A Hearing and Vision Check-Up Schedule After 60

The schedule at a glance

These are general intervals; individual needs differ.

Eyes - Healthy older adult, no known eye disease: a comprehensive eye examination every one to two years after sixty, including a dilated examination if advised. - Diabetes: a dilated retinal examination at least yearly, or as the eye doctor directs. - Glaucoma, macular degeneration, previous retinal problems or cataract surgery: as the eye specialist advises, often every three to twelve months. - Family history of glaucoma, very short- or long-sightedness, or steroid use: possibly more often. - New symptoms or sudden changes: immediately.

Ears and hearing - A baseline hearing test around sixty to sixty-five, if not already done. - Then every one to three years, or as advised, even if no problem is noticed. - Hearing aid users: at least yearly, and when the aids seem less effective. - Noise exposure, diabetes, kidney disease or ototoxic medicines: more often, as the doctor advises. - New symptoms: promptly; sudden hearing loss is an emergency.

Ear examination for wax: whenever there is a blocked feeling, hearing aid problems, or at least yearly for hearing aid users or those with recurrent wax.

Why regular checks matter

• Many eye diseases are painless and gradual. By the time vision is noticeably worse, damage may be permanent. See do you know about the silent thief of sight, glaucoma and glaucoma and macular degeneration: practical home support.
• Hearing loss usually creeps in, and people adapt; testing finds it before relationships and safety suffer. See signs of hearing loss in parents and how to raise it gently.
• Both senses affect falls, driving, medicine use, mood and thinking. See falls risk assessment at home and hearing aids and dementia risk: what the evidence says.
• Glasses and hearing aids need updating as the eyes and ears change.
• Some eye problems reveal systemic disease, such as diabetes or high blood pressure; see can your eyes tell you about your health.

What an eye check includes

A comprehensive eye examination by an optometrist or ophthalmologist may include:

• History: symptoms, medicines, diabetes, blood pressure, family history, previous surgery.
• Visual acuity: reading letters at distance and near, with and without glasses.
• Refraction: checking for glasses prescription.
• Eye pressure (tonometry) for glaucoma.
• Examination of the front of the eye with a slit lamp for cataract and other changes.
• Dilated examination of the retina and optic nerve, with drops that enlarge the pupils, to look for diabetic retinopathy, macular degeneration, glaucoma damage and other disease.
• Visual field test if glaucoma or neurological problems are suspected.
• Retinal imaging or OCT scan in some cases.
• Discussion: results, glasses, eye health, driving and safety.

After dilating drops, vision stays blurry and sensitive for some hours: bring sunglasses and a companion, and avoid driving. See diabetic eye care for older adults and cataract surgery: when you need it.

What a hearing check includes

• History: hearing difficulties, ringing, dizziness, ear problems, noise exposure and medicines.
• Looking in the ears for wax, infection and eardrum condition.
• Pure-tone audiometry, in a quiet booth, to find the softest sounds heard at different pitches.
• Speech tests, with or without noise.
• Middle ear tests if needed.
• Discussion of results, and options: wax removal, medical referral, hearing aids, assistive devices and communication tips.

See a hearing test: what to expect and ear wax and hearing: safe care.

Who to see

• Optometrist: tests vision, prescribes glasses and screens for eye disease; refers to an ophthalmologist when needed.
• Ophthalmologist: a doctor who diagnoses and treats eye disease and performs surgery, such as cataract and glaucoma surgery and retinal treatment.
• Audiologist: tests hearing, fits hearing aids and counsels; see hearing aids: types, costs and how to choose.
• ENT (ear, nose and throat) doctor: examines and treats ear disease, wax, infection, dizziness and sudden hearing loss.
• Family doctor or geriatrician: coordinates, checks medicines and general health, and refers.
• Low vision specialist or occupational therapist: when vision is reduced despite treatment; see low vision home safety: contrast, labels and layout.
• Diabetes team: for eye screening in diabetes.

Urgent signs: do not wait for the schedule

Eyes: go to an eye hospital or doctor at once for: - Sudden loss or reduction of vision in one or both eyes. - A curtain or shadow across the vision, new flashes of light or a shower of floaters. - Severe eye pain, with redness, halos around lights, headache, nausea or vomiting. - Distorted or wavy straight lines or a dark spot in the centre. - A red, painful eye with light sensitivity, or after an injury. - Double vision of sudden onset.

Ears: see a doctor urgently for: - Sudden hearing loss in one or both ears, with or without ringing. - Ear pain, discharge or bleeding. - Severe dizziness or vertigo, especially with vomiting. - Tinnitus in one ear only, or pulsing in time with the heartbeat; see ringing in the ears (tinnitus) at home.

Call 112 for sudden vision or hearing loss with weakness, facial droop, speech difficulty or confusion, which may be stroke.

Preparing for the appointments

• Book early, and choose a time of day when your parent is alert. Avoid tiring days.
• Bring the list of medicines, previous reports, current glasses and hearing aids, and a note of problems and questions.
• Bring a companion to help, take notes and ensure safe travel.
• Tell the clinic about difficulties: mobility, hearing, vision, memory or anxiety, so that they adapt.
• Sunglasses for dilation, and a snack.
• Arrange transport, since driving after dilation is unsafe.
• Tell the doctor about diabetes, blood pressure and heart conditions, and any recent changes.
• Ask for written results and explanations in plain language.
• Do not put anything in the ears beforehand, and avoid loud noise before a hearing test.

After the appointment

• Write down the advice, new glasses, drops, hearing aid plans and next visit dates.
• Put the next appointment on a family calendar and set reminders.
• Fill prescriptions; see eye drops made easy: tips for older hands.
• Update glasses and hearing aids as advised, and check that they are being used; see the first weeks with a hearing aid: what to expect.
• Make home changes such as lighting; see lighting for older eyes: brightness, colour and glare.
• Keep records in one place; see keeping a health record at home.
• Share findings with the family doctor.

A simple family checklist

1. Eye exam booked for this year? Date: ____ 2. Hearing test booked or done in the last one to three years? Date: ____ 3. Diabetes eye screening yearly? 4. Glaucoma, AMD or cataract follow-up on schedule? 5. Glasses and hearing aids working, clean and worn? 6. Spare glasses and batteries? 7. Lighting and safety checked at home? 8. Medicines and eye drops reviewed? 9. Emergency signs known to the family? 10. Next check-up dates saved on the calendar?

Cost and access

Costs vary by clinic and tests. Government hospitals, eye banks, trusts and community camps may offer free or low-cost screening, glasses and cataract surgery. Ask the nearest eye hospital and see government schemes for senior citizens and health insurance for senior citizens in India. Be careful with roadside testing or door-to-door sales; seek qualified professionals.

When to ask a professional

Ask the family doctor to include eyes and ears in annual check-ups, and for referrals. Ask the eye doctor how often your parent should return, and the audiologist about hearing follow-up. Ask a pharmacist about eye drops. Go at once for sudden changes in sight or hearing. Call 112 for stroke signs.