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Are eye exams just as important as other health exams?

Illustration of the importance of eye health

Are eye exams as important as your other checkups?

What do healthy bodies and clear vision have in common? They need routine checkups. A well-maintained body supports healthy eyes, and well-maintained eyes support a healthy body. All routine health exams, including eye exams, serve a similar purpose — to maintain health by detecting issues early.  

Catching eye and vision issues early while they are more treatable is key to a lifetime of clear vision and healthy eyes. This is why annual comprehensive eye exams should be on your yearly health checklist. You go for an annual physical to take care of your body. You go for dental checkups to take care of your teeth. Why not do the same for your eyes? It’s important not to take your eyes for granted — safeguard your eyesight by adding a comprehensive eye exam to your annual self-care routine.

I see fine — why do I need an eye exam?

Your eyes and vision continue to change from the minute you’re born, all the way through old age. Getting your eyes examined yearly is the only way to be sure that you don’t have any underlying health issues. A number of eye diseases can cause eye and vision problems in the future even though they don't show symptoms early on.  

For example, glaucoma can cause irreversible vision loss without any symptoms at its onset. A regular eye exam can detect glaucoma earlier and help prevent irreversible damage to the eye. In addition, common medical conditions such as diabetes, high blood pressure and high cholesterol can be detected early during an eye exam, possibly preventing severe complications in the future. 

READ MORE: What your eye doctor can tell about your heart health

Do I need an eye exam if I had a vision test at the DMV?

Although the eye chart at the DMV is similar to the one at the eye doctor’s office, a DMV vision test is different from an eye exam. A vision test simply tests whether you have the required visual acuity to drive safely according to each state's laws. It can be performed by almost anyone. An eye exam is a full examination of your vision and eye health performed by a qualified eye doctor. There is no substitute for a comprehensive eye exam.

My child sees fine — why do they need routine eye exams?

Myopia

Recent studies have shown that the rate of nearsightedness (myopia) in school-aged kids is nearly 42%. Myopia that progresses into high myopia increases the risk of future sight-threatening complications. Due to this, it is important to monitor the onset and progression of myopia with routine, comprehensive eye exams. 

Several myopia control strategies have shown promise in clinical trials for slowing myopia progression. Routine eye exams provide an opportunity for a doctor to evaluate your child and recommend which strategies would be most appropriate to slow down your child’s myopia. 

A study in Community Eye Health Journal demonstrated that if myopia is slowed by 1 diopter in childhood, the risk of pathological myopia, a type of myopia that can cause vision loss, is lowered by 40%. This highlights the importance of routine eye care for children to help avoid preventable vision impairment. 

Eye strain

The demands on kids’ eyes are much greater than they were in the past. With the increased use of computers, tablets and phones at school and at home, many children get headaches and don’t realize that they are experiencing eye strain. In addition, eye strain from undetected refractive error and issues with eye teaming can result in difficulties at school. 

ADHD

Vision problems and ADHD can present with similar symptoms, including a short attention span, difficulty with schoolwork and an inability to stay on task. Children with uncorrected refractive error or eye teaming issues can begin to avoid detailed near work such as reading and writing. They may lose their place while reading or be unable to recall the content of what they read because the visual task of reading consumes their concentration. 

If your child is having trouble focusing and you suspect they have ADHD symptoms, schedule an eye exam to first rule out vision issues. An eye exam with a qualified eye doctor can determine if a visual problem is the underlying cause. 

READ MORE: Could it be ADHD or a vision problem?

Are my child’s school vision screenings considered eye exams?

Even if your child had a recent vision screening at school and no problems were found, vision issues could still exist. Vision screenings are not comprehensive eye exams. Their limited scope can cause them to miss refractive errors and eye teaming issues.

Without a comprehensive eye exam to identify, correct and manage these otherwise undetected vision problems, children may struggle to achieve their full academic potential. In addition, they may experience difficulties at school, a decreased ability to focus and other issues that can impact their quality of life.

How are eye exams like other routine exams?

During a routine physical exam, a primary care physician will determine the status of your overall health. They will manage or provide a referral for any medical conditions that they find. They will also provide guidance on prevention of conditions that you may be at risk for. 

In the same way, eye doctors will determine the vision and health status of your eyes and manage or provide referrals for any conditions they may have detected. Your eye doctor will also provide guidance for any conditions that you may be at risk for, such as high myopia, glaucoma or cataracts.

Routine eye exams with an eye doctor

In addition to providing an opportunity to ask questions about any eye issues you may be experiencing, a routine eye exam will assess your: 

  1. Vision — You will be asked to read rows of letters on a chart. These letters will gradually get smaller. This provides the eye doctor with a measurement of your visual acuity, the ability to see fine detail with clarity.

  2. Refractive error — A refraction (sometimes called a refractive eye exam) checks your refractive error and makes sure the prescription in your glasses remains current so that you are seeing as clearly as possible. 

  3. Contact lens evaluation — If you wear contact lenses, additional tests such as measuring the front surface of your eyes, or the cornea, will be performed.

  4. Eye movements — This checks whether your eyes work together as a team so that you see a single, clear image. 

  5. Pupil reaction — Your pupils should constrict with light and dilate when there is low light. If this is not the case, you could have an injury to your nerves or brain, or be having a reaction to certain drugs.

  6. Depth perception — Difficulty with depth perception can indicate underlying eye and medical issues.

  7. Color vision — Color blindness that has been present since birth is not a concern. But, a change in color vision perception can indicate a serious condition.

  8. Peripheral vision — Assessing peripheral vision can help detect visual field loss from injuries or diseases such as glaucoma, diabetic retinopathy or stroke.

