Author: Dr Val Phua
Estimated reading time: 21 minutes
Many people arrange an eye examination only when:
- Their vision becomes blurred
- Their spectacles break
- They struggle to read
- They develop eye pain
- They need a driving or employment medical report
However, several important eye diseases may develop before the person notices any change in vision.
These include:
- Glaucoma
- Diabetic retinopathy
- Early age-related macular degeneration
- Retinal tears
- Early cataract
- Keratoconus
- Childhood amblyopia
- Progressive myopia
A person may still read an eye chart clearly while having:
- Peripheral visual-field loss
- Raised eye pressure
- Retinal vascular damage
- Early optic-nerve damage
- Disease affecting only one eye
- Abnormal retinal changes away from the macula
Regular eye examinations are therefore not only about updating spectacle power.
They can help:
- Detect silent eye disease
- Identify changes in prescription
- Monitor childhood visual development
- Assess eye pressure and glaucoma risk
- Examine the retina and optic nerve
- Review contact-lens safety
- Detect complications of diabetes or hypertension
- Establish a useful baseline for future comparison
Singapore National Eye Centre advises that healthy people may generally undergo community eye screening every one to two years, with more frequent assessment when there is existing eye disease, diabetes or a family history of eye disease. HealthHub also recommends a baseline adult eye screening at approximately age 40, after which the interval should be personalised.
The correct interval depends on:
- Age
- Symptoms
- Family history
- Spectacle prescription
- Contact-lens use
- General health
- Medication
- Previous eye surgery
- Existing eye conditions
The central message is:
A healthy person with no symptoms may reasonably have an eye examination every one to two years, but age, myopia, contact-lens wear, diabetes, glaucoma risk and existing eye disease may justify annual or more frequent assessment. Sudden symptoms should never wait for the next routine appointment.
The Quick Answer
A Practical Eye-Examination Schedule
The following is a practical Singapore-oriented guide for people without an established eye disease:
Birth to Three Years
The eyes should be assessed during routine newborn, paediatric and developmental examinations.
Seek a proper eye assessment earlier when there is:
- An abnormal red reflex
- A white pupil
- Constant squint
- Drooping eyelid
- Persistent tearing
- Light sensitivity
- An eye that appears unusually large
- Poor visual attention
- Prematurity or another developmental risk
HealthHub recommends that babies and children aged three and below have their eyes screened during regular paediatric appointments.
Three to Five Years
Every child should have formal vision screening at least once during the preschool years.
A useful target is around age four, before or near school entry.
Screening during this period aims to detect:
- Amblyopia
- Squint
- Unequal prescriptions
- Significant myopia
- Hyperopia
- Astigmatism
- Media opacity
The US Preventive Services Task Force recommends screening every child at least once between ages three and five to detect amblyopia or its risk factors. Singapore HealthHub likewise advises vision testing at age four.
School-Aged Children and Teenagers
Arrange an eye examination every one to two years when vision is normal.
Arrange at least annual assessment when the child:
- Is myopic
- Wears spectacles
- Has a family history of significant myopia
- Has failed school screening
- Squints or sits unusually close
- Has headaches or intermittent blur
- Is receiving treatment for amblyopia or strabismus
HealthHub advises eye examinations every one to two years for children and teenagers. HPB recommends at least annual eye checks for children who are myopic or have been advised to attend by the School Health Service.
Children receiving active myopia-control treatment commonly require review approximately every six months to monitor:
- Visual acuity
- Prescription
- Axial length
- Treatment adherence
- Side effects
- Treatment response
A 2024 childhood-myopia consensus recommended six-monthly axial-length monitoring after a myopia-control intervention has begun.
Adults Aged 17 to 39
A healthy adult with no symptoms or risk factors may have an eye examination every one to two years.
Attend earlier when there is:
- Blurred vision
- Contact-lens wear
- Eye injury
- Strong family history
- High myopia
- Diabetes
- Hypertension
- Medication that may affect the eyes
SNEC states that healthy individuals may undergo screening every one to two years, with shorter intervals determined by medical history and ocular risk.
Adults Aged 40 to 59
Arrange a baseline comprehensive examination at approximately age 40, even when vision seems normal.
This provides an opportunity to assess for:
- Glaucoma
- Presbyopia
- Cataract
- Retinal disease
- Systemic vascular changes
- Previously undiagnosed refractive error
After the baseline examination, a review every one to two years is reasonable for many healthy adults, although the clinician may recommend a shorter or longer interval according to the findings. HealthHub recommends baseline eye-disease screening from age 40 with subsequent timing determined individually.
