A standard ophthalmic exam is a comprehensive series of tests done by an ophthalmologist or optometrist. These doctors specialize in eye health. They’ll use these tests to check both your vision and the health of your eyes.
A standard ophthalmic exam is also known as a comprehensive eye exam or a routine eye exam.
Your age and eye health will determine how often you undergo an eye exam.
Children and teens
According to joint recommendations from the American Academy of Ophthalmology (AAO) and the American Association for Pediatric Ophthalmology and Strabismus, a child should undergo their first basic eye test when they’re a newborn.
They should also get their vision screened at these stages:
- once between ages 6 and 12 months old
- once between ages 12 months and 3 years old
- once between ages 3 and 5 years old
- every 1 to 2 years after 5 years old
These screenings will help their doctor determine whether a more comprehensive exam is needed.
The AAO recommends that adults who have good vision and aren’t experiencing any eye problems get ophthalmic exams at these stages:
- once between ages 20 and 29 years old
- twice between ages 30 and 39 years old
- at 40 years old
- as recommended by their doctor, after age 40 and before age 65 years
- every 1 to 2 years starting at 65 years old
Adults who have any issues with their eyes or vision should see their eye doctor at least once a year, unless the doctor recommends otherwise.
According to the American Optometric Association (AOA), adults who need yearly exams due to a higher risk for eye and vision problems include those who:
- wear contact lenses
- take medications that have eye-related side effects
- have had eye surgery or an eye injury
- have a personal or family history of eye disease
- have occupations that may be hazardous to the eyes (being a welder, for example)
If you have an eye disease, talk with your doctor about how frequently you should have exams.
Diabetes and your eye health
The American Diabetes Association (ADA) recommends that people with type 1 diabetes have their first eye exam within 5 years of being diagnosed. After that initial exam, they should have yearly eye exams.
The ADA also recommends that adults with type 2 diabetes have their first eye exam once they receive a diagnosis. After that initial exam, they should have yearly eye exams.
If you have signs or symptoms of diabetic retinopathy, your eye doctor may recommend more frequent eye exams.
There’s no special preparation needed prior to the test. After the exam, you may need someone to drive you home if your doctor dilated your eyes and your vision hasn’t yet returned to normal.
Remember to bring sunglasses to your exam. After dilation, your eyes will be very sensitive to light. If you don’t have sunglasses, the doctor’s office will provide you with something to protect your eyes.
Your doctor will take a complete eye history and note a variety of things, including:
- your vision problems
- any corrective methods you have, such as glasses or contact lenses
- your overall health
- your family history
- your current medications
Your doctor will perform a visual acuity test.
During this test, you’ll look at a chart containing symbols or shapes (such as the alphabet). The doctor will take note of your ability to correctly identify these symbols or shapes from a distance.
They’ll also perform a refraction test. The purpose of this test is to determine whether light bends correctly when it passes through your lens or if you have a refractive error, such as nearsightedness.
During the refraction test, you’ll use a device with different lenses to view an eye chart 20 feet away. If you wear glasses or contact lenses, the test is also used to determine your prescription.
Your doctor will also dilate your eyes with eye drops to make your pupils larger. The pupils are the black circles at the center of the eyes.
Dilation helps your doctor view the back of the eye.
Other parts of the exam
Other parts of the exam may include checking:
- your 3-D vision, also known as stereopsis
- your peripheral vision to determine how well you see outside of your direct focus
- the health of your eye muscles
Other tests include:
- examination of your pupils with a light to see if they respond properly
- examination of your retina, at the back of the eye, with a lighted magnifying lens to see the health of blood vessels and your optic nerve
- a slit lamp exam, which uses another lighted magnifying device to check various parts of the eye, including your:
- iris, the colored part of the eye
- cornea, the transparent dome that covers the front of the eye
- conjunctiva, the thin membrane covering the whites of the eyes (sclera)
- a colorblindness test, in which you look at circles of multicolored dots with numbers, symbols, or shapes in them
- tonometry, a glaucoma test in which the doctor uses an instrument to make contact with or blow a painless puff of air at your eye (this helps them measure the pressure of the fluid within your eye)
Normal results indicate that you:
- have 20/20 vision, which means that you can see certain objects clearly from 20 feet away
- can differentiate colors
- have no signs of glaucoma, which is characterized by optic nerve damage
- have no other abnormalities of the optic nerve, retina, and eye muscles
- have no other signs of eye disease or conditions
Abnormal results mean that your doctor detected a problem or a condition that may need treatment, including:
- vision impairment requiring corrective eyeglasses or contact lenses
- astigmatism, a condition that causes blurry vision due to the shape of the cornea
These conditions are more common in children, but may also be seen in adults:
- a blocked tear duct, which causes excess watering of the eyes and is more concerning in adults than in children
- lazy eye (ambylopia), which occurs when the brain and eyes don’t work together
- crossed eyes (strabismus), which occurs when the eyes don’t align properly
Your test may also reveal more serious conditions. These can include
- Age-related macular degeneration (AMD). This condition damages a small part of the retina, making it difficult to see details.
- Cataracts. A cataract is a clouding of the lens. This clouding affects your vision. Cataracts are common, especially in older people.
- Corneal abrasion. A corneal abrasion is a scratch on the cornea. It may cause blurry vision or discomfort.
- Damaged nerves or blood vessels. Damage to the nerves and blood vessels may cause symptoms such as bleeding. Diabetes-related damage to the retina is known as diabetic retinopathy.
- Glaucoma. There are many types of glaucoma. The condition can only be detected with an eye exam, and it can ultimately result in blindness.
Your vision will change throughout your life. That’s why getting semi-regular or regular eye exams is important, even if you don’t have any problems with your vision.
If it’s been a while since you’ve had an eye exam, talk with your doctor about scheduling an appointment.