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Family Health Magazine
FAMILY MEDICINE

Is an Annual Eye Exam Necessary?
It all depends on your age

Whether or not you need an annual check-up largely depends on your age. Doctors perform examinations that can detect early signs of disease. It is generally easier to treat diseases discovered early than those found in advanced stages. Various illnesses are more common at different times of life. Treatable eye disease is fairly common in children and quite common in the elderly. Youngsters and seniors have the most to gain from regular check-ups.

Childhood

No one is too young for an eye exam. Newborns are often examined after difficult births when they may have been given lots of oxygen. If you think your baby’s eyes don’t look straight, schedule an exam as soon as possible. Do not be put off by those who say your child will grow out of it!

If there is the slightest suspicion that an infant’s eyes are crossed, consult a medical eye doctor (ophthalmologist) right away. Crossed eyes tend to run in families. The ophthalmologist will ask if any family members had similar problems. The exam is simple and can be done with the baby sitting on mother’s lap. Most often, the crossed-eyes appearance arises from the shape of the baby’s eyelids. In such cases, regular checks done for a year or two may be all that is needed.

The term strabismus describes true crossing of the eyes. Treatment with glasses, eye patches, and even surgery may be necessary. As long as treatment starts early, good vision is still likely.

Many infants have watery eyes caused by blocked tear passages. Usually the condition clears up by itself by the time the child reaches age one. If not, a simple operation is required to open up the tear passage. The operation takes about five minutes and is done on an outpatient basis.

Kids from families in which the use of eyeglasses is common should get eye exams before they start school. If you think your child does not see as well as others, insist on an eye exam. Young children who do need glasses adapt to them well. As a general rule, children should be checked at age two, four and six. They do well with an exam using pictures of animals to test vision. Near-sightedness or myopia commonly begins between age eight and 12 and gets worse until age 20 to 25. Youngsters with myopia need regular testing to be sure that their glasses are doing the job properly.

Teenagers who wear glasses often want to try contact lenses. This possibility can be discussed at the regular testings. Your eye care provider can advise on the fitting of contact lenses, taking eye health into account along with the maturity and personality of your child.

Middle years

Adults between age 20 and 40 who do not wear glasses and have no eye trouble do not need to be seen regularly by an eye doctor. Usually simple vision checks from the family doctor as part of pre-employment, driving and insurance medical exams will be sufficient.

People in this age group who wear glasses should have exams when their glasses need renewing. Others may ask for one if they have problems or concerns about vision. Contact lens wearers should be seen on a yearly basis.

Otherwise, only occasional sporadic infections or allergy symptoms may need attention. People with diabetes should have a yearly medical eye assessment.

Older adults

By age 40 to 45, most people have some difficulty seeing small print in poor lighting conditions. This is caused by the onset of ‘old-sight’ or presbyopia. The problem can be overcome for a while by holding reading material further away. Once your arms become too short and bifocals or reading glasses are needed, it’s time for an eye exam.

As well as measuring for glasses, a check will be made for early signs of other eye disease. If a clean bill of health is found, you will be told to come back after three years. By then, your reading glass prescription may need strengthening. If signs of raised fluid pressure in the eye or glaucoma are present, regular exams will be scheduled.

Sometimes there are early signs of cataracts. An exam every one to two years is advised because blurred vision from the cataract can often be corrected with a change in spectacles. Elderly people with degenerative disease of the retina (the light-sensitive film on the back of the eye) may benefit from regular prescription changes. This is the way to get the most from slowly failing eyesight.

Careful eye exams performed by medically qualified eye doctors sometimes detect signs of diseases elsewhere in the body. Diabetes, heart conditions, blood disease, thyroid gland disease, arthritis and diseases of the brain and nervous system are all conditions that can be uncovered this way. Eye exams definitely complement check-ups performed by family doctors.

Our eyes will usually tell us when there is something wrong. Glaucoma is the exception. It has no warning signs and so it gets its reputation as the silent, slow destroyer of eyesight. Anyone over 40 and those who have relatives with glaucoma should have eye pressure measured. When glaucoma is discovered early, it can usually be fully controlled.

The importance of regular eye medical exams increases at age 40, as the incidence of eye diseases such as glaucoma starts to increase. Systemic conditions such as diabetes and hypertension that can affect the eyes also become much more prevalent.

Yearly medical eye exams are particularly important for seniors because of the gradual increase in the incidence of eye disease.

Long-standing diabetes often causes very severe eye trouble. Anyone with diabetes should have an annual eye exam. Even with diabetes, if it is discovered early, eye disease can be kept under control by modern technology.

You have a lot to gain from regular eye check-ups. They are often very useful in children, but are not necessary in young adults without symptoms. The importance of regular eye exams increases at age 40 and is very valuable for seniors.


FAMILY HEALTH is written
with the assistance of
College of Family Physicans of Canada
Alberta College of Family Physicians
While effort is made to reflect accepted medical knowledge and practice, articles in Family Health Online should not be relied upon for the treatment or management of any specified medical problem or concern and Family Health accepts no liability for reliance on the articles. For proper diagnosis and care, you should always consult your family physician promptly. © Copyright 2012, Family Health Magazine, a special publication of the Edmonton Journal, a division of Postmedia Network Inc., 10006 - 101 Street, Edmonton, AB T5J 2S6    [FM_FHa11]
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