Most adults under 40 with no risk factors need a comprehensive eye exam every 5 to 10 years. That interval shortens as you age: every 2 to 4 years from ages 40 to 54, every 1 to 3 years from 55 to 64, and every 1 to 2 years after 65. These are the 2025 guidelines from the American Academy of Ophthalmology for people without symptoms or known eye conditions. If you have risk factors like diabetes or a family history of glaucoma, you’ll need exams more often.
Recommended Schedule by Age
For healthy adults with no vision complaints, the schedule looks like this:
- Under 40: Every 5 to 10 years
- 40 to 54: Every 2 to 4 years
- 55 to 64: Every 1 to 3 years
- 65 and older: Every 1 to 2 years
The reason the intervals tighten with age is straightforward: your risk of glaucoma, cataracts, and macular degeneration climbs significantly after 40, and these conditions often develop without noticeable symptoms. By the time you notice something is wrong, damage can be permanent. Annual or biennial exams after 65 catch these problems early enough to treat them effectively.
Children and Teens
Kids follow a different track. A newborn’s eyes should be checked at birth for basic health indicators. A second screening happens between 6 and 12 months, typically at a well-child visit. Between ages 3 and 5, your child’s vision and eye alignment should be tested, and again at age 5 when they start school. After that, periodic screenings through school or a pediatrician can catch most issues, though children with a family history of eye problems or any detected abnormality should see an ophthalmologist for a full exam.
Who Needs More Frequent Exams
Several factors push you toward a shorter interval between exams, even if your vision seems fine.
Diabetes is the biggest one. If you have type 2 diabetes, you should get a dilated eye exam at the time of diagnosis and at least yearly after that. Type 1 diabetes carries the same yearly requirement, starting five years after diagnosis. Diabetes damages the tiny blood vessels in the retina, and this damage is treatable when caught early but can lead to permanent vision loss if missed. Women with either type of diabetes who are pregnant or planning to become pregnant need an exam before conception and again early in the first trimester.
Family history of glaucoma is another significant risk factor. Black and Latino/Hispanic adults face higher rates of open-angle glaucoma and should consider exams every 2 to 4 years before age 40, every 1 to 3 years from 40 to 54, and every 1 to 2 years from 55 to 64. High blood pressure also increases your risk of eye problems, as does long-term use of certain medications like corticosteroids.
Vision Screenings Are Not Eye Exams
The quick eye chart test you get at a school, workplace, or DMV is a vision screening, not a comprehensive exam. Screenings check whether you can read letters at a distance. They can flag reduced vision, but they miss a wide range of conditions: early glaucoma, retinal disease, subtle changes in prescription, and problems with how your eyes work together. If a screening turns up an issue, you’ll be referred to an optometrist or ophthalmologist for a full evaluation. But passing a screening doesn’t mean your eyes are healthy. It just means you could read the chart that day.
A comprehensive eye exam includes checking your peripheral vision, eye pressure, the health of your retina (often with dilation), and your exact prescription. It’s the only way to get a complete picture of your eye health.
When Your Prescription Expires
Even if your eyes feel fine, your prescription has a legal shelf life. Federal law sets a minimum expiration of one year for contact lens prescriptions. Some states extend that to two years. Eyeglass prescriptions typically expire after one to two years depending on state law. After expiration, you’ll need a new exam before you can order replacement contacts or updated glasses.
This matters practically: if you wear contacts and your prescription expires, retailers cannot legally fill your order. Planning an exam before your prescription runs out saves you from a gap in supply.
Signs You Need an Exam Sooner
The schedules above are for people with no symptoms. If something changes with your vision between exams, don’t wait for your next scheduled appointment. Common signs that your prescription needs updating include blurry vision at any distance, squinting to read signs or screens, and eye fatigue during activities that used to feel easy. Frequent headaches, especially after reading or screen work, often point to a prescription that’s no longer accurate.
Difficulty seeing at night is another red flag. If road signs look fuzzy or you notice halos around headlights and streetlamps, your prescription may have shifted. Increased sensitivity to light, even dim light, can also signal a change. And if you find yourself holding your phone or a book closer to your face than you used to, that’s a classic sign of age-related farsightedness, which typically starts in your early to mid-40s and progresses for about 20 years.
Any sudden change, like a flash of light, a shower of new floaters, or a dark curtain across part of your vision, warrants an urgent exam rather than a routine one. These can indicate retinal detachment or other conditions that need immediate attention.