Comprehensive Adult Eye and Vision Examination

Publication Date: March 8, 2023
Last Updated: March 9, 2023

Action Statements

Individuals 60 years of age and older with central and/or peripheral vision loss should be counseled by their eye doctor about the potential for an increased risk of falls. (BRecommendation)
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Eye doctors should not rely on a single, normal confrontation visual field test result as proof that a field loss is not present, and should conduct formal perimetry on patients if there is a clinical suspicion of a visual field defect. (B, Recommendation)
(B and C)
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A comprehensive adult eye and vision examination should include, but is not limited to:
  • Patient and family history, including visual, ocular and general health, medication usage, and vocational and avocational visual requirements
  • Measurement of visual acuity
  • Determination of refractive status
  • Assessment of ocular motility, binocular vision, and accommodation, as appropriate, based on patient’s age, visual signs and symptoms
  • Ocular health examination, including evaluation of the anterior and posterior segments, measurement of intraocular pressure, and visual field testing
  • Systemic health assessment, as indicated
  • Ancillary testing, as needed.
(, Consensus Statement)
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At the conclusion of an eye and vision examination, the diagnosis of any eye or vision problems should be explained to the patient and related to the patient’s symptoms, along with a discussion of treatment plans and prognosis. (, Consensus Statement)
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Eye doctors should advise patients on appropriate and trustworthy sources of eye and vision care information, including providing educational materials and counseling about eye health and vision care topics, as needed. (B, Recommendation)
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Eye doctors should counsel their patients on the benefits of a healthy lifestyle and remain alert for new research that demonstrates the effects of diet and exercise on ocular and general health. (, Consensus Statement)
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Eye doctors should counsel their patients on smoking cessation. They should document discussions with their patients about their smoking status and inform them about the benefits to their eyes, vision, and overall health through smoking cessation. (B, Recommendation)
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Eye doctors should counsel their patients who are monocular or, when indicated, at-risk for ocular injuries to wear appropriate eye protection with impact resistant properties. (, Consensus Statement)
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Since exposure to ultraviolet radiation (UV) is a risk factor for disorders of the eye, eye doctors should advise their adult patients about the benefits of the regular use of sunglasses that effectively block at least 99 percent of UVA and UVB radiation and the use of hats with brims when outdoors. (, Consensus Statement)
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Patients who will undergo or have undergone ocular surgery or other specialty care should be counseled by their eye doctor regarding their ongoing need for periodic comprehensive eye and vision examinations. (, Consensus Statement)
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Comprehensive eye and vision examinations are recommended annually for persons 18 through 39 years of age to optimize visual function, evaluate eye changes, and provide for the early detection of sight-threatening eye and systemic health conditions. Risk factors present may result in recommendations for more frequent evaluations. (, Consensus Statement)
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Comprehensive eye and vision examinations are recommended annually for persons 40 through 64 years of age to optimize visual function, evaluate eye changes and provide for the early detection of sight-threatening eye and systemic health conditions. Risk factors present may result in recommendations for more frequent evaluations. (, Consensus Statement)
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For persons 65 years of age or older, annual comprehensive eye and vision examinations are recommended to optimize visual function, evaluate eye changes and provide for the early detection of sight-threatening eye and systemic health conditions. Risk factors present may result in recommendations for more frequent evaluation. (C, Recommendation)
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Adult patients should be advised by their eye doctor to seek eye care more frequently than the recommended re-examination interval, if new ocular, visual, or systemic health problems develop. (, Consensus Statement)
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Recommendation Grading

Overview

Title

Comprehensive Adult Eye and Vision Examination

Authoring Organization

Publication Month/Year

March 8, 2023

Last Updated Month/Year

January 10, 2024

Supplemental Implementation Tools

Document Type

Guideline

External Publication Status

Published

Country of Publication

US

Inclusion Criteria

Male, Female, Adult, Older adult

Health Care Settings

Ambulatory, Hospital, Outpatient

Intended Users

Nurse, nurse practitioner, optician, optometrist, physician, physician assistant

Scope

Assessment and screening, Management, Prevention

Diseases/Conditions (MeSH)

D005128 - Eye Diseases, D014786 - Vision Disorders, D015351 - Vision Screening

Keywords

eye exam, vision exam