Comprehensive Adult Medical Eye Evaluation Preferred Practice Pattern

Patients may seek to undergo a comprehensive adult medical eye evaluation for a variety of reasons. An evaluation is typically recommended for patients who have not been seen by an ophthalmologist for an extended period of time or and for those who have never been examined. Recommended intervals between comprehensive examinations vary with age and risk factors. A thorough ophthalmic evaluation can detect common abnormalities of the visual system and its related structures as well as less common yet extremely serious issues. Such evaluations can also uncover evidence of systemic disease through its associated ophthalmic manifestations. With appropriate and timely intervention, visually impairing conditions such as cataract, and potentially blinding diseases such as glaucoma, age-related macular degeneration, and diabetic retinopathy often have favorable outcomes. The rationale for performing periodic comprehensive medical eye examinations in adults without known ocular conditions or risk factors is to detect ocular diseases, visual dysfunction, or ophthalmic signs of systemic disease. Early recognition, counseling, and treatment may preserve visual function or, in the case of systemic disease, prevent serious illness or even premature death from occurring. Irreversible vision loss has been associated with adverse effects on quality of life and mental health, and self-reported visual loss has been found to be associated with depression. Comprehensive medical eye evaluations are also performed to evaluate new symptoms and to monitor patients with previously identified eye conditions or risk factors. The public health impact of eye disease is substantial. The components of a comprehensive medical eye evaluation include a history, physical and laboratory examination, diagnosis, and initiation of management. The examination includes a careful evaluation for ophthalmic disorders; the treatment plan addresses refractive errors and ocular disease; and referrals are initiated when systemic disease is detected.