When do you need an eye exam? 5 signs it’s time

How often should you get your eyes checked? Ask your eye doctor.

The American Optometric Association (AOA) recommends annual eye exams, but the best person to ask is the optometrist or ophthalmologist who examines your eyes regularly. If you don’t get an eye exam every year, your eyes will usually tell you when they need help.

If you find yourself rubbing your eyes a lot or holding things as far from (or as close to) your face as possible to see them clearly, it’s probably time to see your eye doctor. 

Losing the ability to focus on the fine print happens to the best of us. Presbyopia occurs with age, as the lens inside the eye loses flexibility. But it’s also possible you have latent vision issues that are getting worse.

“Many adults were given glasses when they were younger and figured, ‘Ah, it worked just as well without them.’ So, they never wore them,” says Sandra Block, chair of the World Council of Optometry’s public health committee.

“When they hit 40, they have a real problem reading,” she says. “They were farsighted to begin with and now, not only are they farsighted, they have no accommodative systems so they can’t see clearly up close either.”

Here are five signs you need an eye exam: 

1. You’re having headaches around the eyes

If your eyes are straining to focus, it may be giving you a headache. Frontal headaches or headaches around the temple can indicate your current glasses are too strong or that reading glasses are required. 

“For patients over 40, that kind of headache may mean it’s time to consider progressive eyeglasses that provide correction at distance, intermediate and close range,” says Benjamin Foreman, an optometrist in Plymouth Meeting, Pennsylvania.

For any headache that affects your vision, start with an eye doctor. Ocular migraines, for example, produce an aura — zigzag spots in your vision or little shiny spots that temporarily blur central or peripheral vision. Most migraine auras last maybe 20 minutes before the head pain starts. 

“Ocular migraines are not necessarily serious but they’re something you want to have looked at,” Foreman says.

“Sometimes visual disturbances can indicate something else, like a retinal tear or lack of blood supply to the retina or optic nerve, and that can be incorrectly perceived as an ocular migraine,” Foreman adds.

A headache accompanied by blurred vision in one or both eyes can be a sign of optic neuritis (swollen optic nerve).

“That’s an emergency,” Foreman says. “If it’s a headache with blurred peripheral vision, you want to rule out potential stroke. Often, the more serious issues have more than just visual symptoms.”

SEE RELATED: Eye exams: 5 reasons they are important

2. You’re squinting and still not focusing

Changes in vision can mean different things. For a child, difficulty reading the blackboard often indicates myopia is starting to develop. For an adult, difficulty seeing street signs may be a sign that your distance prescription needs updating or that there's a change in your eye health. 

As people enter their 40s, it gets harder to read ingredients on jars and labels. “Your arms often seem to be getting a little shorter, the lights are not quite as bright as they used to be,” Block says. 

You go to a romantic restaurant and can’t read the menu? Sorry, that’s probably related to aging. “As you get older, you start to need a correction, different from the one you need for distance or reading,” Block says.

Anytime you notice that your vision has changed, it’s important to get an exam to make sure your eyes are still healthy. It may be nothing, it may be something serious, or maybe you just need a new prescription for your glasses or contact lenses.

3. Your eyes feel dry

As women mature, their eyes may appear drier, Block says. That can lead to a number of problems, from blurred vision to reflexive tearing, a common symptom of dry eyes. 

In the United States, Market Scope estimates 17.2 million were diagnosed with dry eye in 2019.

“Changes in vision for distance are not quite as critical, but redness or any type of eye discharge, any type of pain or discomfort — that needs to be addressed immediately,” Block says.

SEE RELATED: Eye emergencies: 7 times when you must see an eye doctor ASAP

4. It’s harder to see at night

If you’re finding it harder than usual to read street signs at night, it could just be that your farsightedness is exacerbated in the dark. If your eyes are irritated by oncoming headlights or staring at a computer screen too long, anti-glare coatings can help.

“In general, it’s harder to drive at night so I always give patients anti-glare coating if they wear glasses for driving, especially at night,” Foreman says. For anyone who stares at a computer screen for several hours a day, he recommends blue-light filtering lenses with an anti-reflective coating.

If discomfort from glare persists even with specially treated eyeglasses, it may indicate cataracts — especially in patients over 50. 

When cataracts begin to affect quality of life, your doctor may suggest surgery to remove the faulty lens and replace it with an intraocular lens that will compensate for your eyeglass prescription. Many patients find they no longer need distance glasses after this surgery.

5. You can’t remember your last visit to an eye doctor

“Ask five different eye care providers how often you should visit an eye doctor and you’ll probably get five different answers,” Block says. “AOA says every year, but some people in practice say if you have no injuries or problems, you don’t need an exam every year.”

Block advises relying on your own eye care provider to tell you how often you should be seen. 

“That doesn’t mean they’re going to dilate you every year, but just make sure things are normal and healthy and there are no changes in your vision or eye health,” she says.

Certain exceptions apply. Doctors agree: Children should have their eyes examined every year and so should anyone with diabetes. 

For the rest of us, regular check-ups are a safeguard, if nothing else. “There are some eye diseases that come with no change of vision and no pain,” Block says.

Page published on Monday, December 23, 2019