Screening check
Should I be screened for vision problems after 65?
Poor eyesight is common in older adults and can creep up slowly. The US Preventive Services Task Force looked at whether adults 65 and older who have not noticed a problem should have a vision test in primary care. Check what it says for you.
About you
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What you will see
What the USPSTF says about vision screening for you.
Educational only, not medical advice. Talk to a clinician about any change in your eyesight.
Source
US Preventive Services Task Force, May 2022 recommendation on screening for impaired visual acuity in older adults.
Validated in
Adults 65 and older seen in primary care who have no known vision impairment and are not seeking care for vision problems.
Limits
It is not an eye test. It does not cover people with vision symptoms or vision loss from another condition such as diabetic retinopathy, and it is not about glaucoma, which has a separate USPSTF statement.
What the USPSTF recommends
| Who | Recommendation | Grade |
|---|---|---|
| Adults 65 and older who have not noticed a vision problem | Evidence is insufficient to weigh the benefits and harms of vision screening in primary care | I |
The 2022 statement is consistent with the 2016 I statement (USPSTF 2022). It applies to adults 65 and older seen in primary care without known impaired visual acuity who are not seeking care for vision problems. It does not apply to people who report signs and symptoms of vision loss, seek care for vision problems, or have vision loss related to another medical condition such as diabetic retinopathy. For people with symptoms, clinicians should use their judgement on how to evaluate them (USPSTF 2022). Glaucoma has its own USPSTF recommendation (also an I statement) (USPSTF 2022).
Why it matters
In 2011, about 12% of US adults aged 65 to 74 and 15% of those 75 or older reported problems seeing, even with glasses or contact lenses (USPSTF 2022). Refractive errors are the most common cause. About half of cases of low vision in both eyes in adults 40 or older are caused by cataracts, and an estimated half of US adults 75 or older have cataracts. Age-related macular degeneration (AMD) is the leading cause of blindness in adults older than 65 (USPSTF 2022). Vision changes can be subtle, progress slowly or appear late, so older adults may not notice or report them (USPSTF 2022).
Why the evidence falls short
Four randomized trials with 4,819 older adults compared vision screening in primary care–type settings with no screening, usual care or delayed screening, and found no difference in visual acuity, vision disorders or vision-related problems with daily function (USPSTF 2022). Eye-chart tests had poor accuracy compared with a full eye exam, and screening questions were not accurate (USPSTF 2022). Treatments such as glasses, cataract surgery and AMD treatments do work once a problem is found, but they have not been studied in people found by screening (USPSTF 2022). The harms of screening in primary care have not been adequately studied (USPSTF 2022).
Common questions
Does "insufficient evidence" mean I should skip eye exams?
No. An I statement means the evidence could not show whether screening in primary care helps or harms people without symptoms. It is not a recommendation against eye care. If your eyesight has changed, tell a clinician.
What tests are used?
In primary care the most common is an eye chart, such as the Snellen chart. Others include the pinhole test, the Amsler grid for central vision and a look at the inside of the eye (fundoscopy) (USPSTF 2022).
Also see the glaucoma screening check, the hearing loss screening check, the fall risk check, the diabetes screening check and all screening tests by age.
Sources
- US Preventive Services Task Force. Screening for Impaired Visual Acuity in Older Adults: US Preventive Services Task Force Recommendation Statement. JAMA. 2022;327(21):2123-2128. www.uspreventiveservicestaskforce.org/uspstf/recommendation/impaired-visual-acuity-screening-older-adults
Written and maintained by the uncovermyrisk.com editorial team. We do not have a medical reviewer; every claim links to its primary source above. Last reviewed: 2026-10-30. Spotted an error? See About.