Background Age-related conditions such as glaucoma, age-related macular degeneration (AMD), diabetic retinopathy (DRP) and cataract have become the major cause of visual impairment and blindness in high-income countries and carry a major socio-economic burden. The aim of the current study is to investigate the prevalence of age-related eye diseases such as glaucoma, age-related macular degeneration, diabetic retinopathy and cataract in a cohort of self-proclaimed healthy elderly, and thus get a rough estimation of the prevalence of undiagnosed age-related eye conditions in the Belgian population.Methods Individuals aged 55 and older without ophthalmological complaints were asked to fill in a general medical questionnaire and underwent an ophthalmological examination, which included a biomicroscopic examination, intraocular pressure measurement, axial length measurement, and acquisition of fundus pictures and Optical Coherence Tomography scans. Information regarding follow-up was collected in the subset of participants who received the advice of referral to an ophthalmologist or the advice to have more frequent follow-up visits, based on the ophthalmological changes detected in their evaluation.Results The cohort included 102 people and comprised 46% men (median age 70 years, range 57-85 years). Referral for additional examinations based on clinical findings, was made in 26 participants (25%). The advice to have more regular follow-up ophthalmologist visits was given to nine additional participants (9%). No significant correlations between baseline characteristics, including eye care consumption, and the need for referral could be identified. Follow-up information was available for 25 out of 26 referred volunteers (96%). Out of these, four (16%) underwent a therapeutical intervention based on study referral, up until 18 months after study participation. All four interventions took place in the age group 65 - 74 years.Conclusions This study shows that even in an elderly population with self-proclaimed healthy eyes and good general health, a significant proportion of subjects showed ocular findings that need regular follow up and/or intervention. Moreover, the frequency of prior ophthalmological examinations does not seem to be relevant to this proportion, meaning that everyone above 55 years old needs a routine ophthalmological evaluation.