How Often Should You Get an Eye Exam and What Happens at One

By East Ridge Eye Center Editorial Team

How Often Should You Get an Eye Exam by Age Group?

How often you should get an eye exam changes at every life stage. The American Academy of Ophthalmology (AAO) and the American Optometric Association (AOA) publish separate but overlapping guidelines — the table below summarizes the key recommendations.

Age Group	Recommended Frequency	Notes
Infants (6–12 months)	At least once	InfantSEE program offers no-cost first exam
Children (3–5 years)	At least once	Before starting school
School-age (6–17 years)	Annually	Vision changes rapidly during school years
Adults 18–39 (healthy, no risk factors)	Every 2 years	Annually if contact lens wearer
Adults 40–64	Every 1–2 years	Presbyopia and early glaucoma risk begin
Adults 65 and older	Annually	Risk of cataracts, AMD, and glaucoma rises sharply
High-risk adults (any age)	As directed by physician	Includes diabetics, those with family history of glaucoma

Children and Teens

Children rarely report blurry vision because they assume everyone sees the same way. The AOA's 2023 report found that one in four school-age children has an undetected vision problem that affects academic performance. A comprehensive exam before first grade establishes a baseline and catches amblyopia (lazy eye) and strabismus (eye turn) during the treatment window when outcomes are best.

Adults 40 and Older

After age 40, the lens of the eye stiffens, making close-up reading harder — a condition called presbyopia. Intraocular pressure (IOP) also tends to rise, increasing glaucoma risk. The Ocular Hypertension Treatment Study, published in the Archives of Ophthalmology, found that adults with elevated IOP had a 9.5% five-year risk of developing glaucoma without treatment. Annual exams allow an ophthalmologist to monitor pressure trends over time.

Adults 65 and Older

Cataracts affect more than 24 million Americans over age 40, according to Prevent Blindness America, and nearly half of all Americans have a cataract by age 75. Age-related macular degeneration (AMD) is the leading cause of vision loss for adults over 60 in the United States. Annual exams at this stage are not optional — they are the primary defense against preventable vision loss.

What Happens at a Comprehensive Eye Exam? A Step-by-Step Look

A comprehensive eye exam at an ophthalmology practice typically lasts 45 to 90 minutes, longer if dilation is performed. Here is what patients can expect, step by step.

Patient history and intake. Staff record current medications, family history of eye disease, any symptoms like floaters or flashes, and occupational visual demands. This context shapes every test that follows.
Visual acuity test. The classic Snellen chart — developed by Dutch ophthalmologist Herman Snellen in 1862 and still in standard use — measures how clearly each eye sees at 20 feet. Results are expressed as a fraction (e.g., 20/40) and determine whether a prescription update is needed.
Refraction assessment. The ophthalmologist or technician uses a phoropter to fine-tune the lens prescription. Patients respond to a series of "which is clearer, one or two?" comparisons that pinpoint nearsightedness, farsightedness, and astigmatism.
Eye muscle and alignment testing. Cover tests and tracking exercises check how well both eyes work together. Misalignment that goes uncorrected in adults can cause chronic headaches and depth-perception problems.
Tonometry (eye pressure measurement). A non-contact air-puff test or applanation tonometry measures intraocular pressure. Normal IOP is 10–21 mmHg. Readings above 21 mmHg trigger further glaucoma evaluation.
Pupil dilation. Dilating drops widen the pupil, giving the physician a clear view of the optic nerve, macula, retina, and blood vessels. Dilation is the gold standard for detecting diabetic retinopathy, AMD, and early retinal tears. Vision may remain blurry for two to four hours after dilation, so patients should arrange a driver or bring sunglasses.
Slit-lamp examination. A binocular microscope illuminates the front structures of the eye — cornea, iris, lens, and anterior chamber — at high magnification. This is how early cataracts and corneal disease are identified.
Dilated fundus examination. The ophthalmologist uses an ophthalmoscope to examine the retina and optic disc directly. Changes in the optic disc's cup-to-disc ratio are an early sign of glaucoma. Retinal hemorrhages or exudates signal diabetic retinopathy.
Results and discussion. The physician reviews all findings, explains any diagnoses, updates prescriptions, and recommends a follow-up schedule. Patients leave with a clear picture of their eye health — and a prescription they can fill on site if needed.

Why Are Regular Eye Exams Important Beyond Just Vision Correction?

Regular eye exams do more than refine a glasses prescription. The eye is the only organ where blood vessels and nerve tissue can be examined non-invasively, making it a window into systemic health.

