How Often Do You Really Need an Eye Exam?
Eye exam frequency should be based on your age and risk factors. Canadian guidelines recommend more frequent exams than most people realize — here is what the evidence says.
Updated · Dr. David Wilkinson
Most people schedule an eye exam when their vision feels blurry or when they think it's "time." But how often you actually need one depends on your age, your health history, and risk factors you may not even know you have.
What do Canadian guidelines recommend?
The Canadian Association of Optometrists publishes exam frequency guidelines based on age:
| Age group | Recommended frequency |
|---|---|
| Infants (6–9 months) | First comprehensive exam |
| Children (2–5 years) | At least one exam before school |
| Children and teens (6–19) | Every year |
| Adults (20–39) | Every 2 years |
| Adults (40–64) | Every 1–2 years |
| Seniors (65+) | Every year |
These are minimum recommendations for people with no risk factors. Many adults need to be seen more often.
What changes the schedule?
Several common risk factors shift the recommendation to annual exams regardless of age:
- Diabetes — diabetic retinopathy can develop and worsen without any symptoms
- Family history of glaucoma — your risk is 4–9 times higher with a first-degree relative affected
- High myopia (strong nearsightedness) — increases risk of retinal detachment, glaucoma, and macular changes
- Previous eye injury or surgery
- Long-term use of corticosteroids — can elevate eye pressure
- African or Caribbean ancestry — higher risk of earlier-onset glaucoma
If even one of these applies to you, the standard schedule is not frequent enough.
Why does this matter if my vision is fine?
The most damaging eye conditions are the ones you cannot feel. Glaucoma destroys peripheral vision gradually and painlessly — by the time you notice, the damage is permanent and irreversible. Diabetic retinopathy can reach a sight-threatening stage before you see a single symptom. Age-related macular degeneration begins with changes only visible during an exam.
A comprehensive eye exam is not a vision check. It is a health assessment of the internal structures of the eye, including the retina, optic nerve, and blood vessels.
What happens if you wait too long between exams?
Conditions that are caught early are almost always easier to manage. Glaucoma detected at an early stage can be controlled with eye drops. Detected late, it may require surgery — and lost vision cannot be recovered.
The same is true for diabetic eye disease, macular degeneration, and even significant prescription changes that lead to eye strain, headaches, and difficulty concentrating.
What about children?
Children should follow a more frequent schedule because the visual system is still developing. Conditions like amblyopia (lazy eye) respond well to treatment before age 7–8, but outcomes drop sharply after age 10. A child who sees poorly in one eye often has no idea — they assume their vision is normal.
In Ontario, annual eye exams are available for all children and teens under 20.
The bottom line
Eye exam frequency is a clinical decision, not a calendar habit. Your age, family history, and health conditions determine how often you should be seen. If you are unsure whether your current schedule is appropriate, your optometrist can help you determine the right interval based on your individual risk profile.
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Book an appointment →Frequently Asked Questions
- How often should adults get an eye exam?
- The Canadian Association of Optometrists recommends adults aged 20–39 have an eye exam at least every two years, adults 40–64 every one to two years depending on risk factors, and adults 65 and older every year. People with diabetes, a family history of glaucoma, or other risk factors should be examined annually regardless of age.
- How often should children have their eyes examined?
- Children should have their first eye exam between 6 and 9 months, a second between ages 2 and 5, and annual exams once they start school. In Ontario, OHIP covers one eye exam per year for everyone under 20.
- Can eye problems develop between exams?
- Yes. Conditions like glaucoma, diabetic eye disease, and macular degeneration can progress significantly between visits with no noticeable symptoms. Annual exams allow your optometrist to detect subtle changes early, when treatment is most effective.
- Do I need an eye exam if my vision seems fine?
- Yes. Many serious eye conditions — including glaucoma and early macular degeneration — cause no symptoms until permanent damage has already occurred. A comprehensive eye exam checks far more than visual clarity.
- What risk factors mean I should be examined more often?
- Key risk factors include diabetes, a family history of glaucoma or macular degeneration, high myopia (strong nearsightedness), a history of eye injury or surgery, and long-term use of certain medications such as corticosteroids. If any of these apply to you, annual exams are recommended.
- Is an eye exam the same as a vision screening?
- No. A vision screening checks basic visual acuity — whether you can read a line on the chart. A comprehensive eye exam evaluates the full health of the eye, including internal structures, eye pressure, and early signs of disease. Screenings miss the majority of conditions that eye exams detect.
Author
Dr. David Wilkinson, OD, FAAO — Pending clinical review
Optometrist, Spadina Optometry
A Toronto native and Fellow of the American Academy of Optometry, Dr. David Wilkinson has been part of our optometric practice since earning his OD from the Illinois College of Optometry in 2007. A certified clinical investigator with a special interest in contact lenses and myopia management, he serves as a part-time Clinical Instructor at the University of Waterloo's Waterloo Eye Institute and previously spent nearly a decade as Practice Advisor at the College of Optometrists of Ontario.