Adults Aged 60 and Above
Annual eye examination is a useful practical schedule for most older adults.
The risk of:
- Cataract
- Glaucoma
- Age-related macular degeneration
- Retinal vascular disease
- Dry-eye disease
- Visual impairment from multiple causes
increases with age.
HealthHub recommends annual eye checks after age 60. Singaporeans aged 60 and above may also access Project Silver Screen for basic vision, hearing and oral-health screening, although this functional screening does not replace a comprehensive medical eye examination when disease is suspected.
Routine Schedule at a Glance
Healthy Babies and Toddlers
- Eye assessment during routine paediatric visits
- Immediate referral for abnormal appearance, behaviour or red reflex
Preschool Children
- Formal vision screening at least once between ages three and five
- A practical target is around age four
School-Aged Children
- Every one to two years when vision is normal
- At least annually when myopic or wearing glasses
- Approximately six-monthly during active myopia control
Healthy Adults Below 40
- Every one to two years
Adults From Age 40
- Baseline comprehensive examination
- Follow-up every one to two years or according to risk
Adults From Age 60
- Usually annually
Anyone with Eye Disease or Significant Risk
- Follow the individual schedule given by the eye-care professional
- This may range from several weeks to one or two years
These intervals are guides rather than rigid rules.
A Vision Screening Is Not the Same as a Comprehensive Eye Examination
The terms vision screening, sight test, refraction and eye examination are often used interchangeably.
They are not necessarily the same.
Vision Screening
A vision screening is a brief test designed to identify people who may require further assessment.
It may check:
- Distance visual acuity
- Myopia
- Colour vision
- Basic ocular alignment
School screening is valuable but limited.
Singapore’s school vision screening primarily checks for myopia. HPB states that it is a preliminary test, may occasionally miss cases or produce false-positive findings, and does not screen for every eye condition.
A child may pass school screening and still have:
- Intermittent squint
- Amblyopia affecting one eye
- Hyperopia
- Eye-coordination difficulty
- Retinal disease
- Other ocular abnormalities
Parents should arrange a comprehensive assessment when they remain concerned despite a normal school result.
Refraction or Spectacle Check
A refraction determines the optical prescription required to correct:
- Myopia
- Hyperopia
- Astigmatism
- Presbyopia
A refraction may answer:
- Do I need glasses?
- Has my prescription changed?
- Can my vision improve with correction?
It does not necessarily evaluate:
- Eye pressure
- Optic-nerve health
- Visual field
- Retina
- Macula
- Corneal disease
- Cataract
- Glaucoma
Comprehensive Eye Examination
A comprehensive eye examination may include:
- Medical and eye history
- Unaided visual acuity
- Corrected visual acuity
- Refraction
- Pupil assessment
- Eye-movement and alignment testing
- Peripheral visual-field assessment
- Slit-lamp examination
- Eye-pressure measurement
- Optic-nerve examination
- Retinal and macular examination
- Pupil dilation when appropriate
Additional testing may include:
- OCT
- Corneal topography
- Fundus photography
- Visual fields
- Gonioscopy
- Pachymetry
- Colour-vision testing
- Binocular-vision testing
- Axial-length measurement
HealthHub and SNEC describe comprehensive eye examinations as including vision, pupils, eye muscles, peripheral vision, slit-lamp examination, eye pressure and assessment of the back of the eye.
Why Regular Eye Examinations Matter
Some Eye Diseases Are Silent
Early glaucoma may not cause:
- Pain
- Redness
- Central blur
- Headache
Peripheral visual-field loss may progress gradually without being noticed.
Early diabetic retinopathy may also be present despite:
- Clear vision
- No floaters
- No distortion
- No eye discomfort
Routine examination can identify disease before irreversible visual loss develops.
One Eye May Compensate for the Other
A person may not realise that one eye has become weaker because the better eye continues to function normally.
Separate testing of each eye may identify:
- Amblyopia
- Cataract
- Macular disease
- Optic-nerve disease
- Retinal vascular occlusion
- Unequal prescription
A useful home check is occasionally to cover each eye separately and compare:
- Clarity
- Distortion
- Colour
- Brightness
- Field of vision
A difference requires assessment but is not a substitute for formal examination.
