Comprehensive Adult Medical Eye Evaluation PPP 2020

By the American Academy of Ophthalmology Preferred Practice Pattern Committee: Roy S. Chuck, MD, PhD,¹ Steven P. Dunn, MD,² Christina J. Flaxel, MD,³ Steven J. Gedde, MD,⁴ Francis S. Mah, MD,⁵ Kevin M. Miller, MD,⁶ David K. Wallace, MD, MPH,⁷ David C. Musch, PhD, MPH⁸

As of November 2015, the PPPs are initially published online-only in the Ophthalmology Journal and may be freely downloaded in their entirety by all visitors. Open the PDF for this entire PPP or click here to access the PPP on the journal's site. Click here to access the journal's PPP collection page.

¹Montefiore Medical Center & Albert Einstein College of Medicine, Bronx, New York

²Department of Ophthalmology, William Beaumont Hospital, Oakland University William Beaumont School of Medicine, Royal Oak, Michigan

³Casey Eye Institute, Oregon Health & Science University, Portland, Oregon

⁴Bascom Palmer Eye Institue, Miami, Florida

⁵Scripps Clinic, La Jolla, California

⁶Stein Eye Institute and Department of Ophthalmology, David Geffen School of Medicine at UCLA, Los Angeles, California

⁷Department of Ophthalmology, Indiana University School of Medicine, Indianapolis, Indiana

⁸Department of Ophthalmology & Visual Sciences, and Epidemiology, University of Michigan, Ann Arbor, Michigan

Highlighted Findings and Recommendations for Care

The recommended frequency for adult comprehensive medical eye examinations for asymptomatic patients, and for patients who do not have risk factors for eye disease, is as follows: under 40 years--every 5 to 10 years; 40 to 54 years--every 2 to 4 years; 55 to 64 years--every 1 to 3 years; and 65 years or older--every 1 to 2 years.

An increased frequency of comprehensive medical eye examinations is recommended for adults who have risk factors for glaucoma, such as African Americans and Hispanics. 

The first recommended adult comprehensive medical eye examination, and subsequent frequency of examination for patients who have diabetes mellitus, depends on the type of diabetes and pregnancy status. The recommendations are as follows: (1) type 1 diabetes mellitus--first examination 5 years after onset and yearly thereafter; (2) type 2 diabetes mellitus--first examination at the time of diagnosis and yearly thereafter; and (3) for women with type 1 or type 2 diabetes--first examination prior to conception and then early in the first trimester of pregnancy. Interval recommendations thereafter will be based on findings at first examination. (Note: Women who develop gestational diabetes do not require an eye examination during pregnancy, and they do not appear to be at increased risk for developing diabetic retinopathy during pregnancy.)

Smoking is a risk factor for many ocular diseases.

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