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There is no single schedule for every adult. The interval depends on age, symptoms, eye history, general health and other risk factors. Guidance from the American Optometric Association (AOA) is not fully consistent: its public age-based table advises exams at least every two years for low-risk adults under 65, while its revised guideline announcement in 2023 recommends annual exams for adults ages 18–64. Ask an eye-care professional which interval fits your circumstances, and seek care sooner if a new eye, vision or relevant health problem develops.
What interval should adults follow?
The recommendations below distinguish a comprehensive eye exam from a dilated exam and from follow-up care for an already diagnosed condition. They are guidance, not a substitute for the schedule your clinician sets after reviewing your history and exam findings.
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| Group | AOA public age-based guidance | Other relevant guidance |
|---|---|---|
| Low-risk adults ages 18–39 | At least every two years. | The AOA’s revised adult guideline announcement recommends annual comprehensive exams for adults ages 18–64. |
| Low-risk adults ages 40–64 | At least every two years. | The AOA’s revised adult guideline announcement recommends annual comprehensive exams for adults ages 18–64. The American Academy of Ophthalmology (AAO) advises a complete exam around age 40, when early signs of eye disease often begin. |
| Low-risk adults ages 65 and older | Annually. | The AOA’s 2023 announcement also recommends annual comprehensive exams. |
| Adults considered at risk | At least annually, or as recommended by an eye-care professional. | The appropriate frequency may depend on the particular risk and whether an eye condition has already been diagnosed. |
The AOA public table and its 2023 guideline announcement give different intervals for low-risk adults under 65. The public table says every two years; the announcement says annually. Because the recommendations do not match, do not assume one interval applies to everyone under 65. Ask your eye-care professional to recommend a schedule for you.
Who may need exams more often?
The AOA identifies a range of factors that can warrant at least annual exams or an interval specifically recommended by an eye-care professional:
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- Personal or family history of eye disease.
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- High or progressive refractive error, or another eye-health concern.
AAO guidance also notes that risk factors can mean more frequent exams than the exam around age 40. If you have a diagnosed eye condition, follow its monitoring plan rather than relying on a general screening interval.
When is a dilated exam recommended?
Dilation widens the pupils so an eye-care professional can examine structures inside the eyes and look for conditions such as diabetic retinopathy, glaucoma and age-related macular degeneration. The National Eye Institute (NEI) gives these risk-specific recommendations for dilated exams:
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- Every one to two years for people over 60, African Americans over 40, and people with a family history of glaucoma.
- At least once a year for most people with diabetes or high blood pressure.
These are recommendations about dilated exams for particular risk groups—not a universal schedule for every adult or a replacement for clinician-directed follow-up when a condition is diagnosed. Ask which parts of an exam you need and how often.
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What counts as a comprehensive eye exam?
A vision screening or a home acuity chart can check aspects of sight, but it does not establish that your eyes are healthy or set a safe personal follow-up interval. A professional comprehensive exam is the relevant appointment for assessing your vision and eye health. A single eye-pressure reading is not enough to diagnose glaucoma, according to the AAO.
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The appropriate exam may include dilation depending on your health, risks and clinician’s assessment. If you are unsure whether a screening or appointment included a comprehensive exam or dilation, ask the provider what was done and when you should return.
Independent reader supportYour contribution helps us test, update, and keep practical guides available for everyone.When should you seek care sooner?
Do not wait for your next routine appointment if a new eye or vision problem develops, or if a relevant change in your health affects your eyes. The AOA advises seeking care sooner than the routine re-examination interval in those circumstances. Contact an eye-care professional to ask how promptly you should be seen.
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Questions to ask at your appointment
- Given my age, health, family history and eye history, when should I have my next comprehensive exam?
- Do I need a dilated exam, and how often?
- Does a medicine, contact-lens use, occupation or other risk factor change my schedule?
- If I have a diagnosed condition, what follow-up plan should I follow?
- What changes or symptoms mean I should contact you before the next routine visit?
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