Glaucoma: The Silent Thief of Sight

Glaucoma affects approximately 3 million Americans, according to the Glaucoma Research Foundation, yet roughly half remain undiagnosed because the disease causes no pain and peripheral vision loss only becomes noticeable after significant nerve damage has occurred. Tonometry and optic nerve imaging during a routine exam catch elevated pressure and structural changes years before a patient notices any symptom.

Diabetic Retinopathy

The Centers for Disease Control and Prevention (CDC) reports that diabetic retinopathy is the leading cause of new cases of blindness among adults aged 20–74. Annual dilated exams are part of the standard of care for all Type 1 and Type 2 diabetic patients, per American Diabetes Association guidelines. Early laser treatment or anti-VEGF injections can prevent up to 90% of severe vision loss when the condition is caught in time.

Hypertension and Cardiovascular Disease

Hypertensive retinopathy — damage to retinal blood vessels from high blood pressure — can be spotted during a dilated eye exam before a patient receives a hypertension diagnosis. Ophthalmologists in Chattanooga frequently coordinate with primary care physicians when retinal changes suggest uncontrolled systemic conditions.

Children's Learning and Development

The American Academy of Pediatrics notes that 80% of learning in a classroom is visual. A child who cannot see the board clearly may be labeled inattentive rather than visually impaired. Vision screenings at pediatricians' offices check only basic acuity and miss conditions like convergence insufficiency, which affects reading fluency.

How Often Should You Get an Eye Exam If You Have Risk Factors?

Certain medical and genetic conditions compress the recommended exam timeline significantly. Patients in these groups should not wait for the standard one-to-two-year interval.

Key facts: High-risk groups requiring more frequent eye exams

Diabetes (Type 1 or Type 2): Annual dilated exam from the point of diagnosis, per the American Diabetes Association Standards of Care 2024.
Glaucoma family history: First-degree relatives of glaucoma patients have a 4–9× higher lifetime risk, according to the Glaucoma Research Foundation. Exam frequency is typically every 6–12 months.
African American patients over 40: The National Eye Institute identifies African Americans as 6–8× more likely to develop glaucoma than white Americans — annual exams are strongly recommended.
Steroid users (oral or inhaled): Corticosteroids raise intraocular pressure in roughly 40% of patients, per research published in Survey of Ophthalmology. Eye pressure monitoring every 6–12 months is warranted.
High myopia (–6.00 diopters or more): Highly myopic eyes have a stretched, thinned retina more prone to tears and detachment. Annual exams with dilated fundus review are standard.
History of eye injury or surgery: Prior trauma changes baseline anatomy and increases long-term risk of secondary glaucoma and cataract formation.
Active rheumatologic disease (lupus, rheumatoid arthritis): Hydroxychloroquine (Plaquenil), a common treatment, requires annual retinal screenings per American Academy of Ophthalmology guidelines to detect early toxicity.

Patients unsure whether they fall into a high-risk category can discuss their full medical history during an initial consultation with the board-certified ophthalmologists at East Ridge Eye Center.

Vision Screening vs. a Comprehensive Eye Exam: What Is the Difference?

A vision screening and a comprehensive eye exam are not the same thing, and confusing the two leads many patients to delay care they actually need.

A vision screening — the type performed at a school, DMV office, or pediatrician visit — uses a single Snellen chart or digital equivalent to test one variable: whether a person can read letters at a standard distance. It takes two to three minutes and requires no specialized equipment. Screenings identify obvious nearsightedness but miss astigmatism corrections, early glaucoma, diabetic retinopathy, macular degeneration, and binocular vision disorders entirely.

A comprehensive eye exam, performed by a licensed ophthalmologist or optometrist, includes eight or more distinct clinical tests, uses multiple instruments including a slit lamp and indirect ophthalmoscope, and evaluates both the optical system and the health of intraocular structures. The AOA explicitly states that vision screenings "are not a substitute for a comprehensive eye examination."

The practical implication: a child or adult who "passed" a school or DMV screening may still have a clinically significant eye condition. East Ridge Eye Center's board-certified ophthalmologists conduct the full spectrum of testing — from basic refraction to retinal imaging — in a single appointment so patients never leave with an incomplete picture of their eye health.

What to Expect at East Ridge Eye Center in Chattanooga

East Ridge Eye Center is located at 932 Spring Creek Road, Chattanooga, Tennessee 37412 and serves patients from across the greater Chattanooga area, East Tennessee, and North Georgia. The practice is staffed by licensed, board-certified ophthalmologists and operates with a relaxed, professional atmosphere designed to put patients of all ages at ease.

The full-service optical shop on site means patients can move from their exam directly to selecting frames or contact lenses without a separate trip to a retail chain. For patients who need more than a glasses update, East Ridge Eye Center performs surgical procedures either in the office itself or in an adjacent ambulatory surgery center equipped for cataract surgery, glaucoma procedures, and other ocular interventions.

