Eye Exam: What It Is, When to Have One, and What To Expect


Understanding the importance of regular eye exams is crucial for maintaining optimal vision and overall eye health. Yet, many people are unsure about what an eye exam entails, when they should have one, and what to expect during the process. 

In this comprehensive guide, we provide you with a detailed overview of how eye exams generally work and what you can anticipate during and after the procedure. Please read on. 

Is a Vision Test the Same as an Eye Exam?

No, a vision test is not the same as an eye exam

A vision test is a simplified evaluation of visual acuity that can be administered by a school nurse, family doctor, or another certified healthcare professional. While it can detect potential eye or vision issues, it does not provide a precise diagnosis.

An eye exam, on the other hand, entails a thorough assessment of your vision and overall eye health and is performed by a qualified eye doctor, such as an optometrist or ophthalmologist. 

What Does a Typical Eye Exam Include?

An eye exam is a painless procedure involving various tests conducted by an eye care specialist to check the condition of your eyes. This consists of the following tests: evaluating your vision, determining if glasses or contacts are necessary, and assessing your eye health for potentially linked diseases.

During the exam, your eye doctor makes use of specialized equipment, instruments, and lights to examine your eyes. Regular eye exams enable your eye care specialist to monitor vision changes, detect eye issues, and contribute to maintaining optimal eye health.

What Are the Three Types of Eye Exams?

Eye examinations come in three distinct types: comprehensive eye exams, routine eye exams, and contact lens exams. The choice of exam depends on factors such as your last appointment and the type of vision correction needed for your eye condition.

  • Routine Eye Exam 

This is a type of examination where your optometrist assesses your visual acuity at various distances and determines whether you require corrective devices like glasses or contact lenses. If needed, your eye doctor will prescribe the appropriate lenses and assist in choosing the right frames for glasses or suitable contact lenses. 

For glasses, advice on lens type and frame selection based on your needs will be provided. Similarly, for contact lenses, you will receive recommendations tailored to your requirements and undergo a contact lens fitting process to ensure ease and comfort.

Typically, a routine eye exam takes less than 30 minutes, making it a convenient and efficient process. It is generally recommended to have a routine eye exam at least once every two years to maintain optimal eye health and ensure accurate vision correction.

  • Comprehensive Eye Exam

A comprehensive eye exam is a thorough evaluation of not only refractive errors but also the overall eye health of an individual. During this exam, your eye doctor screens you for common eye diseases, providing a more in-depth assessment. 

While specific procedures may vary among providers, a comprehensive eye exam typically includes the following assessments:

  • Visual Acuity Test: Similar to a routine eye exam, this test assesses your sharpness of vision.
  • Cover Test: One eye is covered to evaluate how each eye functions independently.
  • Depth Perception Test: Measures your ability to perceive the relative distance of objects.
  • Ocular Motility Test: Evaluates the movement and coordination of your eyes.
  • Slit Lamp Exam: Utilizes a specialized lamp to examine the shape of your eyeball and identify any abnormalities.
  • Pupil Dilation: Your pupils are dilated, allowing the eye doctor to examine the internal structures for signs of disease.
  • Glaucoma Testing: This test measures the pressure inside your eyes, aiding in the detection of glaucoma, a serious eye condition.

These comprehensive assessments provide a detailed understanding of your eye health, ensuring a thorough examination that goes beyond simple vision correction.

  • Contact Lens Exam

This is a specialized examination where your eye doctor conducts specific tests to evaluate your vision with contacts. The initial test measures the surface of your eyes to determine the ideal size and type of contacts for your eyes. Additionally, a tear film evaluation ensures you have enough moisture for comfortable contact lens wear.

Based on these tests, your eye doctor provides a contact lens prescription tailored to your eyes. It’s crucial to note that an eyeglass prescription is not a substitute for a contact lens exam, as the measurements differ significantly. Eyeglass prescriptions are designed for lenses positioned approximately 12 millimeters from your eyes, whereas contact lens prescriptions are for lenses placed directly on the eye’s surface. An improper fit or prescription can harm eye health.

After obtaining the correct fit and prescription, you’ll need to decide on disposable or extended-wear contacts, and whether you want colored lenses. Your doctor provides a trial pair for you to wear for a few days. A follow-up exam in about a week ensures you’ve adjusted to your new lenses, guaranteeing a comfortable and safe experience with your chosen contact lenses.

An optometrist conducting an eye exam to a patient.

What Not to Do Before an Eye Exam

Here are the things you should AVOID doing before an eye exam:

  • Overworking or Straining Your Eyes

Never strain your eyes before your scheduled examination. Resting them well can significantly enhance your comfort during testing exercises. Adequate sleep, ideally 8 hours the night before your appointment, reduces eye fatigue. 

If you spend a lot of time on digital screens, which can lead to digital eye strain, consider minimizing screen time before your appointment. Morning eye exams are ideal for screen users, thus ensuring better accuracy.

Remember to bring your current prescriptive eyeglasses and contact lenses to the exam. Testing the strength and performance of your current corrective eyewear against potential prescription changes is highly important. 

As eyes change with age, it’s common for prescriptions to require adjustments. Also, remember to bring a pair of sunglasses. Pupil dilation during the exam causes light sensitivity for several hours, so it comes in handy for you. 

  • Drinking Caffeine or Alcohol

Caffeine may spike your blood pressure, potentially affecting exam measurements. Opt for decaf or herbal tea in the morning to prevent inaccurate results. Alcohol can also increase blood pressure and cause dry or irritated eyes, impacting the testing process. Refrain from heavy drinking the night before and avoid alcoholic beverages on the day of your exam.

  • Failing to Bring Your Insurance Documents

Ensure a smooth experience by bringing current copies of your vision or medical insurance documents. Even if your information is on file, having updated copies is essential. 

