How Often Do You Really Need an Eye Exam?

If you don’t wear glasses or contacts (you lucky duck, you!), you might feel like you don’t need to have your eyes checked very often. After all, you can see just fine. Why bother?

But even for people with 20/20 vision, regular eye exams are a must. Your eyes are an important part of your body, an eye exam can reveal a lot — not just about your eye health but about your overall health.

“Eye health isn’t separate from the rest of your body’s health,” says ophthalmologist and retina specialist Aleksandra Rachitskaya, MD. She explains how often you should have an eye exam, when to get a baseline eye disease screening and what your eye health can reveal about your overall health.

How often should you get an eye exam?

Think you don’t need to see an eye doctor? Think again. The American Academy of Ophthalmology now recommends that adults ages 19 to 64 have an eye exam once a year, even for people who aren’t experiencing any vision problems.

If you’re under 40, have 20/20 vision and don’t have any risk factors for eye disease, your eye doctor may say you don’t need to come in annually. Follow their guidance on how often to return. But once you turn 40, you’ll also need a baseline eye disease screening, as this is when early signs of disease and changes in vision often begin.

And if you do have risk factors for eye disease? In that case, you should have a baseline eye disease screening done earlier. Some risk factors for eye disease include:

• Wearing glasses or contact lenses
• Having a health condition that can affect your eyes, like diabetes or hypertension
• Past eye surgery or eye injury
• A known family history of eye disease

“If you have risk factors for eye disease, you should see an eye doctor regularly for general check-ups,” Dr. Rachitskaya reiterates.

Why eye exams are so important

Routine eye exams can help catch issues with your eye health before they start to affect your vision. Dr. Rachitskaya outlines a few common eye conditions that can be caught early via exam.

• Age-related macular degeneration (AMD). This eye disease, which affects your central vision, is the top cause of vision loss in people 65 and older. But early diagnosis and treatment can prevent further vision loss.
• Cataracts. When the proteins in the lens of your eyes start to break down, cloudy areas can form and affect your vision.
• Diabetes-related retinopathy. This condition damages blood vessels in the eye, which an ophthalmologist can detect before it affects your vision. “We can see areas of bleeding and swelling in the retina, or abnormal blood vessels developing,” Dr. Rachitskaya shares. “These are hallmarks of diabetes-related eye damage.”
• Floaters. As you age, the jelly-like fluid in your eyes changes consistency, which can cause you to see squiggly lines, threads or spots. “Floaters aren’t always dangerous,” Dr. Rachitskaya clarifies, “but in some circumstances, they can be a sign of something serious going on in the eye.”
• Glaucoma. This is an umbrella term for a category of eye diseases that happen when there’s damage to your optic nerve, usually from pressure building up inside your eye. Glaucoma can cause permanent vision loss, but early diagnosis and treatment can help preserve your sight.

“A lot of times, we can see things in the eye before they manifest into visual symptoms,” Dr. Rachiskaya says. “It’s always best to catch that at an early stage.”

The connection between eye health and other health conditions

Regular eye exams don’t just protect your eyes. They can also help safeguard your overall health.

“If you have a chronic condition like high blood pressure, high cholesterol or diabetes, it’s important to try to manage it,” Dr. Rachitskaya urges, “because we can see manifestations of all of those diseases in the eye.”

Sometimes, your eye health is the first sign that something is off elsewhere in your body. Eye exams can reveal certain health conditions before you even know you have them.

“Routine eye exams can detect a variety of health problems,” she continues. “They’re important not only for eye health but also to determine if there are other issues that need attention.”

Let’s take a look at a few of the conditions that can affect your eyes, along with how early detection can help preserve your vision and protect your overall health.

Diabetes

Unmanaged diabetes can wreak havoc on your eye health. You can have advanced diabetes-related retinopathy and not even know it, especially in the early stages of the disease.

Diabetes can cause abnormal blood vessels to grow inside your eye and start to bleed. Oftentimes, Dr. Rachitskaya says that when people with diabetes come in for an eye exam, they’re found to have bleeding or swelling in the eye that requires treatments like injections, laser treatments and even surgery to help preserve their vision.

Regular exams can keep you from getting to this advanced stage.

“When you have diabetes, it’s essential to be regularly checked by an eye doctor, even if you have no symptoms,” Dr. Rachitskaya advises. “When we look inside the eye, we’re able to see diabetes-related eye disease before you start to develop symptoms.”

Hypertension

High blood pressure can affect the blood flow within your eyes, which can damage your vision. This type of damage can actually be the first clue that you have high blood pressure (hypertension).

“A lot of the small vascular changes that occur from high blood pressure don’t affect your vision until very late in the disease, when you start to develop vision problems,” Dr. Rachitskaya notes. “So, regular screening is key.”

Inflammatory conditions

Chronic inflammatory diseases can also cause inflammation in the eyes. This includes conditions like:

• Crohn’s disease
• Inflammatory bowel disease (IBD)
• Lupus
• Multiple sclerosis
• Ulcerative colitis

Inflammatory diseases can lead to uveitis, inflammation of the middle part of your eye (called the uvea). If it’s not treated, uveitis can cause permanent eye damage.

When to make an appointment with an eye doctor

The bottom line: Eye exams are important for everyone, even people with great vision. And if you have risk factors for eye disease, it’s especially important to be sure you keep up with your appointments.

In any case, if something about your vision starts to change, it’s definitely time to schedule an appointment to see an optometrist or ophthalmologist.

“When something changes, people sometimes think, ‘Well I'm just going to wait it out. Things will probably get better,’” Dr. Rachitskaya acknowledges.

“But any change in your vision should be evaluated because if there is some kind of problem, the sooner we catch it and treat it, the better your visual outcomes.”