Baseline Tests Allow Future Comparison
A single test result may fall within a broad population range.
Comparison over time may reveal:
- Progressive optic-nerve thinning
- Increasing axial length
- Enlarging visual-field defects
- Progressive corneal steepening
- Changing macular structure
- Increasing cataract
- Worsening retinal lesions
Baseline photographs, OCT or visual fields may therefore become more useful during future review.
Who Needs More Frequent Eye Examinations?
Children with Myopia
A child with established myopia should generally have at least annual review.
A shorter interval, commonly around six months, is appropriate when:
- Myopia is progressing
- The child is young
- Axial length is increasing
- Atropine is used
- Defocus spectacles are used
- Dual-focus contact lenses are used
- Orthokeratology is used
The review should not be limited to issuing stronger glasses.
It should assess:
- Rate of progression
- Axial elongation
- Treatment adherence
- Outdoor time
- Near-work habits
- Treatment side effects
- Whether treatment needs to be intensified
Children Receiving Amblyopia Treatment
Amblyopia treatment may involve:
- Spectacles
- Patching
- Atropine penalisation
- Strabismus management
These children may require reviews every few weeks or months during active treatment.
The interval depends on:
- Age
- Severity
- Treatment method
- Response
- Risk to the better eye
- Adherence
Parents should not stop patching or atropine simply because vision appears better.
Children with Squint
A child with an eye that turns:
- Inward
- Outward
- Upward
- Downward
requires assessment even when the turn is intermittent.
Review frequency depends on:
- Visual acuity
- Amblyopia
- Eye alignment
- Binocular vision
- Need for glasses
- Need for surgery
A new constant squint requires prompt examination.
High Myopia
High myopia increases lifetime risk of:
- Retinal tears
- Retinal detachment
- Myopic macular degeneration
- Myopic choroidal neovascularisation
- Glaucoma
- Cataract
A person with high myopia should have regular dilated retinal and optic-nerve assessment at the interval recommended by the ophthalmologist.
A common practical approach is at least annual review, although more frequent examination may be needed when there is:
- Lattice degeneration
- Previous retinal tear
- Retinal detachment in the other eye
- Myopic macular disease
- New symptoms
- Previous retinal treatment
Sudden flashes, floaters or a curtain should not wait for the annual visit.
Contact-Lens Wearers
Contact lenses are medical devices.
Contact-lens wearers should attend regular reviews even when:
- The lenses remain comfortable
- Vision is clear
- The same product has been worn for years
- Lenses are purchased online
A practical minimum is usually annual review.
More frequent follow-up may be needed for:
- New contact-lens wearers
- Children
- Orthokeratology
- Rigid or scleral lenses
- Dry eye
- Keratoconus
- Recurrent redness
- Previous corneal infection
A contact-lens examination assesses:
- Corneal staining
- Lens movement and centration
- Tear film
- Oxygen-related changes
- Deposits
- Eyelid health
- Replacement and hygiene habits
The CDC advises regular visits to an eye-care professional and confirms that contact lenses require a complete eye examination and proper fitting.
Orthokeratology Wearers
Ortho-K requires a more intensive schedule than ordinary glasses.
Typical follow-up may include:
- After the first night
- During the first week
- At approximately one month
- At regular three- to six-month intervals thereafter
The exact schedule depends on:
- Corneal findings
- Treatment-zone position
- Vision
- Lens condition
- Axial-length progression
- Hygiene
Pain, redness, light sensitivity or reduced vision requires immediate lens removal and urgent assessment.
Diabetes
People with type 2 diabetes should have a dilated comprehensive eye examination when diabetes is diagnosed.
People with type 1 diabetes should generally begin comprehensive retinal examinations within five years of onset.
When repeated examinations show no retinopathy and glucose indicators remain within the agreed range, an interval of one to two years may be considered. When any retinopathy is present, examination should occur at least annually and more frequently when progressing or sight-threatening.
In Singapore, annual diabetic retinal screening remains a practical standard for most patients.
Do not postpone screening because:
- HbA1c has improved
- Vision is clear
- A photograph several years ago was normal
- No injections have been required
Pregnancy with Pre-Existing Diabetes
A person with type 1 or type 2 diabetes who is planning pregnancy should ideally have an eye examination before conception.
An examination should also occur during the first trimester.
