Comprehensive eye exams are essential to maintaining good eye health. Some people think that eye exams aren’t necessary if their eyesight seems fine or their glasses are working well. However, like getting a physical exam with your primary care doctor or a cleaning at your dental office, eye exams should be a part of your routine health checkups.
What to expect during an eye exam
An eye exam determines if you have refractive errors (eye-focusing issues that cause blurry vision) that need correction with glasses or contact lenses. Beyond vision, an eye doctor also diagnoses eye diseases. The eyes also point toward other health concerns and can indicate how well your diabetes or blood pressure are controlled.
Optometrists and ophthalmologists are licensed eye doctors who provide comprehensive eye exams. They can diagnose and treat various eye issues, although ophthalmologists perform more advanced procedures such as cataract surgery.
During an eye doctor’s exam, you can expect a series of tests in the following areas:
- Visual acuity: measures how small of a letter size you can read on an eye chart at a set distance
- Ocular motility: checks your eye muscle function
- Cover test: checks your eyes for proper alignment and turning abilities
- Pupillary reflex: measures your pupil’s response to light and accommodation, which includes focusing at close distances
- Refraction: determines refractive error, including myopia (nearsightedness), hyperopia (farsightedness), astigmatism (an irregularly shaped eye), and presbyopia (age-related farsightedness)
- Tonometry: measures the fluid pressure inside your eye
- Slit-lamp exam: examines the structures of the eye under high magnification
- Dilated fundus exam: involves putting drops in your eye to widen your pupils temporarily while the doctor uses magnifying lenses to check the tissue in the back of your eye
Eye exams in children
Babies should receive routine vision screenings with their pediatrician to detect issues such as strabismus (eye turn), amblyopia (lazy eye), and retinoblastoma (an aggressive eye tumor that can be life-threatening). If they find a problem, the pediatrician can refer the child to an eye doctor for a more detailed evaluation.
The American Optometric Association recommends the following screenings:
- Children in the newborn to 2 year-old category should be screened by six months or sooner if the pediatrician or parent notices an issue
- Children between 3 and 5 years old should be examined at least once
- Children between 6 and 17 years old should be examined before first grade and get an exam every 1 to 2 years as recommended by their eye doctor
Risk factors for eye health and vision conditions in babies include:
- Premature birth, low birth weight, or the use of supplemental oxygen
- A family history of eye disease, amblyopia, or high eyeglass prescriptions
- Developmental delays
- Down syndrome or other genetic disorders
- Maternal use of alcohol, cigarettes, or drugs during pregnancy
- Maternal history of infection, including herpes, toxoplasmosis, venereal disease, or human immunodeficiency virus (HIV) during pregnancy
Signs that indicate potential eye problems in kids are:
- Eye turn or crossed eyes
- Frequent blinking
- Eye rubbing
- Closing or covering one eye when reading or looking at objects
- Head tilting
- Avoidance of reading or homework
- Sitting closely to the television or holding screens very close to their face
Eye exams in adults
Adults between the ages of 18 and 64 should have an eye exam at least every two years. Adults over the age of 65 should have annual exams.
If you have existing eye conditions or are at higher risk, your eye doctor may recommend more frequent checkups. These risk factors include:
- A family history of eye diseases like glaucoma and macular degeneration
- Systemic diseases such as diabetes, high cholesterol, or high blood pressure
- Medications that affect the eyes, such as steroids, topiramate, isotretinoin, or hydroxychloroquine
- High refractive error or frequent changes in eyeglass prescription
- Previous eye surgery or injury
- Wearing contact lenses
- Having a visually-demanding job, such as an office worker
- Being exposed to occupational hazards, such as working at construction sites or using toxic chemicals on-the-job
Eye exams involve more than just a checkup for new glasses. They are necessary for preventing and early detection of many eye diseases, some of which cause irreversible vision loss. Your eyes are also an excellent indicator of your overall health. Take care of them by visiting your eye doctor for regular comprehensive exams.
Eye exams should be scheduled routinely, just like your physical or dental exams.
Pediatric eye screenings are necessary to prevent long-term and potentially life-threatening issues such as eye tumors.
Birth history, developmental delays, genetic conditions, and family history can influence a child’s eye health.
Adults should have an eye exam every 1 to 2 years.
Individuals with certain health conditions, medication history, and occupational hazards may require more frequent monitoring.
Many eye issues (like glaucoma) do not show signs until the advanced stages, so an exam is the only way to know if you have a problem.
American Academy of Ophthalmology. Pediatric Eye Evaluations Preferred Practice Pattern.
American Optometric Association. Comprehensive Eye Exams.