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This seems like a straightforward question, but the answer can vary depending on age and risk factors for ocular disease. If you are actively under the care of an ophthalmologist, then the answer to this question is easy: your next exam will be what your eye doctor recommends based on the results of your most recent visit.
Premature infants are at risk for a vascular condition called retinopathy of prematurity (ROP). These babies will have dilated eye exams on a fixed protocol and the exams will likely be arranged by the NICU where the baby is admitted. If a certain threshold of ROP is discovered on exam, the child will receive laser treatment to areas of the retina that do not have blood vessels. This is to prevent retinal detachment and permanent vision loss.
Other infants that should have a screening eye exam are those with a family history of retinoblastoma (a fatal eye cancer), childhood cataracts, childhood glaucoma, or a metabolic/genetic disease that can affect the eye. We recommend that these kids have an eye exam as soon as it is medically feasible.
Infants and Toddlers
A child’s pediatrician will routinely screen during well-baby exams for eye and vision abnormalities during the first few months of life, between 6 to 12 months, at 3 years of age, and at 5 years of age. Problems with the visual system should be identified and addressed as soon as possible so that the visual system can develop normally and amblyopia can be avoided. An inability to perform a screen or any abnormalities discovered should prompt a referral to an ophthalmologist.
Children in School
Every 1 to 2 years, children should be evaluated during well-child visits with the pediatrician, in schools, or during public screenings for visual acuity (can you read the bottom line on the eye chart?) and ocular alignment (are the eyes crossed?). Glasses should be prescribed as necessary to help with school and sports.
The Rest of Us
From puberty to 40 years, a comprehensive eye exam should be performed every 5 to 10 years (unless ocular symptoms, injury, or vision changes occur). From 40 to 65 years, an exam should be performed every 1 to 4 years and people older than 65 should have an exam every 1 to 2 years. The reason why eye exams are recommended more frequently as we age is that the prevalence of eye disease (such as cataract, glaucoma, and macular degeneration) increases as we age.
Diabetics are a special case as they are at risk for significant eye disease and vision loss. Thus, it is recommended that Type I diabetics have their first eye exam 5 years after they are diagnosed with diabetes and then yearly afterward. Type II diabetics should have an eye exam at the time of diagnosis and then yearly afterward.
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