Eye Exams Are Now Recommended Every Year—But Do You Really Need One?

The American Optometric Association (AOA) now recommends that adults between the ages of 18 to 64 get an in-person eye and vision exam every year regardless of their eye health. Previously, the AOA recommended eye exams at least every two years for adults.

But do you really need to have your eyes checked every year if you have no trouble with your vision? Here’s what experts say.

Why You Need Eye Exams

Ronald Benner, OD, president of the AOA and an optometrist, told Verywell that the recommendation was changed to make sure people have a chance to be evaluated for eye changes, improve their sight, and prevent vision problems through early detection of eye disease.

Benner added that eye exams can also reveal more information about your health beyond your sight. For example, an optometrist can closely look inside your eye, including the retina, blood vessels, and optic nerves—structures that are direct extensions of your brain.

“Eye exams safeguard overall health by enabling the doctor of optometry to detect more than 270 serious health conditions, including diabetes, high blood pressure, autoimmune diseases, and cancers,” Benner said.

Rosalyn Perez, OD, FAAO, an optometrist at Manhattan Eye, Ear, and Throat Hospital, told Verywell that regular eye exams can catch more subtle signs of eye disease, as well as other systemic health conditions if a person has no symptoms.

Why You May Not Need a Yearly Eye Exam

While most experts agree that eye exams are important, people who don’t have any symptoms or a family history of eye disease may not need one yearly—despite the updated recommendations.

Howard Krauss, MD, a surgical neuro-ophthalmologist and the director of Pacific Neuroscience Institute’s Eye, Ear & Skull Base Center at Providence Saint John’s Health Center, told Verywell that if a person does not have symptoms, a family history of eye disease, or signs of eye problems, annual examinations are probably more frequent than necessary.

While the AOA’s updated guideline report was evidence-based, Krauss said that the recommendation of annual exams for people 18 to 64 was determined as a “consensus statement.”

Krauss explained that anything that is marked as a consensus statement in the AOA’s report is to be viewed as an opinion rather than a matter of fact.

“Despite the fact that they have close to 200 references in their document, they don’t find evidence to support the position of requiring annual examinations for those under the age of 65,” said Krauss. “The only threshold where they reach evidence that annual examinations are appropriate are for persons 65 years of age or older. To say healthy, young and middle-aged adults should have annual exams, is their opinion. It’s not supported by evidence.”

Daniel Laroche, MD, a glaucoma specialist and a clinical assistant professor of ophthalmology at the Icahn School of Medicine, does not agree that all adults need an eye exam every year—particularly because annual eye exams could strain the healthcare system and may have added costs—though more research is needed to fully understand those effects.

"In my opinion, in people ages 18 to 39, there is a low risk of eye disease,” Laroche told Verywell. “We have to spend more time educating, insuring, and reaching out to those who are over 40 in whom ocular disease is much more prevalent.”

How to Tell If You Need Yearly Eye Exams

Krauss said that certain risk factors make your chances of developing eye and vision problems more likely, and you may need to have more frequent eye exams than other people.

You may need yearly (or more frequent) eye checks if you:

• Have a personal or family history of eye diseases
• Belong to certain racial or ethnic groups
• Have a full-body (systemic) health condition that could affect the eyes (e.g., diabetes, high blood pressure, obesity, or arteriosclerosis)
• Work a job that is visually demanding or hazardous to your eyes
• Take prescription or nonprescription medications with side effects that involve your eyes or vision
• Only have functional vision in one eye
• Wear glasses/contact lenses
• Have had eye surgery or an eye injury
• Have high or progressive refractive error
• Have other progressive eye-related health concerns or conditions

Krauss and Laroche said that even though the AOA guidelines recommend adults get an eye exam every year, how often you really need to have one will depend on your symptoms, risk factors, and overall health.

“There is no hard and fast rule in terms of how frequently people should have eye exams, however, symptoms and risk factors should never be ignored,” said Krauss. “This is not to suggest that people don’t need to be attentive to their health. It’s a matter of exercising caution in your daily life.” 

If you miss out on an annual eye exam, Perez recommends scheduling an appointment as soon as you remember—especially if you fall into an at-risk category.

If Not Everyone Needs a Yearly Eye Exam, Why Did the Recommendation Change?

In a press release, the AOA said that in 2015, data showed that 1.02 million people in the United States were considered legally blind and nearly 8.2 million people had reduced vision caused by uncorrected refractive errors (e.g., you don’t have 20/20 vision and likely need glasses/contacts).

By 2050, the AOA estimates that the number of people with these conditions will double to about 2.01 million people with legal blindness, 6.95 million with visual impairment, and 16.4 million with reduced vision because of uncorrected refractive errors.

Benner said that since more people in the U.S. are projected to have visual impairments and other eye conditions, getting your eyes checked every year can help providers detect, treat, and possibly prevent eye diseases early.

“This recommendation allows the doctor of optometry to evaluate risk factors present and assess eye changes to identify sight-threatening eye and systemic health conditions which can be treated with early detection and intervention,” said Benner, adding that taking a proactive approach can help lead to earlier diagnosis of vision problems, prevent vision loss, and improve health-related quality of life.