Knowledge Centre

Here you’ll find a lot of answers to questions that are asked about your eyes, eye conditions and much more, but if you can’t find the answer here please feel free to call us on 0151 280 7777 or send an e mail to us at info@smithdowneyecare.co.uk or just call in to the shop for a chat!

Am I entitled to a free NHS sight test?

You will qualify for a free NHS-funded sight test if you are:

  • Under 16
  • Under 19 and in full-time education
  • 60 or over
  • Registered as blind or partially sighted
  • Diagnosed with diabetes or glaucoma
  • 40 or over with an immediate relative diagnosed with glaucoma
  • at risk of glaucoma (as advised by an ophthalmologist)
  • eligible for an NHS complex lens voucher.

You are entitled to a free NHS sight test, as well as help towards the cost of your glasses, if you or your partner receive:

  • Income Support
  • Income-based Jobseeker’s Allowance (not Contribution-based)
  • Pension Credit Guarantee Credit
  • Working Tax Credit and are named on, a valid NHS tax credit exemption card
  • Receive Income-based Employment and Support Allowance (not Contribution-based)
  • Are named on a valid NHS certificate for full help with health costs (HC2)

If you’re named on an NHS certificate for partial help with health costs (HC3), you may get some help towards the cost of your sight test.
You maybe asked to show proof that you’re entitled to a free NHS sight test.
For more information about NHS entitlement please contact us or visit the store where we will be happy to answer any questions.

What is a Low Vision?

Low Vision is a condition in which vision cannot be corrected by glasses, contacts, surgery or medicine. People who have vision loss are said to be visually impaired or to have Low Vision and their vision loss is usually caused by an underlying eye disease such as:

  • Age-related Macular Degeneration (AMD)
  • Diabetic Retinopathy
  • Glaucoma
  • Cataracts
  • Other eye diseases and conditions

Those with Low Vision typically have difficulty reading, writing, watching television, recognizing people’s faces or engaging in other daily living tasks.
Low vision aids help visually impaired patients maximize their remaining vision. These aids are usually issued after an evaluation of the condition and the use of solutions/low vision aids that include both magnification devices and non-optical products such as updated lighting.

How do we treat dry eye?

In some cases patient’s symptoms can be relieved simply by altering the external influences above. Environmental factors can be helped by making simple changes – for example avoidance of dehydrating environments such as air conditioning; if your job involves lots of computer work take regular breaks to rest your eyes. Protecting the eye from dehydrating influences such as a cold wind by wearing spectacles or sunglasses may also help.

Tears must be distributed efficiently, replaced or conserved in order to provide relief. As Dry Eye syndrome is caused by an imbalance of tears on the eye’s surface the most logical way to treat the problem is to artificially replace the tears and by so doing improve both quantity and quality. Surprisingly, having a watery eye can actually be caused by a lack of tears. This results in dry patches which the eye tries to correct by a flood of watery tears. Sometimes too much tear flow just needs better lubrication; think of a car engine with water in it, it will be wet but will not be well lubricated. There are a variety of artificial tears available and you will be advised the best option for your particular problem and how to use your treatment.

What is Dry Eye?

Dry Eye means that your eyes may not be making enough tears, that the tears which are being produced are of poor quality or that the tears that are produced evaporate away. The normal function of tears is to keep the surface of the eye wet and lubricated so any shortage of tears or reduction in their quality can produce a gritty, burning sensation of the eyes and can also disturb vision.

What are the symptoms of dry eye?
Dryness, burning or itchy eyes. Gritty eyes, irritation from wind or smoke. Blurred or smeary vision, tired, irritated or red eyes. Watery eyes, sensitivity to light or contact lens discomfort.

What are the causes of dry eye?

  • Ageing
  • Blepharitis
  • Dry environment and pollution
  • Computer use
  • Contact lens wear
  • LASIK surgery
  • Preservatives
  • Hormonal changes, especially in women e.g. menopause

Dry Eye may also be caused by general health problems or disease e.g. people with arthritis are more prone to Dry Eye (Sjogren’s Syndrome = arthritis + Dry Eye + dry mouth)

Certain types of medications (anti-acne, some beta-blockers, oral contraceptives, antihistamines, diuretics, decongestants, alcohol & anti-depressants…) CAUTION: do not alter or adjust your prescribed medicines without discussing with your Doctor.

What is Age-Related Macular Degeneration (ARMD)?

