what should be a simple question does not have the most simple answer.

The source that I believe should be the most reliable would be the American Academy of Ophthalmology. Unfortunately, I found much of the information unclear - such as what constitutes a screening and what is a complete eye exam. I thought I understood a screening was an exam by a physician who is not an eye doctor, and a complete eye exam was done by either an ophthalmologist or optomestrist. I'm not sure though. From their website, I've obtained the following information:

For individuals at any age at risk for eye disease (family history, hypertension, diabetes) or with symptoms of eye problems, see an ophthalmologist to determine how frequently your eyes should be examined. The rest of the recommendations are for people who have no known eye problems or risks.

Before Age 3: children should be screened for eye problems during their regular pediatrician's exams (most other sites suggest an exam at 6 months and at 3 years but I couldn't find anything that specific on the American Academy of Ophthalmology website), and then have vision testing done starting around 3 years old. Children should be seen even younger if they have a family history of vision problems or if they show any of the following: crossed eyed, lazy eye, or drooping of the upper eyelid.

From Ages 3 to 19: screening every one to two years during their regular doctor's appointment.

From ages 20 to 39: complete eye exam at least once between the ages of 20 and 29 and at least twice between ages 30 and 39. Have an eye exam if you develop vision changes or pain, flashes of light, seeing spots or ghost-like images, lines appear distorted or wavy, or you experience dry eyes with itching or burning,

From ages 40 to 64: if there is no evidence of eye disease, get a screening exam to obtain a baseline at age 40 (unfortunately, I think they should say a complete eye exam - as it seems they are suggesting a more complete evaluation should be done at this age) which is the age when early signs of disease and changes in vision may start to occur. The eye doctor will then make recommendations on how frequently you should have your eyes examined, based on the findings of the screening exam.

From Age 65 and Over: have an eye exam every one to two years to check for diabetic retinopathy, age-related macular degeneration, glaucoma, cataracts, and other eye conditions.

You will need to see your eye doctor more frequently than recommended above if you have a family history of eye problems, are African American over age 40, have diabetes, or have a history of eye injury. If you have any of these issues, they recommend you see your eye doctor to find out how often you should be examined.

Additionally, these recommendations do not replace regular visits to the eye doctor for treatment of injuries and ongoing disease. These recommendations also do not replace vision examinations for eye glasses or contact lenses.

A much clearer recommendation (although not necessarily better or worse) can be found in this document from the American Optometric Association:

18 to 40, every two years if asymptomatic/risk free, every one to two years or as recommended if at risk
41 to 60 , every two years if asymptomatic/risk free, every one to two years or as recommended if at risk
61 and older, annually if asymptomatic/risk free, and annually or as recommended if at risk

Patients at risk include those with diabetes, hypertension, a family history of ocular disease, or whose clinical findings increase their potential risk; those working in occupations that are highly demanding visually or are eye hazardous; those taking prescription or nonprescription drugs with ocular side effects; those wearing contact lenses; those who have had eye surgery; and those with other health concerns or conditions.

As with the ophthalmology website, they leave some discretion to clinical judgment for those at risk.

Another clear source (although also not necessarily better or worse) would be the Prevent Blindness America website, which is a volunteer organization that has been around over 100 years, advocating for ways to reduce the risk of blindness, they recommend:

For Caucasians: ages 20-39 should have an eye exam every 3-5 years; 40-64 should have eye exams every 2-4 years, and over age 65 should have an eye exam every 1-2 years.

For African Americans: ages 20-64 should have an eye exam every 2-4 years, and ages 65 and older should have an eye excam every 1-2 years.

They do state that higher risk populations such as those with diabetes, history of eye trauma, history of eye surgery, or a family history of glaucoma may need to have their eyes examined more frequently. They also caution that people who are having eye problems should see a doctor right away.

The initial question of how often to have an eye exam was really based on the notion of how often to get eyes examined for a vision examination for eye glasses or contact lenses - not necessarily how often to get eyes checked for diseases. The real question is - if you wear glasses or contacts, how often should you have an eye exam?

To try to answer that question I searched a lot harder as reliable information was not easy to find.

Interestingly, I could not find anything on the ophthalmology web sites recommending how often to have eyes examined if you wear contacts or glasses. It could just be that I couldn't find the information, or they don't have a blanket recommendation.

As to the issue with contact lenses, the first clue to an answer I found was from the University of Georgia's Health Center Vision Clinic web site, they clearly explain the reason for needing annual eye exams for contact lens wearers.

The state of Georgia requires that every contact lens wearer have a yearly eye examination in order to purchase additional contacts because many problems that occur from contact lens wear cannot be detected by the wearer until the condition has reached a level of urgency that could result in loss of sight or discontinuation of contact lens wear. We monitor contact lens wear yearly to prevent problems that may arise and may recommend newer and more advanced lens technology for our patients.

The American Optometric Association has a document on the care of the contact lens patient (link is to quick reference form) which has recommendations on the frequency of exams. Specifically, during initial weeks and months to allow any necessary mechanical or optical refinements in lens prescription(s); to monitor adaptation and minimize ocular complications, and to reinforce appropriate CL care
- Every 6-12 months for healthy patients wearing cosmetic CLs
- Every 3-4 months (or more frequently) for patients who may be at risk for ocular compromise during CL wear
- Whenever the patient experiences an unexpected problem in vision or ocular condition
- Emergency services should be available 24 hours a day, every day of the year

So they recommend every 6-12 months for the average contact lens wearer without complications. Most other sites I found recommend evaluations every year, and given the potential complications of wearing contact lenses, it makes sense to have your eyes checked every year.

As to how often to have your eyes examined if you wear glasses, that has been really tough to find. It shouldn't be that tough, but the main thing I found is how often you need new glasses. The sites that answer that question give the logical answer to have your glasses replaced when your prescription changes. Obviously you would get an eye exam if you think your vision isn't clear. Amazingly, this is one area I couldn't find a reliable consensus of how often to get an eye exam if you wear glasses. Several sites state every year or every two years based on what your eye doctor recommends, but I couldn't find any reference for those suggestions.

So - if you have a reliable reference (there were a few websites with articles by eye doctors which said one to two years - but I couldn't find an authoritative reference such as the American Optometric Associations published recommendation) please let me know. I'm sure it's out there and I just couldn't find it.

Disclaimer: This post is for informational purposes only and should not be viewed as providing medical advice. If you have a health concern, consult a health care professional. Do not rely on the information you've read here.
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