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Can People With 20/20 Vision Need Regular Eye Exams?

Even though it is recommended that everyone gets an annual eye examination with an eye doctor, most people often skip this appointment. The logic behind this is simple: I have perfect vision, and no problems going about my daily activities, so I don’t need an eye exam. In fact, some people will even decide to substitute an eye exam with an online vision check, or a vision check in a shop window, and come up with a more scientific sounding reason: My vision is 20/20, how can people with 20/20 vision need regular eye exams.

The answer for this is simple. Perfect vision does not mean perfect eye health. In fact, most of the major eye problems are actually without symptoms and do not affect vision, in at least the early stages.

What are the components of a comprehensive eye examination?

It is important to remember that in India, optometrists and opticians do not perform an eye evaluation beyond the power of glasses. So a vision test can actually give you a false sense of security about the health of your eye.

Comprehensive eye exams are performed by eye doctors and involve not only checking your vision and power of glasses, but also the complete health of your eyes. This include measuring your eye pressures, eye alignment, as well as evaluation of the front (anterior segment) and back of the eye (including retina and optic nerve).

An annual eye exam consists of the following even for people with 20/20 vision:

  1. Test for Vision: Vision for near and distance is checked, and in case of children, sometimes the doctor will order a dilated check for power of glasses, because children can actually have 20/20 vision despite needing glasses.

  2. Testing of eye pressure: An eye pressure check is mandatory after the age of forty because elevated eye pressures are related to glaucoma, a disease which can cause irreversible vision loss, and has no symptoms till very advanced stages.

  3. Testing for overall health of the eye, including a dilated evaluation of lens and retina: In addition to measuring your eye pressures and checking the power of glasses needed, your eye doctor will check for eye diseases and also look for the impact of systemic diseases like diabetes and high blood pressure on the eye.

Which are the common diseases which can be picked up by a comprehensive and regular eye exam even in patients with 20/20 vision?

People with 20/20 vision must have a comprehensive eye evaluation because, perfect vision can actually mask these potentially serious eye problems also. These include dry eye, eye allergies, cataract, glaucoma, age related macular degeneration, diabetic eye disease, hypertensive eye disease and even eye tumors. All of these diseases can actually coexist, at least in the early stages, with perfect 20/20 vision.

What are the benefits of regular eye exams for people with 20/20 vision?

These include:

  • Establishing a baseline, so any changes in eye structure or vision can be picked up faster after comparing with previous eye examinations.

  • Early detection and management of eye diseases means better eye health and vision in the long run.

  • Sometimes several systemic diseases like diabetes, high blood pressure and even some cancers like leukemia can be diagnosed and monitored by a comprehensive eye check-up.

How often do people with 20/20 vision need a regular eye exam?

The frequency of eye examination depends on your age and general physical health. However, most adults, people even with 20/20 vision, need an annual eye check-up and your doctor will usually inform you if your next check needs to be scheduled earlier. A general rule of thumb for comprehensive eye exams is:

  • Age 6 months

  • Age 3

  • Age 5 or 6 – before joining school and every two years thereafter

  • Age 18 to 40 – at least every two years, preferable every year

  • Age 41 and older – at least once every year


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