This condition occurs when the support cells that help the light sensitive cells at the macula function effectively become less efficient. This leads to a build up of waste materials at the macula, which can eventually affect central vision.

What is the macula?
The macula forms part of the retina, which is a layer of nerve cells that lines the inside of the eye. The macula is located at the back of the eye and is made up of many light-sensitive cells. These cells produce our vision and help us to complete detailed tasks such as writing and looking at photographs.

‘Age-related macular degeneration is the leading cause of legal blindness in those over the age of 65 in western countries.’

Are there different types of age-related macular degeneration?
There are two main types of age-related macular degeneration. The main difference between the two types is that one involves the growth of new blood vessels behind the macula, and one does not.
‘Wet’ macular degeneration occurs when leaky new blood vessels develop. This can result in rapid loss of central vision, although peripheral or side vision is not affected.

‘Dry’ macular degeneration results from slow progressive age change. A person could have the early stages or dry macular degeneration and not notice any problems with their vision. Gradually, over many years, the central vision may start to deteriorate, although this may not occur in both eyes.

If a person has dry macular degeneration, they are more likely to go on to develop wet macular degeneration than someone who has no macular degeneration at all.

Who is at greater risk of age-related macular degeneration?
• People over 65 years of age
• People who smoke
• People without a balanced diet
• People who suffer from obesity

These are only general guidelines, and so it is important for everyone to have regular eye tests. When you go for an eye test, your optometrist will check the health of your eyes, including the retina and macula. He or she will be able to pick up signs of age-related changes and let you know about them.

People between the ages of 18 and 70 should normally have an eye test every two years. People aged over 70 should have an eye test annually. We will let you know if, for any reason, you should have your eyes examined more frequently than this.

Can I sleep in my contact lenses?

There are contact lenses that you can wear on an extended wear basis ( up to 30 days day and night) but they are special lenses that need to be prescribed and checked to make sure it is healthy and safe to do so. If you are not sure of the type of lens you wear and would like to be able to wear your lenses night and day we offer free trials ( subject to prescription and an up to date sight test) call us on 0151 280 7777 to book an appointment (if you want to you can also book online just click the link at the top of the page)

What is Blepharitis?

Blepharitis refers to inflammation of the eyelids. Oils and other products normally secreted by the eye and eyelids build up on the lid surface and eyelashes resulting in eye irritation and often redness. It’s a common disorder and occurs in two forms:

  • Anterior Blepharitis – this is when the inflammation affects the outside front edge of your eyelids, where your eyelashes are connected. Two possible causes are bacterial infection and dermatitis.
  • Posterior Blepharitis – this is when the inflammation affects the inside front edge of your eyelids, where they come into contact with your eye. This is caused when something affects the glands that are found at the rim of your eyelids, for example skin conditions such as dermatitis or acne rosacea.

Signs & Symptoms
Regardless of which type of blepharitis you have, you will probably experience such symptoms as eye irritation, burning, tearing, foreign body sensations, crusty debris (in the lashes, in the corner of the eyes or on the lids), dryness and red eyelid margins.

How can eyelid hygiene help?
Developing a regular routine of eye hygiene is essential in the treatment of blepharitis as it tends to recur and rarely disappears completely. It is important that you clean your eyelids every day, whether or not you are experiencing any symptoms. You should consider it part of your daily routine, like showering or brushing your teeth. Daily eyelid care helps prevent the build up of oils and crusted matter around the eyelid and lash area.

Treatment
Treatment depends on the type of blepharitis you have. Visit our specialist dry eye clinic for more information. Your treatment may include applying warm compresses to the eyelids, cleansing them, using an antibiotic and massaging the lids. If your blepharitis makes your eyes feel dry (usually because your tears evaporate more quickly) you may be recommended to use a dry eye treatment as well. The warm compresses are designed to both loosen crusts on your eyes before you cleanse them and make the tear secretions more liquid and less greasy.

What is Glaucoma?

Glaucoma is a gradual loss of peripheral vision leading to tunnel-like vision and even blindness. It causes damage to the optic nerve where it leaves the eye to carry visual information to the brain.

Glaucoma is the second most common cause of blindness. When left untreated, most types of Glaucoma progress towards a gradual worsening of irreversible, visual damage, often without any warning or symptoms.

