How often to have your eyes tested, by age and risk

The question usually arrives like this: “I can see fine, why would I have my eyes tested?” And it is a reasonable question, but for one detail. The eye conditions that cost the most sight on the Murcian coast progress for years without taking any sight away at the start. Glaucoma begins at the edge of the visual field, which is exactly the part the brain fills in by itself. Diabetic retinopathy begins in the peripheral retina. Macular degeneration can affect one eye first while the other compensates.

The Spanish general council of colleges of opticians-optometrists puts at up to 50% the cases of sight loss that can be avoided through early detection and appropriate treatment. That percentage is the only reason it is worth reading a table of intervals.

The table, by age

Valid if you have none of the risk factors in the next section.

Two clarifications about that table.

The American Academy of Ophthalmology recommends the baseline examination at 40 precisely because it does not depend on symptoms: it gives you a picture of the back of the eye to compare everything that comes afterwards against. Without that first picture, a slow change is indistinguishable from what is normal for that person. For patients of 65 and over, the same academy sets the interval at one or two years.

For healthy young adults, that academy talks about a much longer interval, five to ten years. We shorten it for a practical reason: at an optician’s the examination also measures the prescription, and the prescription does change over those years. A young person who sees blurred at the wheel does not have a disease, they have half a dioptre more.

The factors that shorten the interval

If you are in any of these situations, the table above does not apply to you. The interval is set by the risk factor, not by your age.

Diabetes

Annual, and from the moment of diagnosis if it is type 2 diabetes. The American Academy of Ophthalmology sets it out that way in its practice guidance on diabetic retinopathy: screening at diagnosis and at least once a year from then on. In type 1 diabetes, annual screening begins five years after diagnosis.

It is the factor most people ignore, because diabetic retinopathy neither hurts nor blurs until it is advanced.

Family history of glaucoma

Annual from the age of 40. Having a father, a mother or a sibling with glaucoma multiplies your risk. The American Academy of Ophthalmology includes it among the main factors alongside age and ancestry. And glaucoma gives no symptoms until the loss of visual field is considerable, at which point what has gone does not come back.

High myopia

Annual, with an examination of the peripheral retina. High myopia lengthens the eyeball and stretches the retina, which raises the risk of detachment and of other changes at the back of the eye. If you are short-sighted by more than six dioptres, the examination is not about whether you need new glasses.

High blood pressure

Annual. The retina is the only place in the body where blood vessels can be seen directly, without opening anything.

Contact lens wear

Annual as a minimum, even if you see perfectly. The cornea of a lens wearer copes badly with a lack of supervision.

Many hours a day on screens

It does not shorten the interval by itself, but it changes what has to be looked at. Here the examination must include binocular vision and accommodation, not just the distance prescription.

Long-term medication

Some long-term treatments require specific ophthalmological monitoring. If you have been taking something for years, bring the box or the report to your appointment.

What cannot wait for the next check-up

These things are looked at within days, not months. If any of them happens to you, ring your optician or go to eye casualty.

• New floaters, all at once, especially if they come with flashes of light.
• A curtain or a shadow coming in from one side of the visual field.
• Sudden loss of vision in one eye, even if it is brief and recovers on its own.
• Double vision that appears from one day to the next.
• Severe eye pain with a red eye, nausea or coloured haloes around lights.
• Straight lines that look wavy when you look with one eye. Cover one, look at a door frame, and repeat with the other.

That last test takes five seconds and is worth repeating once a month from the age of sixty.

What an optician’s does and does not do

It is worth stating plainly, because there is confusion and because the law here is specific.

An optician-optometrist measures the prescription, assesses binocular vision and accommodation, measures the intraocular pressure, evaluates the front of the eye and examines the back of it. With that they detect signs that require ophthalmological assessment and refer you on. They do not diagnose diseases and they do not treat them. The Spanish general council puts it the same way: the optician-optometrist observes the early signs of those conditions and advises the patient to see the corresponding specialist.

That referral is, in practice, the value of an eye examination. Nobody goes to an ophthalmologist off their own bat at 62 with no symptoms at all. But they do drop into the optician’s to change their glasses.

What to bring to your appointment

• The glasses you use, all of them. Including the reading glasses from the chemist and the prescription sunglasses.
• Your previous prescription, if you have it.
• Your list of medication.
• The ophthalmologist’s report, if you have ever been seen by one.
• Your European Health Insurance Card or your private insurance, if you are a foreign resident and would like us to explain how to claim reimbursement in your own country.

And some idea of what you need to see for: driving at night on the coast road does not ask the same of you as reading on the porch. Tell us. The right prescription is the one that suits what you do, not the one that comes out roundest on the machine.

If it is more than two years since your last test

It is the most common case we see in Puerto de Mazarrón, particularly among foreign residents who stopped having a regular optician when they moved. The full examination takes a little under an hour, it is done in Spanish, English or German, and it ends with an explanation of what we have seen, whether you need to change your glasses or not.

If you leave here having bought nothing but with a date to come back, the visit has done its job.