Depending on the retinal findings, monitoring may be required:
- Each trimester
- More frequently for active disease
- For up to one year after delivery
Gestational diabetes without pre-existing diabetes does not generally require this retinopathy schedule.
High Blood Pressure
There is no single universal examination interval for every person with uncomplicated hypertension.
A more regular dilated assessment is appropriate when there is:
- Hypertensive retinopathy
- Diabetes
- Kidney disease
- Retinal vein occlusion
- Significant visual symptoms
- Severe or poorly controlled hypertension
Blurred vision or visual loss with a blood pressure above 180/120 mmHg may indicate acute organ damage and requires emergency medical assessment rather than a routine eye appointment.
Family History of Glaucoma
A first-degree relative with glaucoma increases concern, particularly when the affected relative:
- Developed glaucoma young
- Has advanced disease
- Required surgery
- Lost significant vision
Arrange a baseline comprehensive examination earlier rather than waiting until symptoms appear.
Follow-up may include:
- Eye-pressure measurement
- Gonioscopy
- Corneal-thickness measurement
- Optic-disc photography
- OCT
- Visual fields
The interval should be based on the complete risk profile rather than eye pressure alone. Glaucoma guidance supports targeted screening of higher-risk individuals and a baseline comprehensive examination at approximately age 40.
Raised Eye Pressure or Glaucoma Suspect
A person may be classified as a glaucoma suspect because of:
- Raised eye pressure
- Suspicious optic discs
- Thin corneas
- Abnormal visual fields
- Narrow drainage angles
- Family history
- Previous steroid response
Follow-up may range from a few months to approximately one or two years, depending on:
- Degree of risk
- Test reliability
- Change over time
- Treatment status
A glaucoma suspect should not assume that one normal OCT or field test permanently excludes the disease.
Diagnosed Glaucoma
Glaucoma review may be needed every:
- Few weeks after treatment changes
- Several months when stable
- More frequently when progressing
Appointments may involve different combinations of:
- Eye pressure
- Visual fields
- OCT
- Optic-disc assessment
- Gonioscopy
- Medication review
The next appointment should follow the treating ophthalmologist’s schedule rather than an age-based screening calendar.
Cataract
Early cataract may be reviewed periodically when it does not significantly affect daily life.
A shorter interval may be needed when there is:
- Rapidly worsening vision
- Increasing glare
- Driving difficulty
- Diabetes
- Steroid exposure
- Narrow angles
- Uncertainty about retinal health
Cataract surgery is generally based on functional visual difficulty rather than the cataract reaching a particular appearance or age.
Age-Related Macular Degeneration
People with:
- Drusen
- Pigmentary changes
- Intermediate AMD
- AMD in the other eye
- Strong family history
require a personalised retinal-review schedule.
Monitoring may include:
- Visual acuity
- Dilated retinal examination
- OCT
- Fundus photography
- Home Amsler-grid monitoring
New distortion, a central dark patch or sudden central blur requires prompt review rather than waiting for the next planned appointment.
Previous Retinal Tear or Detachment
A person with a previous retinal tear or detachment remains at risk of:
- New tears
- Fellow-eye disease
- Recurrent detachment
- Epiretinal membrane
- Cataract after surgery
Follow the retinal specialist’s schedule.
Seek urgent assessment for:
- New flashes
- Sudden increase in floaters
- A curtain or shadow
- Loss of peripheral vision
- Sudden reduction in vision
Previous Eye Surgery
After:
- Cataract surgery
- LASIK
- SMILE
- PRK
- ICL
- Glaucoma surgery
- Retinal surgery
- Corneal transplantation
the immediate postoperative schedule takes priority over routine screening intervals.
Once the eye is stable, future examinations remain important because surgery does not prevent unrelated age-associated eye disease.
For example:
- LASIK does not prevent glaucoma or cataract.
- Cataract surgery does not prevent retinal disease.
- Retinal surgery does not protect against glaucoma.
- ICL does not eliminate the need for long-term eye-pressure and lens assessment.
Medications That May Affect the Eyes
Certain medicines require a specific eye-monitoring plan.
Examples include:
- Hydroxychloroquine
- Chloroquine
- Long-term corticosteroids
- Ethambutol
- Tamoxifen
- Selected cancer treatments
For hydroxychloroquine, the 2025 AAO revision advises baseline assessment soon after treatment begins, including fundus examination, OCT and fundus autofluorescence. Annual OCT and autofluorescence screening is recommended during treatment, although annual testing may be deferred during the first five years when dosage is appropriate and no major risk factor is present.
