Eye health resource
Why Regular Eye Exams Matter After 40
After 40, presbyopia becomes common and the risk of several eye diseases rises with age. Learn how exam timing depends on age and risk factors, and what an eye exam can detect.
Reviewed for accuracy by Justin Bazan, OD on .
Turning 40 does not create one universal eye-exam schedule, but it is a useful age to become more attentive to changing near vision and long-term eye-health risk. Presbyopia often begins in the 40s, and the likelihood of cataract, glaucoma, macular degeneration, diabetic eye disease, and other conditions generally rises with age.
Presbyopia Is a Normal Age-Related Change
Presbyopia is the gradual loss of the eye's ability to focus comfortably at close distances. People often first notice that small print is harder to read, they need more light, or they want to hold reading material farther away.
Presbyopia is not an eye disease and does not mean your eyes are unhealthy. Reading glasses, progressive or bifocal lenses, computer-specific glasses, multifocal or monovision contact lenses, and other options can help depending on your prescription and daily needs.
Eye Disease Risk Also Changes With Age
Some eye diseases can develop before noticeable symptoms appear. A comprehensive eye exam can look for findings associated with conditions such as:
- Glaucoma — optic-nerve damage that may affect peripheral vision gradually.
- Cataract — clouding of the natural lens that can cause blur, glare, or reduced contrast.
- Age-related macular degeneration — changes involving the macula and central vision.
- Diabetic eye disease — retinal changes related to diabetes.
- Dry eye and eyelid disease — common sources of burning, fluctuating vision, irritation, and contact-lens discomfort.
An eye exam does not guarantee that disease will be prevented, but identifying a problem earlier can create more options for monitoring, risk reduction, or treatment.
How Often Should Adults Over 40 Have Eye Exams?
Current American Optometric Association guidance is not perfectly uniform for asymptomatic, low-risk adults. The AOA's 2023 adult clinical practice guideline supports annual comprehensive examinations for adults ages 18 through 64, while its current public frequency table lists at least every two years for asymptomatic, low-risk adults ages 40 through 64 and annual examinations beginning at age 65.
Rather than presenting either interval as a universal rule, Park Slope Eye recommends that exam timing reflect the patient's individual risk. Factors that may justify annual or more frequent care include:
- a personal or family history of eye disease;
- diabetes, hypertension, autoimmune disease, or another systemic condition with possible eye effects;
- contact-lens wear;
- high or progressively changing refractive error;
- medications with possible ocular side effects;
- previous eye surgery or injury;
- vision in only one functional eye; or
- new eye or vision symptoms.
What Happens at a Comprehensive Eye Exam?
A comprehensive eye exam can include visual acuity, refraction for an eyeglass prescription, assessment of eye alignment and focusing when appropriate, slit-lamp examination of the front of the eyes, and evaluation of the retina and optic nerve.
Park Slope Eye also uses Optos Daytona wide-angle retinal imaging, and nearly all patients choose it. OCT is added when detailed cross-sectional imaging of the retina or optic nerve would provide useful information. Dilation is used when symptoms, risk factors, or examination findings make it clinically necessary.
What If I Have Diabetes or High Blood Pressure?
Diabetes and hypertension can affect the retina and other ocular tissues. Tell your eye doctor about these conditions and how they are being managed. Your recommended follow-up may be more frequent than a low-risk schedule.
Medical insurance may apply when the visit is for a medical eye condition or disease monitoring, depending on the plan and services performed.
Do Not Wait for the Routine Interval If Something Changes
New flashes or floaters, a curtain or shadow in vision, sudden vision loss, significant eye pain, persistent redness, new double vision, or a meaningful new visual change should not wait for a routine appointment interval.
If you are due for an exam or your vision needs have changed, book an appointment with Park Slope Eye.
Originally published . Substantially updated .