Additionally, carry a government-issued ID. Digital copies might be accepted, and your insurance provider can fax relevant documents to the office; it’s advisable to confirm insurance acceptance beforehand. Plan ahead for a hassle-free eye exam.

How Often Should I Get an Eye Exam?

How frequently you should have eye exams is determined by your age, your health, whether you wear contact lenses, your family medical history, and other factors.  

Here’s what the experts say about how often you should see an eye doctor for routine exams:

Recommendations by the American Optometric Association

The American Optometric Association (AOA) is the national association that represents optometrists in the United States. Optometrists (ODs) are eye doctors who are trained in the diagnosis and treatment of vision problems and eye disease. They may treat certain eye diseases with medicine, but they are not licensed to perform eye surgery.

If you have no special risk factors for vision problems or eye disease, the AOA recommends that you have regular eye exams according to the following schedule:

Your AgeHave Your Eyes Examined
From birth to 24 monthsBy 6 months of age
2 to 5 yearsAt age 3
6 to 18 yearsBefore first grade, then every 2 years
18 to 40 yearsEvery 2-3 years
41 to 60 yearsEvery 2 years
61 and olderAnnually

People with added risk factors for vision or health problems should have their eyes examined more frequently.  Risk factors for different age groups include the following:

Risk factors for infants and young children:

  • Infants born prematurely or with low birth weight.
  • Infants whose mother had rubella, sexually transmitted disease (STD), or AIDS-related infection during pregnancy.
  • Family history of crossed eyes or eye disease.
  • Family history of high Refractive error (i.e. nearsightedness, farsightedness, or astigmatism).

Risk factors for school-aged children:

  • Reading and/or learning difficulties.
  • Complaints of headaches or tired eyes.
  • Squinting.
  • Needing glasses for nearsightedness at an early age.
  • Family history of high refractive error.

Risk factors for adults:

  • Individuals diagnosed with diabetes or hypertension.
  • Family history of diabetes or hypertension.
  • Family history of Glaucoma or cataracts.
  • Individuals who have a visually demanding job or an occupation that may be hazardous to the eyes.
  • Individuals taking medications that may have ocular side effects.
  • Individuals who have other health concerns or conditions.

The AOA recommends that you see your eye doctor to determine how frequently you should have your eyes examined if you have (or might have) any of the above risk factors.

The AOA also stresses that individuals over age 60 have an increased risk of developing cataracts, macular degeneration (AMD), and other sight-threatening eye conditions.  Therefore, people in this age group should have eye exams at least once per year.

Recommendations by the American Academy of Ophthalmology

The American Academy of Ophthalmology (AAO) is the national association that represents ophthalmologists in the United States.  Ophthalmologists are medical eye doctors (MDs) who are trained in the diagnosis and treatment of vision problems and eye disease.  Ophthalmologists undergo more extensive training in the treatment of eye disease and medical conditions than optometrists, and they are licensed to perform eye surgery.

The American Academy of Ophthalmology (AAO) recommends the following schedule for eye exams (for individuals with no special risk factors for vision problems or eye disease):

Your AgeHave Your Eyes Examined
Birth to 24 monthsScreening during regular pediatric exams
3 to 5 yearsScreening every 1-2 years during regular exams
6 to 19 yearsExams as needed
20 to 29 yearsOne exam
30 to 39 yearsTwo exams
40 to 64 yearsEvery 2 to 4 years
65 and olderEvery 1 to 2 years

The AAO recommends that the screenings for eye disease and vision problems in their guidelines should be performed by an ophthalmologist, a pediatrician, or a trained screener.

The AAO also stresses that certain factors can put you or your children at increased risk for eye disease. These include:

  • Developmental delay
  • Premature birth
  • Personal or family history of eye disease
  • African-American heritage (increases the risk of glaucoma)
  • Previous serious eye injury
  • Use of certain medications
  • Certain diseases that affect the whole body (e.g. diabetes or HIV infection)

If any of these factors affect you or your children, the AAO recommends that you check with an ophthalmologist to see how often you should have an eye exam.

Recommendations by Vision Council of America

Vision Council of America (VICA) is a national non-profit trade association for the optical industry in the United States.  Together with the Better Vision Institute (BVI) – an independent non-profit advisory board to VICA – Vision Council of America provides a forum for the three professional disciplines involved in vision care (optometry, ophthalmology, and opticianry) to come together to address and promote America’s vision health.

VICA points out the following reasons why annual eye exams are a good idea for all children and adults:

  • One in four school-aged children has an undiagnosed vision problem that interferes with learning.
  • If not detected early in children, amblyopia can have long-term consequences.
  • About 80% of learning in a child’s first 12 years comes through the eyes.
  • Over 10 million Americans suffer from computer vision syndrome (CVS) – a variety of eye and vision problems associated with computer use.
  • More than 90 percent of sports-related eye injuries can be prevented by wearing protective eyewear.
  • People aged 40 and older are at greater risk for glaucoma, cataracts, and other sight-threatening diseases.
  • Vision problems affect over 86 million Americans over the age of 40.
  • Older drivers with vision impairment are 200 percent more likely to be involved in an auto accident.

VICA stresses that school vision screenings can miss certain eye problems, and that vision problems can be symptom-free in their early stages, making it hard to know if a problem is developing.  According to VICA, the most effective way to detect vision problems is through a comprehensive eye exam performed by an eye doctor (optometrist or ophthalmologist).

Key Takeaway

Choosing when to schedule eye exams for yourself and your children is your responsibility.  Whether you decide to follow the recommendations of the American Optometric Association, the American Academy of Ophthalmology, or the Vision Council of America, be sure everyone in your family has regular eye exams to protect their precious gift of sight and ensure they are seeing their world as clearly and comfortably as possible.