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When should a child have his/her first eye examination?

Always before they start school and ideally even younger. Good vision is vital for general development, and often, even though your child may be seeing well and not having any symptoms, a problem with one eye only or a muscle problem can cause difficulties with learning. Small babies with suspected vision problems will usually be referred to the hospital, but toddlers can have their eyes tested at the practice.

Why have I been told that I have dry eyes when they are watering all the time?

Dry eye is a complex issue. Somewhat simplified:

Tears naturally stop the eyes from drying out as well as protecting them from infection. If the tears are too watery to moisturize the eyes, you get dry eyes and lots of watering! The tears need to have the right balance of components. If this balance isn’t correct the eye reacts by producing watery tears which creates the watering eyes. Artificial tears try to break this cycle and retain a healthy balance of tear components.

Many things can cause tear problems including age, hormonal changes, and prolonged computer use.

Is a cataract a film across the eye?

No. A cataract forms within the eye, and is a clouding of the natural lens in the eye, behind the iris (the coloured part of the eye). It usually occurs later in life, but head injuries, medications and general diseases mean that cataracts can be seen in younger people too. While still having the inherent risks of surgery, cataract surgery is commonly performed and is usually very successful with the person often needing only reading spectacles afterwards.

I find it difficult to use eye drops. Do you have any advice?eye-drops-200x300

Remember to wash your hands first. Most people find it easiest to look upwards while gently pulling the lower eyelid downwards. Now put the eye drop onto the lower part of the eye. If you find that difficult, sometimes resting the bottle on the bridge of your nose with you head tilted back puts the dropper just above the correct position over your eye. Gently hold the inner corner of your eye for a while to stop the drop running away through the tear ducts. Wait five minutes before putting another drop into the eye. Be careful not the let the tip of the bottle touch the eye or eyelids, and to keep the bottle cap as sterile as possible while you are instilling the drop.

What is glaucoma?

Glaucoma is an eye disease that causes irreversible damage to the optic nerve resulting in a progressive, permanent loss of vision. It is often association with high pressure of the eye (intraocular pressure IOP). Early detection and treatment can slow the progression of the disease and is usually very successful. There are usually no symptoms to indicate that you have glaucoma in the early stages. Regular eye examinations are essential Most people associate the ‘puff of air test’ during the eye examination as the check for glaucoma. This together with peripheral vision testing and 3D OCT is currently the best way of detection glaucoma early. We advise everyone with a family history of glaucoma to have our gold eye examination including 3D OCT.

I have a bleed on the white of my eye. What must I do?

Always make an appointment with your doctor or optometrist to rule out other problems. If you are diagnosed as having a subconjunctival haemorrhage , it is essentially harmless. It often occurs spontaneously after coughing, heavy lifting or vomiting. The blood will clear without treatment over a few weeks. Your vision will be unaffected, and there will be no discharge or watering from the eye. There may be a charge for this appointment.

What is a macular hole?

Macular hole is very easily diagnosed and monitored using 3D OCT.

Please contact us to book an appointment.

Link to macular hole page on

Am I entitled to a free eye examination under the NHS?

You are entitled to an eye examination paid for by the NHS if;

– you are under 16 years of age

– you are under 19 years of age and in full time education

– you or your partner are getting income support

– you or your partner are getting family credit

– you are over 60 years of age

– you suffer from glaucoma

– you are over 40 years of age and have a direct family history of glaucoma

– you have diabetes

– you are registered as blind or partially sighted

– you require complex spectacle lenses

At Brown & White we suggest an extended examination including further testing which is partially covered by the NHS. See our eye examinations page for more details.

I am on a low income/am a student but do not qualify for NHS help in the above groups. Can I get help?

You can apply for help towards the cost of eyecare. Please ask for a form.

Do I need to see my GP before I can have an eye examination?

No. All you need to do is make an appointment.

What has my general health got to do with my eyes?

