Recommended examination frequency for the pediatric patient

Patient Age	Examination Interval
	Asymptomatic/Low Risk	At Risk
Birth to 2 years	At 6 to 12 months of age	At 6 to 12 months of age or as recommended
3 through 5 years	At least once between 3 and 5 years of age	At least once between 3 and 5 years of age or as recommended
6 through 17 years	Before first grade and annually thereafter	Before first grade and annually, or as recommended thereafter

The extent to which a child is at risk for the development of eye and vision problems determines the appropriate re-evaluation schedule. Children with ocular signs and symptoms require a prompt, comprehensive examination. Furthermore, the presence of certain risk factors may necessitate more frequent examinations based on professional judgment. Factors placing an infant, toddler or child at significant risk for eye and vision problems include:

• Prematurity, low birth weight, prolonged supplemental oxygen at birth
• Family history of myopia, amblyopia, strabismus, retinoblastoma, congenital cataracts, metabolic or genetic disease
• Infection of mother during pregnancy (e.g., rubella, toxoplasmosis, venereal disease, herpes, cytomegalovirus or human immunodeficiency virus)
• Maternal smoking, use of alcohol or illicit drug use during pregnancy
• Cortical visual impairment
• Difficult or assisted labor, which may be associated with fetal distress
• High or progressive refractive error
• Strabismus
• Anisometropia
• Academic performance problems
• Known or suspected neurodevelopmental disorders
• Systemic health conditions with potential ocular manifestations
• Wearing contact lenses
• Having functional vision in only one eye
• Eye surgery or previous eye injury
• Taking prescription or nonprescription drugs (e.g., over the counter medications, supplements, herbal remedies) with potential ocular side effects

Recommended examination frequency for the adult patient

Patient Age (Years)	Examination Interval
	Asymptomatic/Low-Risk	At Risk
18 through 39	At least every two years	At least annually, or as recommended
40 through 64	At least every two years	At least annually, or as recommended
65 and older	Annually	At least annually. or as recommended

Patients at risk include those:

• A personal or family history of ocular disease
• Belonging to certain racial and ethnic groups
• Systemic health conditions with potential ocular manifestations
• Occupations that are highly demanding visually or have a high potential of being hazardous to
  the eyes
• Taking prescription or nonprescription drugs with ocular side effects
• Having functional vision in only one eye
• Wearing contact lenses
• Eye surgery or previous eye injury
• High or progressive refractive error
• Other eye-related health concerns or conditions

Patients who have undergone refractive surgery (LASIK, PRK, SMILE) should still have an eye exam every 1-2 years for monitoring of overall ocular health.