Adults under 40 with healthy eyes need an eye disease screening every 5 to 10 years. Plan on a baseline exam around 40, then a dilated exam every 1 to 2 years once you're over 60. Diabetes, high blood pressure, contact lenses, or a family history of glaucoma move you to every year or two at any age.
Those numbers come from two places. The American Academy of Ophthalmology recommends screening every 5 to 10 years before 40 even if your vision seems fine, because that baseline helps catch diseases that start showing up after 40. The National Eye Institute recommends a dilated eye exam every 1 to 2 years if you're over 60, African American and over 40, or have a family history of glaucoma, and at least once a year for most people with diabetes or high blood pressure.
Eye exam schedule at a glance#
| Who |
How often |
| Under 40, no symptoms or risk factors |
Every 5 to 10 years |
| Around 40 |
A baseline eye disease screening if you haven't had one recently |
| Over 60 |
Dilated exam every 1 to 2 years |
| African American and over 40 |
Dilated exam every 1 to 2 years |
| Family history of glaucoma |
Dilated exam every 1 to 2 years |
| Diabetes or high blood pressure |
Dilated exam at least once a year |
| Contact lens wearers |
Every year, or as your eye doctor recommends |
| Known eye disease, past eye surgery, or a medicine that affects the eyes |
Whatever your ophthalmologist sets |
If you need glasses and your vision changes between exams, you don't have to wait. Blurry road signs, squinting at your phone, or headaches after reading are reasons to book sooner.
Is a vision test the same as an eye exam?#
No, and the difference matters. A vision test (the letter chart, plus the "which is clearer, one or two?" part) tells you how sharp your sight is and what prescription you need. You can see 20/20 and still have early glaucoma or diabetic damage to the retina, because those diseases usually cause no symptoms until vision is already lost.
A full dilated exam adds the parts that look for disease. Drops widen your pupils so the doctor can see the retina and optic nerve at the back of the eye. They'll usually also measure eye pressure and check your side vision. Pressure alone isn't a reliable glaucoma test: the NEI notes in its statement on glaucoma detection that many people with glaucoma would pass a pressure check, which is why it recommends the full dilated exam for anyone at higher risk.
A quick screening at a school, a driver's license office, or a glasses shop is a vision test. It doesn't replace a dilated exam.
Optometrist or ophthalmologist?#
An optometrist does vision tests, prescribes glasses and contacts, and can do a full dilated exam and manage many common eye conditions. An ophthalmologist is a medical doctor who treats eye disease and does surgery. For routine exams, either is fine. If you have diabetes with eye changes, glaucoma, or another diagnosed eye condition, you'll usually be followed by an ophthalmologist. An optician fits and sells glasses but doesn't examine your eyes.
How often should you get an eye exam with diabetes?#
At least once a year, dilated. The NEI says people with diabetes should get a comprehensive dilated eye exam at least once a year, and that people who already have diabetic retinopathy may need exams as often as every 2 to 4 months. Retinopathy usually has no symptoms early on, so the exam is how it gets caught while treatment works best.
High blood pressure gets the same yearly recommendation from the NEI. Good home readings don't rule out damage in the eye. If you track your numbers, our guide to checking blood pressure at home covers how to get readings your doctors can trust.
Contact lens wearers need yearly checkups#
A comfortable lens doesn't prove your cornea is healthy. The CDC's contact lens guidance recommends seeing your eye care provider every year, or as recommended, along with a few habits that lower the risk of serious infections:
- don't sleep in lenses unless your eye doctor has prescribed them for overnight wear
- keep lenses away from all water, including the shower, pool, and tap water for rinsing
- replace your lens case at least every three months
If your eye turns red, hurts, waters heavily, becomes sensitive to light, or your vision blurs while you're wearing contacts, take the lenses out, switch to glasses, and call your eye doctor. Don't use leftover antibiotic or steroid drops from a previous infection. The wrong drop can make some infections worse.
Can you drive after a dilated eye exam?#
Dilation blurs your vision and makes you sensitive to light for a few hours. The NEI suggests bringing sunglasses and having someone drive you home. If it's your first time being dilated, plan on not driving until you know how your eyes react.
Bring your current glasses, your contact lens box or prescription, and a list of medicines. Some drugs, like long-term steroids and hydroxychloroquine, need regular eye monitoring, so the eye doctor needs to know what you take.
Symptoms that need same-day care#
Some eye problems can't wait for your next scheduled exam. The NEI calls retinal detachment a medical emergency. Contact an eye doctor or go to the emergency room right away if you notice:
- a sudden shower of new floaters
- flashes of light in one or both eyes
- a dark shadow or curtain over part of your vision
- sudden vision loss or distortion in one eye
- severe eye pain, or an eye injury
If a chemical splashes into your eye, start rinsing with clean, lukewarm water immediately and keep going while someone calls for help.
Slower changes still deserve a prompt appointment: double vision, new trouble driving at night, or a child whose eye starts to turn in or out.
Keeping track of the next exam#
Before you leave each appointment, ask when your next exam is due and whether it needs dilation. Long gaps like "five years" are the easiest to lose track of, so put it in a recurring reminder in ChoreLists.com or your calendar alongside your other preventive health checkups.