“Everything”. Many health problems can cause visual problems. For example:

– rheumatoid arthritis – dry eyes

– diabetes – fluctuating vision

– migraine – visual disturbances

– head injuries – double/blurred vision

– sinusitis – pain around the eyes

– menopause – tear problems leading to dry eye/blurry vision

– high blood pressure – leaky blood vessels

What is the difference between 20/20 vision and 6/6 vision?

There is no difference. Both of these indicate excellent distance vision. 20/20 is the imperial version measured in feet, and 6/6 is the metric equivalent measured in metres.

Why do you need to know what medication I am taking?

All medication has the potential to cause unwanted side effects. (Have a look at the list of potential side effects on the insert received with your medication.) Some medicines are known to cause specific ocular side effects, and others come with specific ocular warnings. Some are really important to know about if considering eye surgery for Cataracts or other conditions.

Can I have prescription sunglasses?

Yes. Ask to see our Maui Jim range of polarized sunglasses and our special offers on Wimbledon sunglasses.

My specs have broken. Can you fix them?

Some repairs can be done on site, but it may be necessary to order a part or send the frame away to be repaired. We recommend that you have a second pair of specs in case you cannot drive or read without them.

I like the idea of varifocals, but I’ve heard that some people have trouble adjusting to them. What happens if I do too?

Varifocal spectacle lenses have improved vastly in recent years. We are able to design specific lenses to meet your individual requirements. Our qualified dispensing opticians will be able to advise you. This means that it is rare for anyone to have difficulties wearing varifocal lenses. However, if you are still having trouble after trying your lenses and having your specs adjusted, please contact us. We will do everything we can to help you get specs that are suitable to your requirements and that you can wear comfortably.

My spectacle lenses are scratched. Can you polish out the scratches?

Unfortunately not. Lenses are made up to your prescription, and the shape, curve and thickness of your lenses are what makes this prescription. By polishing the lenses, the prescription would change.

Pupillary distance/Can I have my PD measurement?

The PD (distance between the pupils) is not part of the prescription and is not given routinely at the end of an eye examination. It is always in your best interests to be accurately measured for PD when consideration of the frame, lens design, spectacle use and prescription can be taken into account at the same time. Although you are fully entitled to have your prescription made up into spectacles elsewhere, we believe that the prescribing and dispensing of spectacles are closely linked, and we would ask that you speak to your Brown and White optometrist and dispensing optician regarding any queries you have in this regard.

I am seeing black spots. What are floaters? (Including retinal detachment)

Often, people who have healthy eyes see floaters. They appear as spots, lines or cobweb effects, usually when you look at a plain surface such as a white wall or a clear blue sky. They often appear when the clear jelly in the main part of your eye gets older.

What are flashes?

Sometimes the jelly in the main part of your eye shrinks a little and tugs on the retina (the light-sensitive layer) at the back of your eye. This can cause flashes of light at the edge of your vision. These differ from the disturbance of vision that can occur with migraine.

When should I be concerned?

If you suddenly notice a shower of new floaters, or floaters along with flashes or a dark shadow or “curtain” in your vision, then you should seek advice urgently. These symptoms can mean that the retina is tearing. Go to an Accident and Emergency Department if necessary.

What will happen if the retina tears?

The retina is at the back of your eye. It receives the images and sends them to the brain. This is one of the things that enable you to see. If the retina tears, it may come away from the back wall of the eye. This is called retinal detachment . It can result in partial or complete loss of vision.

How is retinal detachment treated?

A tear may be treated by using a laser. If treated quickly, you may have a better chance of full recovery. However, if your retina has become detached, you will need surgery. The operation may restore most of your vision but may come too late for a full recovery.

Look out for:

· flashes or floaters getting worse

· a black shadow in your vision

· a sudden cloud of spots

· a curtain or veil over your vision

· any sudden loss of vision.

Go to an Accident and Emergency Department without delay if you notice any of these symptoms.

What is the difference between an optician, an optometrist, a dispensing optometrist, an ophthalmologist, an orthoptist, etc?


They are doctors of medicine and are registered with the General Medical Council. They work in hospitals and your optometrist will refer you to an ophthalmologist should you require surgery or more in depth investigation.

