Table 38 – Guidelines for Routine Eye Examinations.

Organization	Year	Policy
Canadian Task Force on the Periodic Health Examination (7)	1995	The optimal frequency of visual acuity testing is uncertain. Since age-related macular degeneration and diabetic retinopathy have dire consequences there is good evidence of effective treatment, the prudent physician may wish to include funduscopy in the periodic health exam Older people who have a family history of glaucoma, are black, have severe myopia or have diabetes are at greatest risk of glaucoma. A prudent recommendation is to include periodic assessment by an ophthalmologist who has access to automated perimetry. The optimal interval is uncertain.
Canadian Ophthalmological Society	2005	Canadians are recommended to have an eye examination every 3 to 5 years until the age of 40 and then every 2 to 4 years until the age of 65. Those with risk factors for eye diseases should get an eye examination annually. People over 65 should have an examination every 2 years - or annually if they have any risk factors
Canadian Association of Optometrists	No date	The minimum recommended frequency of examination for those at low risk is as follows: Adult (20 to 64 years) – Every one to two years Older adult (65 years and older) – Annually The frequency of examination for those at high risk will be determined by the examining optometrist on the basis of one’s health and visual status at the preliminary examination. Some of the factors which may indicate high risk are as follows: Adult: diabetes; hypertension; family history of glaucoma; those whose work is visually demanding or who face eye hazards.
Centers for Medicare and Medicaid	2005	Glaucoma screening can lead to early detection and treatment, which can prevent, slow, or stop vision loss from the disease. Medicare covers annual glaucoma screening for people at high risk for the disease; this section describes this benefit and provides information and resources for health care professionals and organizations to support the delivery and promotion of this benefit for appropriate Medicare beneficiaries. What Medicare covers: Medicare covers annual glaucoma screening for the following persons considered to be at high risk for this disease: Individuals with diabetes; Individuals with a family history of glaucoma; African Americans over the age of 50; and Hispanics 65 and older (new addition to the benefit in 2006). Medicare will pay for glaucoma screening examinations when they are furnished by or under the direct supervision in the office setting of an ophthalmologist or optometrist, legally authorized to perform these services under State law. The beneficiary will pay 20% as the co-payment or coinsurance after meeting the yearly Part B deductible. A glaucoma screening examination includes the following: A dilated eye examination with an intraocular pressure measurement; and A direct ophthalmoscopy examination, or a slitlamp biomicroscopic examination. Other helpful information: Medical advances have made it easier to diagnose and treat glaucoma before even moderate vision loss occurs. Because glaucoma progresses with little or no warning signs or symptoms, and vision loss from glaucoma is irreversible, it is very important that people at high risk for the disease receive annual screening, and that those who have it are treated and monitored routinely
American Academy of Ophthalmology	2005	Adults without risk factors: Age (years) Frequency of Eye Exam Under 40 every 5-10 years 40-54 every 2-4 years 55-64 every 1-3 years 65 or older every 1-2 years Adults with risk factors for glaucoma (e.g. increased IOP, family history of glaucoma, African or Hispanic/Latino descent): Age (years) Frequency of Eye Exam Under 40 every 2-4 years 40-54 every 1-3 years 55-64 every 1-2 years 65 or older 6-12 months
American Optometric Association	2005	Persons without risk factors 18-60: every 2 years 61 and older: annually Persons at risk (diabetes, hypertension, family history of ocular disease, or whose clinical findings increase their potential risk such as those working in occupations that are highly demanding visually or are eye hazardous, those taking prescription or non prescription drugs with ocular side effects, those wearing contact lenses those who have had eye surgery and those with other health concerns or conditions) 18-60: 1-2 years or as recommended 61 and older: annually or as recommended
United Kingdom, College of Optometrists	2005	16-69 years: every 2 years 70 and older: annually Persons 40 and older with a family history of glaucoma or with ocular hypertension who are not part of a monitory scheme: annually Diabetics who are not part of a diabetic retinopathy monitoring scheme: annually
National Eye Institute	2004	People at high risk for glaucoma who do not have the disease should be examined every 2 years. People with seemingly normal vision should also be referred to an eye care professional, if they fit into any of the following categories: People with diabetes who have not had an eye examination through dilated pupils in the past year; Blacks over age 40 who have not had an eye examination through dilated pupils in the past two years; Anyone over age 60 who has not had an eye examination through dilated pupils in the past two years.
Prevent Blindness America		In general, the recommended frequency of comprehensive eye examinations for people without symptoms or special risk factors is: Age Caucasian African-American 20-39 Every 3 to 5 years Every 2 to 4 years 40-64 Every 2 to 4 years Every 2 to 4 years 65 or older Every 1 to 2 years Every 1 to 2 years People with special risks, such as diabetes, a previous eye injury, surgery or a family history of glaucoma, may need an eye exam more frequently.
U.S. Preventative Services Task Force	1996	Routine vision screening with Snellen acuity testing is recommended for elderly persons (“B” recommendation). The optimal frequency for screening is not known and is left to clinical discretion. Selected questions about vision may also be helpful in detecting vision problems in elderly persons, but they do not appear as sensitive or specific as direct assessment of acuity. There is insufficient evidence to recommend for or against routine screening with ophthalmoscopy by the primary care physician in asymptomatic elderly patients (“C” recommendation).