ST. LOUIS—After a systematic review of the evidence and assessment of the benefits and harms of treatment options, the American Optometric Association's (AOA) Evidence-based Optometry Committee has offered a new consensus on the frequency of eye exams for adults ages 18-39 and details the potential components of a comprehensive adult eye examination. Within the second edition of the AOA evidenced-based clinical practice guideline, the organization said there are new statistics, 14 evidence-and consensus-based action steps within it, a partial list of systemic diseases with ocular complications and a slight, but significant, shift in a recommendation on the frequency of care.

"Comprehensive Adult Eye and Vision Examination, Second Edition is posted here.

Originally published in 2015, the updated adult eye and vision examination guideline was developed over 16 months and “describes appropriate examination procedures for evaluation of the eye health and vision status of adult patients to reduce the risk of vision loss and provide clear, comfortable vision. It contains recommendations for timely diagnosis, intervention, and, when necessary, referral for consultation with and/or treatment by another health care provider.”

The guideline's objectives, the AOA said, include enabling doctors of optometry to:

  • Recommend appropriate timetables for eye and vision examinations for adults.

  • Select appropriate examination procedures for adults.

  • Examine eye health, vision status and ocular manifestations of systemic disease in adults.

  • Minimize/avoid the effects of eye and vision problems in adults through prevention, early detection and diagnosis, and patient management through education and counseling.

  • Inform/educate individuals and other health care practitioners on the importance of good vision and the need for, and frequency of, comprehensive adult eye and vision exams.
“The goal of the Evidence-based Optometry (EBO) Committee is to develop a guideline that all of optometry can follow, to adjust their practice based on what the best evidence shows,” said Carl Urbanski, OD, chair of the EBO Committee, who was also on hand for the release of the first adult eye guideline. He noted, “Doctors of optometry are lifelong learners, and the committee took the most current evidence and delivered it in a format that works for our clinicians, so they can adjust their mode of practice to fit what the evidence shows is the best way to approach diagnosis and care of the patient. It also serves as a resource to other health care professions, as well as the public.”

Stated AOA president Ronald L. Benner, “This update solidifies the work and commitments of the AOA to create an evidence-based guideline tool for our doctors to provide the care our patients deserve. The amount of volunteer time that was spent to produce and get this guideline right shows the commitment that the AOA has made to advance the patient care provided by optometry across the country.”

More details about the new AOA Practice Guidelines are posted here.

In response to a question from VMAIL, an AOA spokesperson said, "The guideline includes a strong consensus statement, recommending comprehensive eye and vision examinations annually for people 18 to 39 years of age to optimize visual function, evaluate eye changes and provide for the earlier detection of sight-threatening eye and systemic health conditions. The guideline focuses explicitly on clinical guidance for delivering an in-person, comprehensive eye exam."

The spokesperson pointed out, "The AOA Position Statement Regarding Telemedicine in Optometry" was most recently updated in October 2022. Developed by the AOA Telehealth Council and approved by the AOA board, the position statement builds on a year’s worth of feedback gleaned from a joint AOA-industry listening session, known as the Patient Experience Summit.

"The AOA Position Statement on Telemedicine in Optometry has several highlights, including updated criteria for ensuring high-quality telemedicine in optometry, effects on the doctor-patient relationship and the use of direct-to-patient technologies, wording regarding the appropriate use of augmented or artificial intelligence and information on use cases related to telemedicine in optometry. Just as technology evolves, the AOA is committed to engaging with stakeholders to evaluate the advances in telemedicine and consistently update this policy," the spokesperson said.