Optometrist/Ophthalmic Optician

Optometrists are the people who test your eyes. They have the right training to examine eyes and diagnose vision problems, eye diseases and other conditions. They can prescribe glasses and/or contact lenses and adjust glasses or lenses as required. They are registered with the General Optical Council.

Dispenser/Dispensing Optician

Dispensing Opticians primarily fit glasses. Some (CLO’s (contact lens opticians)) also fit contact lenses. They give advice on frame choice and spectacle lenses. It is illegal to call yourself a dispensing optician or to work as one in the UK, unless qualified and registered with the General Optical Council.


In the UK both optometrists and dispensing opticians are commonly referred to as ‘opticians’.


Orthoptists often work in hospitals in conjunction with ophthalmologists. They are often involved with school vision screening. They investigate, diagnose and treat abnormalities of eye movement and eye position. They regularly deal with problems related to:

– ocular motility (eye movement)

– binocular vision (how the eyes work together)

– amblyopia (lazy eye)

– strabismus (squint/cross eye

What is short-sightedness/myopia?

Short-sightedness is very common and often presents during the teens. Distance vision is blurry, but close vision is usually very good. Screwing the eyelids up often improves distance vision. You will notice a negative sign in front of the sphere part of your prescription.

What is long-sightedness/hyperopia?

Long-sighted people have difficulty seeing things close up, but can have problems with distance vision too. They often complain of difficulty reading, eye strain and tired eyes. You will notice a positive sign in front of the sphere part of your prescription.

What is astigmatism?

Astigmatism is not as bad as it sounds, and in fact is very common! It means that surfaces of the eye are irregularly curved. It is often described as having the front of the eye shaped like a rugby ball, instead of equally curved like a football. Astigmastism often occurs together with short- and long-sightedness. Astigmatism causes vision to lack definiton. It is indicated on your prescription as cyl.

What is amblyopia/lazy eye?

An eye that appears to be normal and without disease, but where there is uncorrectable loss of vision is called amblyopia. It is often to do with the development of the eye in childhood, although can be caused by other reasons too. Usually children present with poor vision in one eye or a cross or turned eye.

OUCH! I’m feeling my age: my arms are too short/I think I need my first pair of reading spectacles! (Presbyopia)

When the natural lens in the eye loses flexibility and there is increasing difficulty to focus on close objects, we term this presbyopia. It is a natural process and is usually first noticed by people in their forties. Holding things further away, needing a good light, eye strain and tiredness when reading are common symptoms.

For people who are short-sighted, they have to take their spectacles off to see things close by.

What is strabismus/cross or turned eyes?

Improperly functioning eye muscles, or uncorrected long-sightedness are often the cause of strabismus, although there are other causes too. There is often a family history of strabismus. Symptoms include a cross or turned eye, squinting and sometimes double vision. Early detection is very important. Please contact us to book a gold examination if you are concerned.

I am moving. Can I have a copy of my records?

Usually a copy of your prescription (which you receive at the end of every eye examination) is sufficient to take to your new optician. However, if you have a particularly complex history, we are able to supply a copy of your records. Please see our ‘patient downloads’ section of our website for a request form. Link to page

Do your staff have to do ongoing training?

All General Optical Council registrants (optometrists and dispensing opticians) are required to do ongoing study to remain registered and practising. At Brown & White, we strive to ensure that all staff members have continuing training and development so that we can offer cutting edge technology and excellent customer service.

Can I have safety specs to wear over my normal glasses?

Yes, these are available. There are different standards of safety specs and it is essential to check that you are getting the correct level of protection for your requirements. It is also possible to make prescription safety glasses which may be more comfortable than using over glasses for long periods.

Can I have prescription 3D specs instead of struggling to wear the ones given out at the cinema over my usual glasses?

As you can imagine, there is lots of development in this field of optics at the moment. While 3D prescription spectacles are available we would suggest care as there are various methods of creating the 3D effect and your spectacles have to work in conjunction with the specific tv/movie/handset. At Brown & White we aim to be at the forefront of new developments and we will be watching this area with interest.