Important hydroxychloroquine risk factors include:
- Excess daily dose
- Longer duration
- Kidney disease
- Concurrent tamoxifen
- Older age at treatment initiation
Medication should not be stopped solely because an eye test has been arranged.
The ophthalmologist and prescribing doctor should communicate when toxicity is suspected.
Long-Term Steroid Use
Steroids may be given as:
- Eye drops
- Tablets
- Inhalers
- Injections
- Skin preparations
- Nasal sprays
Significant or prolonged exposure may increase the risk of:
- Raised eye pressure
- Glaucoma
- Posterior subcapsular cataract
The appropriate interval depends on:
- Dose
- Route
- Duration
- Personal pressure response
- Family history
A known steroid responder may require early and repeated eye-pressure checks.
Autoimmune or Inflammatory Disease
People with conditions such as:
- Rheumatoid arthritis
- Lupus
- Ankylosing spondylitis
- Inflammatory bowel disease
- Sarcoidosis
- Thyroid eye disease
may require eye assessment because of:
- Uveitis
- Dry eye
- Scleritis
- Medication toxicity
- Corneal disease
- Optic-nerve or orbital complications
The examination interval depends on symptoms, medication and previous ocular involvement.
Neurological Disease
Eye assessment may form part of care for:
- Multiple sclerosis
- Myasthenia gravis
- Stroke
- Brain tumours
- Parkinson’s disease
- Pituitary disease
- Cranial-nerve palsy
New double vision, visual-field loss or sudden change in vision requires prompt assessment.
Premature Babies
Babies born very prematurely or with very low birth weight may require specialist retinal screening for retinopathy of prematurity.
This follows a neonatal schedule based on:
- Gestational age
- Birth weight
- Retinal findings
- Neonatal history
Parents should follow the neonatal or paediatric ophthalmology schedule exactly.
People with Down Syndrome or Developmental Conditions
These patients have higher risks of selected problems such as:
- Refractive error
- Strabismus
- Keratoconus
- Cataract
- Poor accommodation
They may require earlier and more frequent comprehensive assessment than an ordinary school screening provides.
Previous Eye Injury
A previous injury may lead to delayed complications including:
- Traumatic cataract
- Angle-recession glaucoma
- Retinal tear
- Retinal detachment
- Corneal scarring
- Lens instability
An eye that appears normal soon after trauma may still require later review.
When Not to Wait for a Routine Examination
An age-based schedule applies only when the eyes are stable and there are no concerning symptoms.
Sudden Visual Loss
Seek urgent assessment for sudden loss of vision in one or both eyes.
Possible causes include:
- Retinal artery occlusion
- Retinal vein occlusion
- Retinal detachment
- Vitreous haemorrhage
- Optic neuritis
- Stroke
- Acute glaucoma
New Flashes and Floaters
A few longstanding floaters are common.
Urgent assessment is required for:
- A sudden shower of floaters
- New flashes
- A curtain or shadow
- Loss of peripheral vision
- New blur after the symptoms begin
These may indicate a retinal tear or detachment.
Painful Red Eye
A painful, red or light-sensitive eye may indicate:
- Corneal infection
- Uveitis
- Acute glaucoma
- Scleritis
- Severe corneal abrasion
Contact-lens wearers should remove the lens immediately.
New Double Vision
New double vision may be caused by:
- Cranial-nerve palsy
- Stroke
- Thyroid eye disease
- Myasthenia gravis
- Orbital disease
- Decompensated strabismus
Sudden double vision with neurological symptoms requires emergency assessment.
Chemical Injury
After chemical exposure:
- Irrigate the eye immediately with copious clean water or saline.
- Continue rinsing for at least 20 to 30 minutes.
- Remove contact lenses when possible.
- Seek urgent medical assessment.
Do not delay irrigation while looking for a specialised solution.
Eye Trauma
Seek prompt assessment after:
- High-speed foreign body
- Metal-on-metal injury
- Blunt trauma
- Penetrating injury
- Racquet or ball injury
- Firework injury
Do not press on an eye that may have ruptured.
Warning Signs in Children
Arrange prompt assessment when a child has:
- A white pupil
- Constant eye turn
- Abnormal red reflex
- Persistent head tilt
- Shaking eyes
- Drooping eyelid
- Significant light sensitivity
- One eye appearing larger
- Repeated closure of one eye
- Poor visual attention
- Loss of previously normal visual behaviour
A white pupil in a photograph should not simply be attributed to camera flash without assessment.
