• AAO PPP Committee, Hoskins Center for Quality Eye Care
    Comprehensive Ophthalmology
    Compendium Type: I

    By the American Academy of Ophthalmology Preferred Practice Patterns Committee: Robert S. Feder, MD,1 Timothy W. Olsen, MD,2 Bruce E. Prum, Jr., MD,3 C. Gail Summers, MD,4 Randall J. Olson, MD,5 Ruth D. Williams, MD,6 David C. Musch, PhD, MPH7

    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 journal's PPP Collection page.

    1 Northwestern Medicine, Chicago, Illinois
    2 Emory Eye Center, Emory University, Atlanta, Georgia
    3 Department of Ophthalmology, University of Virginia Health System, Charlottesville, Virginia
    4 Department of Ophthalmology and Visual Neurosciences, University of Minnesota, Minneapolis, Minnesota
    5 Moran Eye Center, University of Utah Health Care, Salt Lake City, Utah
    6 Wheaton Eye Clinic, Wheaton, Illinois
    7 W.K. Kellogg Eye Center, Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, Michigan

    HIGHLIGHTED 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 5–10 years; 40 to 54 years—every 2–4 years; 55 to 64 years—every 1–3 years; and 65 years or older—every 1–2 years. (moderate quality, strong recommendation)


    The first recommended adult comprehensive medical eye examination, and subsequent frequency of examination for patients who have diabetes mellitus, varies depending on the type of diabetes and whether a woman is pregnant. The recommendations are as follows: (1) type 1 diabetes mellitus—first examination 5 years after onset and yearly afterwards; (2) type 2 diabetes mellitus— first examination at the time of diagnosis and yearly afterwards; 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. (moderate quality, strong recommendation) (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.)

    Recommended frequency of comprehensive medical eye examinations for adults who have risk factors for glaucoma, such as African Americans and Hispanics, by age group is as follows: under 40 years—every 1–2 years; 40 to 54 years—every 1–3 years; and 55 and older—every 1–2 years. (moderate quality, strong recommendation)