Can I prevent my child’s short-sightedness progressing so quickly?

This field of study, known as myopic control, is developing rapidly at present. Myopia may not be determined by genetic factors alone; environmental factors may play a significant role too.  Please see our Myopia Management page for techniques which have been proved to reduce the progression of myopia by over 50%.

Controversial methods include:

Undercorrecting shortsightedness – increases progression

Wearing gas permeable contact lenses – has no effect

Bifocal or varifocal spectacle lenses – can have an effect dependant upon the individual

Possibly more promising methods include:

Orthokeratology contact lenses

Some multifocal monthly contact lenses

MiSight Daily Contact Lenses

Using certain medications – not available in the UK

Spending time outdoors

Special peripheral control spectacle lenses – not available in the UK

It seems that 14 hours per week (or more) spent outdoors in good light, significantly reduces myopia progression. Remember to wear sunglasses to prevent UV damage.

What is the difference between wet and dry macular degeneration?

The classifications vary somewhat, but macular degeneration is commonly divided into two types – wet and dry.

Dry is the more common type, it develops slowly and causes a gradual deterioration in central vision. Dry macular degeneration can develop into wet over time.

Wet is rarer, and refers to the growth of new blood vessels in the retina that can cause swelling and bleeding in the macula (the part of the eye used for central vision). Wet macular degeneration often occurs rapidly and the resultant drop in vision is often quite sudden. Treatment is available for some forms of wet macular degeneration, so it is important to report a sudden change in vision immediately to your optometrist or ophthalmologist.

I don’t want to wear my glasses permanently. What are the options to surgery?

With the developments in contact lenses, even if you have tried them in the past, this option is worth re-considering. Contact lenses are available that, under certain conditions, are suitable for wearing even during sleep.

Orthokeratology contact lenses are special in that their unique design means that the lenses are only worn at night during sleep, and not during the day. Often, no spectacle wear is required during the day either! At Brown & White, we fit orthokeratology lenses at our Luton and Hook branches.

Bates’ ‘Seeing without glasses’ book (now out of print) has shown how eye exercises can help some people improve their vision to a point where they no longer need specs.

I have been referred to the hospital for high pressures. Will I have glaucoma?

A few years ago the referral criteria for intraocular pressures changed. It is now more likely that you will be referred for pressures that are on the high side of normal. However, in our Hampshire and Bedfordshire branches we are now involved with local schemes and will do further tests that may mean you won’t have to be referred. However, if you are referred to the hospital, and found to have glaucoma, treatment is good and the earlier glaucoma is detected the better.

What can I do about my droopy eyelid?

A droopy eyelid(s) can occur at birth or later in life and may be related to other medical conditions. It is best to report it to your doctor, especially if it has occurred suddenly, if it is affecting your vision, or is associated with other symptoms like double vision.

Why does my eyelid twitch?

Most often a twitching eyelid is due to stress or tiredness. Sometimes though, it can be caused by eye strain, or excessive caffeine or alcohol intake.

Do specs make your eyes get worse?

Although it’s a common perception that eyesight gets worse after getting your first pair of glasses, many conditions affecting the eye will progress at the same rate, specs or no specs.

I wear my spectacles all the time. Do I have any options when I go swimming, rather than not seeing or still continuing to wear my specs?

Wearing contact lenses while swimming significantly increases your risk of eye infections, so at Brown and White we do not recommend this. However, prescription swimming goggles are available. (As are prescription diving masks.) Please ask your dispensing optician for further information.

What is my risk of getting glaucoma?

Glaucoma affects 1 in 50 people over age 40, and 1 in 10 in over 75’s. This risk increases if you have a direct family member with glaucoma, if you have diabetes, and/or if you are of Afro-Caribbean descent.

A thin cornea is the single most important risk factor for developing glaucoma if you have normal intraocular pressures. At Brown and White we are able to measure corneal thickness using additional tests with the OCT (ocular coherence tomographer).