How Often Should You Get an Eye Exam? Schedules by Age and Risk

Most people book an eye test only when something feels wrong: the small print is harder to read, road signs look blurry or the eyes feel tired. But some of the most important eye diseases, including glaucoma, diabetic retinopathy and early macular degeneration, cause no pain and no noticeable symptoms until damage is already done. Regular examinations are the only reliable way to catch them early, when treatment works best.

How often you need an exam depends mainly on your age, your general health, your family history and whether you already wear glasses or have an eye condition. This article summarises the schedules recommended by major organisations, explains which groups need closer follow-up, and describes what a comprehensive eye examination actually includes, so you know what to expect and what to ask for.

Why regular eye exams matter

An eye exam does two jobs. The first is checking whether you need glasses or contact lenses, or whether your current prescription is still right. The second, and often more important, is checking the health of the eye. Glaucoma, for example, slowly damages the optic nerve and narrows side vision; most people do not notice until a large part of the visual field is lost, and that loss is permanent. According to the World Health Organization, at least one billion people worldwide have a vision impairment that could have been prevented or has yet to be addressed.

Eye exams can also reveal signs of conditions elsewhere in the body, such as high blood pressure, diabetes, raised pressure around the brain and, occasionally, tumours. Our guide to eye examinations explained covers the different tests in more detail.

Eye exams for children

Children's eyes develop rapidly, and problems such as amblyopia (lazy eye) and strabismus (squint) respond best to early treatment. Children rarely complain about poor vision because they assume everyone sees the way they do.

These recommendations follow the general approach of the American Academy of Pediatrics, the American Academy of Ophthalmology and the NHS screening programme, although exact timings vary between countries. Children who fail screening, wear glasses or have a family history of eye problems need comprehensive exams and more regular follow-up. Our article on when a child should have their first eye exam explains each stage in detail.

Myopia often begins in school-age children and can progress quickly, so children with myopia usually need checks at least once a year. Encouraging outdoor play is one of the simplest protective measures.

Eye exams for adults

For healthy adults without symptoms or risk factors, professional recommendations differ slightly between organisations and countries, but the general pattern is similar. In the UK, the NHS recommends a sight test at least every two years for most people. The American Academy of Ophthalmology recommends a baseline comprehensive medical eye exam at age 40, when early signs of disease and vision changes may begin, with the follow-up interval determined by the findings, and more frequent exams from age 65.

Around the early to mid 40s, most people notice that reading up close becomes harder, a normal change called presbyopia. This is a good time for a thorough exam, both to sort out reading glasses and to establish a baseline for future comparisons. Our article on your eyes after 40 explains other changes to expect.

Who needs eye exams more often?

Certain groups have a higher risk of eye disease and need closer monitoring. Your eye care professional will set the exact interval.

People with diabetes

Diabetes can damage the blood vessels of the retina, causing diabetic retinopathy, a leading cause of vision loss in working-age adults. Early stages cause no symptoms. Guidelines from the American Diabetes Association and national screening programmes generally recommend retinal examinations at least once a year for most people with diabetes. People with type 1 diabetes are typically advised to start within a few years of diagnosis, and people with type 2 diabetes at the time of diagnosis, because the disease may have been present for some time. Pregnant women with pre-existing diabetes need more frequent checks.

Family history of glaucoma

Having a parent or sibling with glaucoma significantly increases your risk. Other risk factors include older age, African or Caribbean ancestry (especially for open-angle glaucoma), East Asian ancestry (for angle-closure glaucoma), high eye pressure, thin corneas and high myopia. People with a family history should tell their optometrist and are often advised to have regular checks from around age 40, or earlier. In the UK, close relatives of people with glaucoma over 40 may be eligible for free NHS eye tests. Read more about family history and eye disease risk.

High myopia

High myopia, usually defined as minus 6 dioptres or more, stretches the eyeball. This increases the risk of retinal tears and detachment, myopic macular degeneration, glaucoma and cataract. People with high myopia should have regular dilated examinations of the retina and should know the warning signs of retinal detachment.

Other risk groups

• People with high blood pressure, high cholesterol or a history of stroke
• Those taking medications that can affect the eyes, such as long-term corticosteroids or hydroxychloroquine, which require specific screening
• People with a family history of macular degeneration
• People with previous eye injury or surgery
• Those with autoimmune diseases associated with eye inflammation
• People who smoke
• Anyone whose work involves high visual demands or eye hazards

What a comprehensive eye exam includes

A basic vision screening, such as reading a chart at a driving licence office, only checks how well you see. A comprehensive eye exam by an optometrist or ophthalmologist is much more thorough. It typically includes:

1. History: symptoms, general health, medications, family history and visual needs at work and home.
2. Visual acuity: reading letters at distance and near, with and without glasses.
3. Refraction: determining the lens power that gives the clearest vision; this produces your glasses prescription. Our guide on how to read your glasses prescription explains the numbers.
4. Eye movements and alignment: checking that the eyes work together.
5. Pupil reactions: testing how the pupils respond to light, which can reveal optic nerve problems.
6. Eye pressure (tonometry): measuring intraocular pressure, a key risk factor for glaucoma.
7. Slit lamp examination: using a microscope to examine the eyelids, cornea, iris and lens.
8. Dilated retinal examination: drops widen the pupils so the retina, macula and optic nerve can be examined fully. Retinal photographs or optical coherence tomography (OCT) scans may also be used.
9. Visual field testing: checking side vision when glaucoma or neurological problems are suspected.
10. Additional tests as needed, such as colour vision, contrast sensitivity or binocular vision assessment.

If your pupils are dilated, your vision may be blurry and sensitive to light for several hours. Bring sunglasses and avoid driving until the effect has worn off.

Online tests are not a substitute

Online vision checks and apps can be useful for spotting changes between visits, but they cannot measure eye pressure, examine the retina or optic nerve, or detect most eye diseases. Treat them as a prompt, not a replacement.

When to see a doctor

Do not wait for a scheduled check if you notice changes. Book an appointment for gradually worsening vision, more difficulty reading, increasing glare at night, or eye discomfort that does not settle.

Regular eye examinations are a small investment of time that can protect your sight for life. If you are not sure when you had your last one, it is probably time to book.