What Happens During a Comprehensive Eye Examination?
Medical and Eye History
The clinician may ask about:
- Visual symptoms
- Previous glasses
- Contact lenses
- Eye surgery
- Eye injury
- Family history
- Diabetes
- Hypertension
- Medication
- Occupation
- Driving
- Screen and near-work habits
Visual Acuity
Each eye is tested separately, usually:
- Without correction
- With current correction
- With pinhole when needed
Refraction
Refraction determines whether vision improves with a new optical prescription.
Children may require cycloplegic eye drops to relax focusing and obtain a more accurate result.
Pupil Assessment
Pupil responses may reveal asymmetric retinal or optic-nerve function.
Eye Alignment and Movement
Testing may identify:
- Squint
- Cranial-nerve palsy
- Double-vision disorders
- Thyroid eye disease
- Binocular-vision problems
Slit-Lamp Examination
The slit lamp examines:
- Eyelids
- Tear film
- Conjunctiva
- Cornea
- Anterior chamber
- Iris
- Natural lens
Eye-Pressure Measurement
Eye pressure is one glaucoma risk measurement.
A normal reading does not exclude glaucoma, and a raised reading does not automatically prove glaucoma.
Optic-Nerve and Retinal Examination
The clinician assesses:
- Optic-disc appearance
- Macula
- Retinal blood vessels
- Peripheral retina
- Signs of diabetes or hypertension
- Retinal tears or degeneration
Pupil Dilation
Dilation enlarges the pupil and allows a broader view of the retina.
It is particularly useful for:
- Diabetes
- High myopia
- Flashes and floaters
- Retinal disease
- Reduced vision
- Optic-nerve assessment
- Cataract evaluation
Dilating drops may temporarily cause:
- Glare
- Light sensitivity
- Near blur
- Difficulty driving
Arrange alternative transport when advised.
OCT
OCT uses light to create cross-sectional images of:
- Retina
- Macula
- Retinal nerve-fibre layer
- Optic nerve
It helps monitor:
- Glaucoma
- AMD
- Diabetic macular oedema
- Epiretinal membrane
- Macular hole
- Other retinal conditions
An OCT is an adjunct to clinical examination rather than a universal stand-alone screening test.
Visual Fields
A visual-field test may be used for:
- Glaucoma
- Neurological disease
- Optic-nerve disorders
- Retinal disease
- Driving assessment
Corneal Topography
Topography maps corneal shape.
It may be appropriate for:
- Keratoconus
- Increasing astigmatism
- Contact-lens fitting
- Orthokeratology
- Refractive-surgery assessment
Which Eye-Care Professional Should I See?
Optometrist
An optometrist may provide:
- Visual assessment
- Refraction
- Spectacle prescribing
- Contact-lens fitting
- Basic ocular-health evaluation
- Myopia management
- Referral when medical disease is suspected
Ophthalmologist
An ophthalmologist is a medically trained eye specialist who diagnoses and treats eye disease using:
- Medication
- Laser
- Injections
- Surgery
- Specialist monitoring
An ophthalmologist is particularly appropriate when there is:
- Eye disease
- Surgery
- Significant retinal risk
- Glaucoma
- Unexplained visual loss
- Pain
- Trauma
- Abnormal screening findings
Optician
An optician primarily dispenses and fits spectacles and optical appliances according to the applicable scope of practice.
A spectacle purchase should not be assumed to include a comprehensive medical eye assessment.
Common Myths
“I Can See Clearly, So I Do Not Need an Eye Examination”
False.
Glaucoma and diabetic retinopathy may develop before central vision changes.
“An Eye Examination Is Only for People Who Wear Glasses”
False.
Eye disease can occur without refractive error.
“School Screening Checks for Every Childhood Eye Problem”
False.
Singapore’s school screening primarily checks for myopia and is not a complete eye examination.
“My Child Passed Screening, So Amblyopia Is Impossible”
False.
Screening tests are not perfect, and new problems may develop later.
“A Glasses Check Includes an Examination of the Retina”
Not necessarily.
Ask what the appointment includes.
“Eye Pressure Alone Screens for Glaucoma”
False.
