You’re 60 and Haven’t Had a Dilated Eye Exam? Here’s What You Should Know

If you are 60 or older and your vision still feels “good enough,” it is easy to assume your eyes are healthy. You may still read, drive, watch television, and manage daily tasks without much trouble. But vision alone does not always tell the full story.

Several eye diseases become more common with age, and many begin without obvious symptoms. A comprehensive dilated eye exam helps an eye doctor look beyond your glasses prescription and examine the retina, optic nerve, macula, lens, and blood vessels inside the eye.

The National Eye Institute recommends a dilated eye exam every one to two years for adults over 60, with more frequent exams for some people based on their health and risk factors.

Below are the most important things to know if you have not had a dilated eye exam recently.

1. Seeing clearly does not always mean your eyes are healthy

Many people wait for blurry vision before scheduling an eye exam. The problem is that some eye diseases remain quiet during their early stages.

Glaucoma often begins without symptoms. Vision loss usually develops slowly, starting with side vision, so people may not notice the change until the disease has progressed. The National Eye Institute notes that about half of people with glaucoma do not know they have it.

Early age-related macular degeneration may also cause no symptoms. A person may continue reading and recognizing faces while changes are already developing in the macula, the part of the retina responsible for detailed central vision.

Why it’s missed: People often judge eye health by how clearly they see at that moment.

2. A vision test is not the same as a dilated eye exam

Reading letters from an eye chart checks visual sharpness. It helps identify whether glasses or contact lenses might improve your vision.

A dilated eye exam goes further.

During dilation, drops widen the pupils so the doctor can examine a larger area inside the eye. This gives a clearer view of the retina, optic nerve, macula, blood vessels, and lens. It helps identify eye disease before symptoms become obvious.

A comprehensive exam may also include:

• visual acuity testing

• peripheral vision testing

• eye-pressure measurement

• pupil response testing

• eye-muscle evaluation

• examination of the retina and optic nerve

Why it’s missed: Many people assume an updated glasses prescription means they have received a complete eye-health evaluation.

3. Several common age-related conditions are easier to manage when found early

A dilated eye exam helps detect several conditions which become more common with age.

Glaucoma

Glaucoma damages the optic nerve and often develops without early warning signs. Early detection allows treatment to begin before more vision is lost.

Age-related macular degeneration

AMD affects central vision and becomes more common after age 55. Early AMD may not cause symptoms, which is why regular eye exams matter.

Cataracts

Cataracts develop when the natural lens becomes cloudy. Early cataracts may not cause noticeable symptoms, but later changes include blurry vision, faded colors, glare, and trouble seeing at night.

Diabetic retinopathy

Diabetes can damage small retinal blood vessels before a person notices vision changes. Dilated exams help identify bleeding, leakage, or swelling early.

Why it’s missed: These conditions often develop gradually, giving people time to adapt to subtle changes.

4. One eye often compensates for the other

Eye disease does not always affect both eyes equally.

If one eye loses some vision gradually, the stronger eye may take over. The brain combines information from both eyes and often hides the difference during everyday activities.

A person may not notice a problem until they cover one eye, struggle with depth perception, or experience more advanced changes.

This compensation is one reason regular exams matter even when daily vision seems stable.

Why it’s missed: The stronger eye masks changes happening in the weaker eye.

5. Changes blamed on aging may still need treatment

Some changes are common as people grow older. Many adults need brighter light to read, stronger near correction, or more time adjusting between bright and dark environments.

Still, age should not become an automatic explanation for every change.

Symptoms worth discussing include:

• increasing glare while driving

• trouble seeing at night

• wavy or distorted lines

• faded colors

• difficulty recognizing faces

• reduced side vision

• repeated prescription changes

• blur in one eye

• new floaters or flashes

Cataracts, AMD, glaucoma, retinal disease, and prescription changes can all affect vision differently. An exam helps separate normal aging from a condition needing monitoring or treatment.

Why it’s missed: Gradual changes often feel like an unavoidable part of getting older.

6. Your general health affects your eye risk

Eye health is closely connected to overall health.

Diabetes and high blood pressure increase the importance of regular eye exams. The National Eye Institute states that most people with diabetes or high blood pressure need a dilated eye exam at least once a year, though the right schedule depends on individual risk.

Your doctor should also know about:

• family history of glaucoma or macular degeneration

• smoking history

• previous eye surgery

• severe nearsightedness

• steroid use

• cardiovascular disease

• past eye injuries

These details help determine how often your eyes should be checked.

Why it’s missed: People often separate eye care from their broader medical history.

7. Early detection helps protect independence

Vision supports much more than reading an eye chart. It affects driving, walking, balance, medication management, cooking, and recognizing faces.

Untreated vision problems can make daily activities harder and may increase fall risk. The CDC advises older adults to receive regular dilated eye exams as part of protecting vision and reducing preventable vision loss.

Finding changes early often means:

• more treatment options

• closer monitoring

• better planning

• reduced risk of preventable vision loss

• greater confidence with daily activities

Why it’s missed: People often think eye exams protect eyesight alone, rather than overall independence.

What happens during a dilated eye exam?

A dilated exam is usually straightforward.

First, the doctor checks your vision and asks about symptoms, health conditions, medications, and family history. Eye pressure and peripheral vision may also be tested.

Next, drops are placed in the eyes to widen the pupils. Once the pupils open, the doctor uses lights and magnifying lenses to examine the internal structures of the eye.

The exam itself is generally painless. Afterward, near vision may remain blurry and the eyes may feel sensitive to light for several hours. Sunglasses often help. Some patients prefer arranging transportation, especially if they do not feel comfortable driving after dilation.

How often should someone over 60 have an exam?

The National Eye Institute recommends a comprehensive dilated eye exam every one to two years for adults over 60. Some people need yearly or more frequent monitoring based on medical history, eye findings, and risk factors.

You may need a shorter interval if you:

• have diabetes or high blood pressure

• have glaucoma or a glaucoma risk

• have macular degeneration

• have a family history of serious eye disease

• previously had retinal disease or eye surgery

• take medications which affect the eyes

• notice new visual symptoms

Your eye doctor should recommend a schedule based on your individual needs.

Do not wait for a routine appointment if symptoms appear suddenly

Some symptoms need faster evaluation.

Contact an eye doctor promptly for:

• new flashes of light

• a sudden increase in floaters

• a dark curtain or shadow

• sudden vision loss

• new distortion

• eye pain

• double vision

• new halos around lights

• marked redness with blurred vision

The CDC advises seeking care for decreased vision, eye pain, double vision, floaters, halos, flashes, or significant redness rather than waiting for the next routine visit.

What this means for your eyes

Turning 60 does not mean vision loss is inevitable. It does mean regular eye care becomes more important.

A dilated eye exam looks for problems your daily vision might not reveal. It helps find glaucoma, macular degeneration, cataracts, diabetic eye disease, and other changes while there is still time to monitor or treat them.

If you have not had a dilated eye exam in the past one to two years, scheduling one is a practical step toward protecting your sight and independence.

Book with us

If you are 60 or older and have not had a recent dilated eye exam, schedule an evaluation with South Bay Retina. Our team can examine your retina, optic nerve, and overall eye health and recommend the right follow-up schedule for you.

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