About half of vision loss and blindness can be prevented through early diagnosis and timely treatment, according to the National Eye Institute. And the most effective way to detect problems early is with a full eye exam. Recently, the American Optometric Association updated their guidance for how often adults should get eye exams.
The new guidance recommends annual eye exams for all adults 18 and older. Previously, annual recommendations were reserved for adults ages 18 to 64 who were at risk for eye or vision problems and for all adults 65 and older. Adults ages 18 to 64 who were not deemed at risk were previously recommended an eye exam every two years.
According to the AOA, the increase in frequency can help prevent younger adults from developing eye diseases later in life.
In a statement announcing the new guidelines, Dr. Ronald Benner, president of the AOA, said that “comprehensive eye exams provide the opportunity for early detection of eye health and visual performance problems, as well as the prevention of vision loss.” He added that eye and vision disorders are “linked to decreased quality of life,” physical and mental challenges, which have broad implications “for the entire health care system.”
The Importance of Regular Eye Exams
The new decision isn’t favorable among all eye doctors, however, some of whom cite financial burdens or the need to conserve resources for those who are older and more at risk for disease. In the AOA guidelines, the organization cites potential risks associated with more frequent eye examinations, including patient anxiety about testing procedures or unnecessary referrals, yet maintains that the “benefits significantly outweigh the risks.”
Additionally, research shows that frequent eye exams can help prevent aggressive diseases from developing or connect people to care before symptoms become too hard to treat.
For example, in a 2016 study on routine eye exams’ impact on asymptomatic people, researchers found that 58% of participants had eye changes requiring interventions, including new management, prescription changes or newly detected critical diseases. The researchers concluded that “comprehensive routine optometric eye examinations detect a significant number of new eye conditions” in asymptomatic patients and can also result in changes to treatment or care.
When in “over half the people you find something you need to do something” — whether that’s changing their eyeglass prescription, prescribing new glasses or referring them to treatment for an eye disease — an extra eye exam is worth the cost, says Dr. Beth Irving, a professor in the School of Optometry and Vision Science at the University of Waterloo in Canada and lead researcher on the study.
“The thing about most diseases, eye diseases as well, is that the longer you leave them, the harder they are to treat and the likelihood of good outcomes decreases,” Irving explains. “If you don’t have regular exams, you miss that stuff.”
Dr. Donny W. Suh, an ophthalmologist with the UCI Health Gavin Herbert Eye Institute in Irvine, California, agrees. He notes that people tend to think that eye exams are only necessary if a person is older or experiencing vision problems, but that that is a “common misconception.” He adds that eye exams are not solely about correcting vision but also about assessing overall eye health and detecting potential silent diseases. Eye exams are important for people of all ages, as certain eye conditions can change and develop early in life and progress over time.
Looking into the eye can also help detect other diseases beyond those related to eye health or vision, he adds. “The eye is a window to our overall health.”
[READ: Foods That Are Good for Your Eyes.]
Common Eye Problems
Under the new guidelines by the AOA, all adults ages 18 and older should get annual comprehensive eye exams.
Whether your eye exam serves to help you see more clearly or to monitor your risk for eye diseases, getting your eyes checked regularly by an optometrist or ophthalmologist (eye doctor) is an important health screening.
The primary causes of vision impairment and blindness in the United States are age-related diseases of the eyes and refractive errors. Age-related diseases of the eyes are conditions that can impact anyone but are more common as people age. Refractive errors occur when the shape or curve of the eye impacts vision. These can start in childhood or develop over time, with people who have a family history of refractive errors at higher risk.
The four most common types of refractive errors:
— Nearsightedness, or myopia, which impacts a person’s ability to see objects that are far away
— Farsightedness, or hyperopia, which impacts a person’s see items that are close and is the most common type of refractive error
— Astigmatism, which occurs if a person has an irregular curve in the eye’s cornea and distorts vision
— Presbyopia, which impacts a person’s ability to read at about an arm’s length away and can occur with age almost universally
Common age-related vision diseases include:
— Cataracts. Cataracts can occur when proteins in the eye’s lens break down, according to the American Academy of Ophthalmology. This can cause your eyes to look cloudy and/or cloud vision. As cataracts progress, people can be at risk for visual problems or blindness. Cataracts are the leading cause of blindness worldwide, the Centers for Disease and Prevention notes.
— Dry eye. A condition in which the eyes either do not produce enough tears or there is an issue with the quality of the tear production. Artificial tears and ophthalmic lubricants can help alleviate symptoms.
— Glaucoma. Glaucoma results from a damaged optic nerve, according to the AAO. It can cause local and systemic pain, redness and impaired vision, among other symptoms. Left untreated, glaucoma can also lead to blindness.
— Age-related macular degeneration. AMD is a progressive eye disease that blurs a person’s central vision.
— Diabetic retinopathy. Diabetic retinopathy impacts the small blood vessels in the eye and is “the most common microvascular complication of diabetes” for adults of any age, according to the AOA. A microvascular complication refers to something that is impacting the small blood vessels. It also can cause vision loss or blindness.
Irving says that early detection and intervention for these diseases can be crucial, as “treatment gets more intense and less effective” the longer the disease progresses.
The good news is that a routine eye exam that includes eye dilation can detect the early signs of these eye conditions.
[SEE: Do You Need Eyeglasses? Watch for these Common Signs.]
What Types of Eye Issues Can Younger Adults Get?
While older adults are most at risk for age-related eye disease, younger adults can also experience eye problems. For some, these can impact their day-to-day functioning or increase the risks of future problems.
According to the AOA, most eye problems experienced by adults younger than 40 are due to refractive errors, which occur when the length or curve of the eye is abnormal and impacts vision, and eye injury, when the eye gets bruised or scratched. The organization adds that the “visual demands of the workplace,” like long hours of computer work and screen time, increase the need for vision assessment and protection in younger adults.
Digital eye strain in particular can impact health by causing discomfort, fatigue, itchy eyes or dry eye.
[Do Blue Light Glasses Work? Here’s What Experts Say]
What to Expect in an Eye Exam
The eye is the only part of the human body where blood vessels and tissues can be viewed directly in its natural state. Nevertheless, eye exams tend not to be too physically intense, and most follow a pretty standard process.
Here are some steps of the exam to expect:
Patient and family history
Most doctors will start by asking you about your personal and family history, which can include questions about vision, eye health, general health and medication usage.
Measurement of visual acuity
Remember the letter chart? That’s how doctors measure visual acuity.
Determination of refractive status
Your doctor may assess your refraction status by shining a specialized light in your eye. With this technology, the doctor can see how the light is entering your eye and to what extent it is in focus. If the light is not focused correctly, you may need prescription glasses or contact lenses.
Ocular health examination
For this, the doctor may dilate your eyes to do a more thorough assessment of your eye health. This involves using eye drops that cause your pupils to widen, allowing in more light and giving your doctor a better view of the back of your eye. You should expect to experience blurry vision and sensitivity to light for a few hours after the dilation. Not all eye exams include a dilation, but it is part of a comprehensive assessment.
Further health assessments or diagnosis as needed
To prepare for an eye exam, Suh recommends that people who wear contacts or glasses bring those with them to the appointment. If you are getting your eyes dilated and your appointment is within driving distance, he says to ask a friend or family member to drive you home. And, he adds, “don’t forget to schedule your next eye exam.”
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Update 06/13/24: This story was previously published at an earlier date and has been updated with new information.