Glaucoma assessment may require:
- Optic-nerve examination
- OCT
- Visual fields
- Gonioscopy
- Corneal thickness
“A Normal Eye Pressure Means I Cannot Have Glaucoma”
False.
Normal-tension glaucoma occurs despite pressure readings within the statistically normal range.
“I Had LASIK, So I No Longer Need Eye Examinations”
False.
LASIK changes the cornea but does not prevent:
- Glaucoma
- Cataract
- Retinal disease
- Presbyopia
“Cataract Surgery Means the Eye Is Permanently Healthy”
False.
Other eye diseases can still develop.
“I Only Need an Examination When My Prescription Changes”
False.
Prescription stability does not prove retinal or optic-nerve stability.
“Diabetes Screening Is Unnecessary When HbA1c Is Good”
False.
Good control reduces risk but does not eliminate it.
“A Retinal Photograph Replaces Every Other Test”
False.
Photography may not adequately assess:
- Eye pressure
- Cornea
- Cataract
- Visual field
- Refraction
- Eye alignment
“Dilation Is Required at Every Appointment”
Not always.
The need depends on:
- Age
- Symptoms
- Prescription
- Diagnosis
- Purpose of the examination
“Annual Examinations Are Excessive for Everyone”
Not everyone requires an annual comprehensive examination.
Healthy low-risk adults may reasonably attend every one to two years.
“Two Years Is Always Safe”
No.
Symptoms, risk factors and existing disease override routine intervals.
Frequently Asked Questions
Should I Have an Eye Examination Every Year?
Annual examination is particularly sensible when you:
- Are aged 60 or above
- Wear contact lenses
- Have diabetes
- Have high myopia
- Have an existing eye condition
- Have significant family history
- Take medication affecting the eyes
Healthy low-risk adults may be advised every one to two years.
At What Age Should a Child Have Their First Eye Test?
The eyes should be observed during routine infant and paediatric checks.
Every child should undergo formal vision screening at least once between ages three and five.
Is School Screening Enough?
Not when:
- The child has symptoms
- The child is myopic
- There is a squint
- The child has failed screening
- Parents remain concerned
- There is significant family history
How Often Should a Myopic Child Be Checked?
At least annually.
Approximately six-monthly review is appropriate when myopia is progressing or active myopia-control treatment is being used.
How Often Should Contact-Lens Wearers Be Checked?
A practical minimum is usually annually.
Attend sooner for:
- Redness
- Pain
- Reduced comfort
- Fluctuating vision
- Recurrent deposits
- Difficulty removing the lens
How Often Should Someone with Diabetes Be Checked?
Type 2 diabetes requires retinal assessment at diagnosis.
Type 1 diabetes generally requires initial assessment within five years of onset.
Examinations are usually annual, although selected well-controlled patients with repeated normal results may be considered for one- to two-year intervals. Existing or progressing retinopathy requires more frequent assessment.
Does High Blood Pressure Mean I Need Annual Eye Examinations?
Not automatically in every uncomplicated case.
Annual or more frequent assessment is reasonable when there is:
- Hypertensive retinopathy
- Diabetes
- Kidney disease
- Visual change
- Retinal vascular disease
How Often Should I Be Checked for Glaucoma?
The interval depends on:
- Age
- Family history
- Eye pressure
- Optic-disc appearance
- Corneal thickness
- Drainage angle
- Visual fields
- OCT
A baseline examination around age 40 is useful, with earlier assessment for a strong family history.
Is a Dilated Examination Necessary?
It is especially valuable for:
- Diabetes
- High myopia
- Flashes and floaters
- Retinal disease
- Unexplained visual loss
- Macular disease
- Certain optic-nerve conditions
Can an Eye Examination Detect General Medical Disease?
Eye findings may suggest or document effects of:
- Diabetes
- Hypertension
- Autoimmune disease
- Neurological disease
- Thyroid disease
- Blood disorders
- Medication toxicity
An eye examination does not replace general medical assessment.
Can I Drive After Dilation?
Some people retain adequate distance vision, while others experience significant glare or blur.
It is safer to arrange alternative transport when dilation is expected.
What Should I Bring?
Bring:
- Current spectacles
- Contact lenses and packaging
- Medication list
- Previous eye reports
- Family eye history
- Recent diabetes or blood-pressure results
- Relevant referral letters
Should I Stop Contact Lenses Before the Appointment?
For an ordinary contact-lens check, wear them as instructed so the fit can be assessed.