Office hours are Monday through Thursday, 8 a.m. to 4 p.m., and Friday, 8 a.m. to noon. New and existing patients can reach the office at (423) 894-1453 to schedule an appointment. The practice treats entire families — from first pediatric exams to cataract consultations — under one roof, which makes coordinating care across generations straightforward for Chattanooga-area households.

Frequently Asked Questions

How often should you get an eye exam as a healthy adult?

Healthy adults aged 18–39 with no risk factors and no known eye conditions should have a comprehensive eye exam every two years, according to the American Academy of Ophthalmology. Adults who wear contact lenses should be examined annually because contacts require an updated prescription and a check for corneal health. Adults over 40 should move to annual exams due to increasing risk of presbyopia and glaucoma. Any new symptom — floaters, flashes of light, sudden blurry vision — warrants an unscheduled exam regardless of when the last one occurred.

What happens during a comprehensive eye exam?

A comprehensive eye exam typically includes a patient health history review, visual acuity testing with a Snellen chart, a refraction test using a phoropter to determine your lens prescription, eye pressure measurement (tonometry) to screen for glaucoma, pupil dilation with dilating drops to examine the retina and optic nerve, and a slit-lamp evaluation of the cornea and lens. The full appointment usually runs 45 to 90 minutes. Dilation can blur near vision for two to four hours afterward, so patients should bring sunglasses or arrange a driver.

How often should children get eye exams?

The American Optometric Association recommends that infants receive their first eye exam between six and twelve months of age, a second between ages three and five, and then annual exams once they start school. School-age children experience rapid visual changes, and one in four children has an undetected vision problem that affects reading and classroom learning, according to AOA research. Pediatric vision screenings at schools only test basic distance acuity and miss conditions like convergence insufficiency and amblyopia — a comprehensive exam is the only reliable alternative.

Can an eye exam detect health conditions other than vision problems?

Yes. A dilated eye exam can reveal signs of diabetes, high blood pressure, autoimmune disease, and certain neurological conditions. The retina's blood vessels are the only blood vessels in the body visible without cutting the skin, making them a direct indicator of vascular health. Diabetic retinopathy, hypertensive retinopathy, and even early signs of multiple sclerosis can be identified by an ophthalmologist during a routine dilated fundus exam before a patient has received a systemic diagnosis from their primary care physician.

What is the difference between an ophthalmologist and an optometrist?

An ophthalmologist is a medical doctor (MD or DO) who completed four years of medical school, a one-year internship, and a minimum three-year ophthalmology residency. Ophthalmologists diagnose and treat all eye diseases, prescribe glasses and contact lenses, and perform eye surgery — including cataract removal, glaucoma procedures, and retinal surgery. An optometrist (OD) completed a four-year optometry program and focuses primarily on vision correction and eye health monitoring. East Ridge Eye Center is an ophthalmology practice staffed by board-certified ophthalmologists who provide the full spectrum of medical and surgical eye care.

Does insurance cover routine eye exams?

Coverage varies by plan type. Medical insurance (such as UnitedHealthcare, BlueCross BlueShield, or Aetna) generally covers eye exams when a medical diagnosis — glaucoma, diabetic retinopathy, or cataracts — is involved. Routine refraction for glasses or contact lenses is often covered under a separate vision benefit plan, such as VSP or EyeMed. Medicare Part B covers annual dilated eye exams for high-risk patients, including diabetics and those with a family history of glaucoma. Patients should contact their insurer or call East Ridge Eye Center at (423) 894-1453 to verify benefits before scheduling.

Conclusion

Understanding how often you should get an eye exam — and what happens at one — removes the uncertainty that keeps many people from scheduling an appointment they genuinely need. The timeline is clear: annual exams for children, adults over 65, and anyone with a risk factor like diabetes or glaucoma; every two years for healthy adults in their 20s and 30s. Each visit goes well beyond reading an eye chart, covering everything from intraocular pressure measurement to a detailed look at the retina through a dilated pupil.

East Ridge Eye Center in Chattanooga offers that full level of care — comprehensive exams, an on-site optical shop, and surgical capability when a condition requires it — all from a practice built on individualized attention. If your last exam was more than a year ago, or if you have never established care with a board-certified ophthalmologist, now is the right time to act. Call the office at (423) 894-1453 or visit eastridgeeyecenter.net to request an appointment. The team sees patients Monday through Thursday, 8 a.m. to 4 p.m., and Friday until noon.

Sources

American Academy of Ophthalmology eye exam frequency guidelines — American Academy of Ophthalmology
American Optometric Association comprehensive eye examination recommendations — American Optometric Association