  9. Eye health — Your eye doctor will use specialized instruments to look at the outside and inside of your eyes under high magnification with a bright light. Your pupils may be temporarily dilated so that the structures located inside the eye, such as the lens, optic nerve and retina, can be examined.

A comprehensive eye exam can take an hour, or even longer, depending on the tests needed to fully evaluate your vision and the health of your eyes. 

How eye exams supplement routine physical exams

Some medical conditions may be detected early by an eye doctor during a routine eye exam. Your heart, arteries, veins and tiny blood vessels supply blood, oxygen and nutrients to your body. Conditions such as high blood pressure, high cholesterol and diabetes harm blood vessels throughout the entire body, including the eyes. 

The arteries and veins in your eyes can provide clues about what is happening in the small blood vessels of the brain, heart and other parts of the body. This can lead to earlier detection of disease and referral to the appropriate specialist for treatment, decreasing the risk of advancement and/or complications. 

In fact, an eye doctor may be the first to detect if you’re at risk for a heart attack or stroke. Without a routine visit to the eye doctor, this opportunity to maintain your eye and overall health is lost.

READ MORE: How blood vessel damage links heart disease and eye disease 

Routine physical with a primary care doctor

Your primary care doctor will perform a comprehensive exam to ensure that you are in good health and that you do not have risk factors that could cause poor health in the future. In addition to taking a full medical history and performing a physical and other appropriate testing, a routine annual physical will include:

  • Blood pressure screening — Blood pressure should be checked at least once every two years or more often if you are at risk.

  • Cholesterol screening — For low-risk individuals, men should start cholesterol screening at age 35, and women should start at age 45. For high-risk individuals, screenings should begin at age 20 for both men and women.

  • Diabetes screening — If you have high blood pressure, are overweight or have a family history of diabetes or heart disease, your doctor may test your blood sugar level for diabetes. 

Routine dental exams

Dental checkups serve a similar function to eye checkups: They catch problems early before they result in a larger issue. In fact, dental checkups may have some importance to your eye health as well. Although more research is needed, a 2017 study found that a recent loss of a tooth was linked to an increased risk of primary open-angle glaucoma. While scientists continue to investigate the association, it underscores the value of taking care of both your dental health and your eye health. 

You maintain the health of your teeth and gums with dental checkups, even when you aren’t having tooth pain. You do this to avoid cavities, gum recession and other dental issues so that you have a lifetime of healthy, strong teeth. Similarly, catching eye problems early with routine checkups will help to maintain the health of your eyes.

So, when you make an appointment for a checkup with your dentist, it may be a good idea to make an appointment with your eye doctor at the same time!

Other routine exams

In addition to routine checkups with your primary care doctor, dentist and eye doctor, there are some exams that should be scheduled routinely, as recommended by medical guidelines. These appointments serve a similar purpose to all routine checkups — to detect issues early while they are more treatable. 

Well-woman visit

An annual woman’s health checkup includes a: 

  • Pelvic exam to check internal organs for abnormalities

  • Clinical breast exam to check for lumps and other signs of breast cancer

  • Pap test to screen for cervical cancer 

Depending on a woman’s age and health, a Pap test (or Pap smear) may only be needed every three years rather than annually.

Mammogram

A screening mammogram detects breast cancer and improves the ability of a doctor to identify small tumors. It reduces the risk of death from breast cancer by detecting it earlier while the cancers are small. This allows a woman to have more treatment options and improves the chances for a good outcome. Current guidelines recommend screenings start at age 40, or earlier if they have a higher risk of developing breast cancer.

Colonoscopy

Colon cancer starts from small growths called polyps. A colonoscopy detects these polyps and allows the doctor to remove them, decreasing the risk of colon cancer. The latest guidelines recommend that adults age 45 to 75 screen for colon cancer. With a colonoscopy. Your primary care doctor can advise you on how often you should have this screening based on your individual risk. 

How often should I get a routine eye exam?

The American Optometric Association (AOA) recommends that babies have an eye evaluation between the ages of 6 and 12 months of age. Children should have a comprehensive eye exam at least once between the ages of 3 and 5 years and once more before first grade. School-aged kids should have an annual eye exam, preferably before school begins in the fall.

An adult who does not have any current eye health or vision conditions should have an eye exam at least every two years — every year is optimal. People over 65 should get eye checkups every year because the risk for certain eye conditions increases with age. This is also true if you have other risk factors or if you wear eyeglasses or contacts. 

If you have eye or vision issues, contact your eye doctor and schedule an appointment to be seen. And if you aren’t having any issues, keep it that way by scheduling a routine, annual eye exam!

A review on the epidemiology of myopia in school children worldwide. BMC Ophthalmology. January 2020. 

High myopia and its risks. Community Eye Health Journal. 2019.

Myopia control: Why each diopter matters. Optometry and Vision Science. June 2019.

School-aged vision: 6 to 18 years of age. American Optometric Association. Accessed March 2022.

The heart and the eye: Seeing the links. American Academy of Ophthalmology. December 2015.

Health screenings for men ages 18 to 39. MedlinePlus: National Library of Medicine. March 2022.

Health screenings for women ages 18 to 39. MedlinePlus: National Library of Medicine. March 2022.

Prospective study of oral health and risk of primary open-angle glaucoma in men. Ophthalmology. November 2016.

Dental check-up. Cleveland Clinic Foundation. August 2019.

Women's health checkup. MedlinePlus: National Library of Medicine. January 2022.

Pap and HPV tests. U.S. Department of Health and Human Services: Office on Women’s Health. January 2019.

Mammography (mammogram). Radiological Society of North America. March 2021.

Why you should get a colonoscopy. Cleveland Clinic Foundation. February 2021.

Colorectal cancer screening tests. Centers for Disease Control and Prevention. February 2022. 

Comprehensive eye exams. American Optometric Association. Accessed March 2022.

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