For:
- Corneal topography
- LASIK assessment
- Keratoconus evaluation
- Precise corneal measurement
the clinic may ask you to stop lenses in advance.
What if My Examination Was Normal?
Follow the recommended interval.
A normal examination is reassuring but does not guarantee lifelong protection.
An Eye-Examination Checklist
Babies and Young Children
- Are the eyes straight most of the time?
- Do both pupils appear dark and equal?
- Does the child follow faces and objects?
- Is there persistent tearing or light sensitivity?
- Has formal preschool vision screening been completed?
School-Aged Children
- Can the child see the board?
- Is the child squinting?
- Are books or screens held very close?
- Is one eye being closed?
- Is myopia being reviewed regularly?
- Is axial length being monitored during myopia control?
Adults
- When was my last comprehensive examination?
- Was my eye pressure measured?
- Was the retina examined?
- Do I know my family eye history?
- Has my prescription changed?
- Do I wear contact lenses safely?
Adults Aged 40 and Above
- Have I had a baseline glaucoma and eye-disease assessment?
- Is near vision becoming difficult?
- Is night glare increasing?
- Do I have diabetes or hypertension?
- Is there family history of glaucoma or AMD?
Adults Aged 60 and Above
- Am I attending annual examinations?
- Is cataract affecting driving or reading?
- Have I noticed distortion?
- Is one eye worse than the other?
- Are glaucoma, diabetes and AMD being monitored?
Seek Earlier Assessment for
- Sudden blur
- New distortion
- Flashes or floaters
- Curtain or shadow
- Eye pain
- Redness with light sensitivity
- Double vision
- Eye trauma
- Chemical exposure
- A white pupil in a child
The Bottom Line
There is no single examination interval that suits every person.
A practical schedule for healthy people is:
- Babies and toddlers: eye assessment during routine paediatric care
- Preschool children: formal vision screening at least once between ages three and five
- Children and teenagers: every one to two years
- Myopic children: at least annually
- Children receiving myopia control: approximately every six months
- Healthy adults: every one to two years
- Adults aged 40 and above: baseline comprehensive screening followed by an individualised schedule
- Adults aged 60 and above: usually annually
Singapore National Eye Centre advises that healthy people may undergo eye screening every one to two years, while those with existing eye conditions, diabetes or family history may require more frequent checks.
The routine age schedule should be shortened when there is:
- Myopia
- Contact-lens wear
- Diabetes
- High blood pressure
- Glaucoma risk
- High myopia
- Existing cataract or retinal disease
- Eye medication requiring toxicity screening
- Previous surgery
- Significant family history
Do not wait for a routine appointment when there is:
- Sudden visual loss
- New distortion
- Flashes and floaters
- A curtain or shadow
- Painful redness
- New double vision
- Chemical injury
- Significant eye trauma
The most important message is:
Regular eye examinations protect more than spectacle clarity. They help detect silent disease, monitor risks that change with age and preserve vision by finding problems while treatment is most effective.
References
- Singapore National Eye Centre. General Eye Examination. Current information accessed August 2026.
- HealthHub Singapore. Eye Examinations for Eye Diseases.
- Singapore National Eye Centre. Eye Exams: What a Complete Eye Examination Includes.
- Health Promotion Board Singapore. Health Screening for Primary School.
- Health Promotion Board Singapore. Good Eye Care Habits.
- US Preventive Services Task Force. Vision Screening in Children Aged Six Months to Five Years.
- Lawrenson JG, et al. UK and Ireland modified Delphi consensus on myopia management in children and young people. 2024. PMID: 39295273.
- American Diabetes Association Professional Practice Committee. Retinopathy, neuropathy and foot care: Standards of Care in Diabetes—2026.
- Marmor MF, Ahn SJ, Ehlers JP, et al. Recommendations on screening for hydroxychloroquine retinopathy: 2025 revision. Ophthalmology. 2026. PMID: 41232611.
- Centers for Disease Control and Prevention. Why Eye Exams Are Important.
- Centers for Disease Control and Prevention. About Contact Lens Types.
- American Academy of Ophthalmology Preferred Practice Pattern Glaucoma Committee. Primary Open-Angle Glaucoma Suspect Preferred Practice Pattern. Ophthalmology. 2026. PMID: 41665582.
- HealthHub Singapore. See, Hear and Eat Better—Project Silver Screen.
- HealthHub Singapore. Making Eye Health a Priority.
