Eyecare

Forty-five minutes, and a photograph of the back of your eye

The examination

What the forty-five minutes are spent on

A standard appointment elsewhere is twenty minutes. The extra time is not luxury; it is the part where we look at the eye itself rather than only at what it can read.

Ten minutes of questions
What you have noticed, what you do all day, how far the screen is, how the driving is at night, what runs in the family, and every medicine you take. Half of what we find starts here.
How well each eye sees
The chart, then lenses held in front of it until the letters sharpen. This is the part everybody expects, and it takes about ten minutes.
How the two eyes work together
Muscle balance and focusing. This is where the headaches and the tired afternoons usually turn up, and it is often skipped when time is short.
The pressure inside the eye
A short puff of air, or a gentler contact method if the puff bothers you. One of the two things we watch for glaucoma.
The front of the eye, under magnification
The lids, the tear film and the lens, which is where dryness and early cataract show themselves.
A photograph of the retina
Included in every adult examination, not charged as an extra. We keep the image, so in two years we are comparing rather than guessing.
What we found, in plain words
Five minutes at the end. You leave with a written prescription, a note of anything we are watching, and a date to come back.

Particular cases

Children, driving, screens and dryness

Children
From three years old. We do not need a child to read letters or to answer reliably; there are pictures, matching cards and objective tests that work on a child who says nothing at all. A first examination is worth having before school rather than after a teacher has raised it.
Driving
We measure against the legal standard and tell you plainly whether you meet it, including the number plate distance and the width of your field of vision. If you do not meet it, we will say so, we will put it in writing, and we will not pretend otherwise because it is an uncomfortable conversation.
Screens all day
Screens do not damage eyes. They do expose a focusing problem that a shorter working distance would have hidden, and they make people blink less, which is a different problem with a different answer. We will tell you which of the two you have, and sometimes the answer is not glasses.
Dry, gritty eyes
Common, tedious, and mostly manageable. We look at the tear film under magnification and give you a routine to try. If it does not improve in six weeks, come back rather than buying a fourth kind of drop.

Fees

What an examination costs, and what is in it

One fee per appointment. Nothing in the examination is charged as an extra, because we do not think a retinal photograph should be optional.

What is included	Adult examination00	Children under sixteen00	Contact lens appointment00	Urgent appointment00
Time booked	45 minutes	30 minutes	60 minutes, first fit	30 minutes, same day
Retinal photograph	Included	Where the child allows	Included	If relevant
Pressure and field checks	Included	Where the child allows	Included	If relevant
Written prescription	Yes, yours to keep	Yes, yours to keep	Yes, both pairs of figures	If the sight has changed
Recheck within the period	Free within 3 months	Free within 3 months	Two follow-ups included	Included
Suggested interval	Every 2 years	Every year	Every year	As advised
	Book	Book	Book	Telephone us

If you are entitled to a publicly funded examination, tell us when you book and we will bill the scheme instead of you. The examination is the same one.

Limits

When to come sooner, and what we do when we cannot help

Do not wait for your recall letter

A two-year interval is for eyes that are behaving. Telephone us the same day, or go to a hospital eye department if we are shut, if any of these happen:

Sight goes in one eye, suddenly, whether or not it comes back.
A curtain or shadow crosses part of your vision.
A sudden shower of new floaters, or flashes of light in the corner of your eye.
A red, painful eye with light hurting it, rather than a red eye that merely itches.
Double vision that has just started.
A blow to the eye, or anything that went in and has not come out.

None of these are an imposition. We would far rather look at six eyes that turn out to be fine than miss the seventh.

What we are, and what we are not

We are optometrists, not eye surgeons. We can find a great deal and treat very little of it. The honest list is short.

We can manage ourselves: the prescription, the focusing and muscle problems, dry eye, lid inflammation, and watching anything that is stable and slow.

We find and refer: cataract, glaucoma and suspicion of it, macular degeneration, the changes that diabetes leaves in the retina, retinal tears and detachment, and anything in the optic nerve that looks wrong.

We do not do at all: surgery, injections, laser, or the sort of treatment that needs a hospital behind it. Nobody here will tell you that a supplement, an exercise or a particular lens will reverse a disease. If you are told that somewhere else, that is a reason to leave.

What a referral actually looks like

If we find something, you will hear it from us in the room, in plain words, before you pay for anything. We write to your doctor the same day and give you a copy of what we wrote; nothing about your eyes is described to somebody else in terms you have not seen.

We then tell you how quickly you need to be seen, and we are specific: today, this week, or within a few months. If it is today, we telephone the hospital while you are still sitting here rather than leaving it to a letter.

And we do not sell you glasses that afternoon. If the hospital is going to change your eye, a new prescription made before that is money wasted, and we would rather you kept it.

Questions

Things people apologise for asking

None of these need an apology. They are the six questions we are asked most quietly.

It has been nine years since my last test.
That is not unusual and nobody here will comment on it. Book the standard appointment; there is no catching-up fee and no lecture.
Am I meant to know the answers? I think I gave the wrong ones.
You cannot give a wrong answer. Half the questions are deliberately close together and the correct reply is often 'they look the same', which tells us as much as choosing one. Saying you are unsure helps us; guessing to be polite does not.
Will you make me have the air puff?
No. Plenty of people cannot bear it. There is a contact method that touches the eye with a drop of anaesthetic first, which most people find easier, and it measures the same thing.
Can I bring somebody in with me?
Yes, into the room and for the whole appointment. Parents, partners, carers and interpreters are all welcome, and we will still address you rather than them.
Do I have to buy glasses from you afterwards?
No. The prescription is written out and handed to you, and it is valid anywhere for two years. We will not ask why, and you will be treated exactly the same next time.
Are you going to find something terrible?
Almost certainly not. The great majority of examinations end with a small change in prescription and nothing else. When we do find something, it is usually early, slow, and better found now than in two years.

Book the forty-five minutes

Mornings on market days fill first. Thursday afternoons are the quietest in the week.

Book an examination

Forty-five minutes, and a photograph of the back of your eye

Ten minutes of questions

How well each eye sees

How the two eyes work together

The pressure inside the eye

The front of the eye, under magnification

A photograph of the retina

What we found, in plain words

Children

Driving

Screens all day

Dry, gritty eyes

Do not wait for your recall letter

What we are, and what we are not

What a referral actually looks like

Book the forty-five minutes