Up to 50% of affected people are not even aware they have it. There are actually several types of glaucoma but the vast majority of cases are termed ‘primary’ as they occur without a known cause. Some forms do occur at birth but it generally appears in people aged 40 and over and it frequency increases with age along with other risk factors such as racial ancestry, family history and high myopia.

Although irreversible, early treatment or surgery can halt or slow down the disease and early detection is therefore essential. Regular eye exams are recommended and a family history of glaucoma will entitle you to a free NHS test if you are over 40.

What is digital eye fatigue?

Smartphones, computer screens, eBook readers, smartwatches. On average, people own 4 digital devices and spend 60 hours a week accessing content on them.

The prolonged, everyday use can lead to digital eye fatigue, the ocular discomfort and visual disturbance that occur after 2 or more hours of digital device use. The most common and bothersome symptoms of digital eye fatigue are tiredness and dryness. Nearly 70% of adults report experiencing symptoms of digital eye strain. Adults in their 20s are the hardest hit, with 73% of them reporting symptoms.

Tiredness and dryness
Although the number of hours a person spends using digital devices certainly plays a role (30% of adults spend more than 9 hours a day using digital devices!), the types of screens and switching among devices may also pose problems for many users. For instance, reflections and glare may cause users to squint or partially close their eyes to reduce the discomfort.
Glare, reflections, and luminance variations lead to blinking issues that ultimately contribute to tear instability and dry eyes. Evidence shows that concentrated computer screen use results in reduced blink rates, disrupting the normal distribution of tears and increasing corneal exposure.

But it’s not just the number of blinks that matter. The completeness of those blinks also affects tear stability. Inadequate blinking not only fails to coat the ocular surface sufficiently, but it may also reduce visual acuity and cause blurred vision.
Contact lens wearers feel this dryness more acutely than spectacle wearers. Up to 85% of contact lens wearers using digital devices experience at least one dryness-related symptom, compared with 71% of non-wearers.
Because 90% of patients don’t talk about the ocular discomfort they experience from using digital devices, many may assume that nothing can be done about it.

  • What types of digital devices (smartphone, tablet, laptop, etc.) do you use?
  • How many hours a day do you use your digital devices?

How do your eyes feel after looking at digital devices for long periods of time or after a long day of using digital devices?
Some relief can be gained by blinking more frequently, taking regular short breaks from the digital screen to look at distance objects (the 20/20/20 rule), increasing the size of digital text, or adjusting the distance from their workstation. However, this seems to have limited success.

The better option is to book an appointment with us and we can discuss all the options available to you such as filters, computer specs, anti-fatigue lenses or contact lens updates.

How does diabetes affect the eyes?

Diabetes can harm your eyes. It can damage the small blood vessels in your retina which is at the back of your eye. This condition is called diabetic retinopathy. Diabetes also increases your risk of having glaucoma, cataracts, & other eye problems.

If you have diabetes, make sure you attend regular screening and get checked regularly at an opticians to take good care of your eyes.

What is a Cataract?

Cataracts cause glare and haloes around lights, night driving problems, blurred, cloudy, filmy or fuzzy vision. It is normal for the lens inside the eye to change with age. With most people, the lens gradually becomes less clear and not as much light is able to pass through.

This is one of the reasons why people often need stronger light for reading as they become older. Because of this, more light is scattered within the eye which can result in greater sensitivity to bright light. The lens can even become cloudy, which is known as a cataract.

Cataracts are mostly found in people over the age of 70. Hundreds of thousands of people undergo successful treatment each year for cataracts. Treatment is not always necessary and usually depends on how much the cataract is interfering with your vision.

Can eye problems cause headaches?

If you’re suffering from frequent headaches, ask yourself, “When was my last eye check?”

A routine eye exam can turn up a variety of issues that may be causing headaches. Astigmatism, long-sightedness, or presbyopia ( the need to wear reading glasses). These types of eye conditions can usually be corrected with the use of contact lenses or glasses. In some cases staring at the computer screen for too long, or working on overly bright or dim light may be the culprit. Adjusting workplace lighting, or remembering to take a break ( the 20 20 20 rule- see separate section on digital eye fatigue) to give your eyes a rest can remedy those problems. However, other things can cause headaches for example; ear problems, jaw problems, sinus problems, arthritis, or high blood pressure.

What do contact lenses cost?

Contact lenses are now very affordable and daily disposable lenses can cost from less than a pound a pair so if your only wearing them occasionally then 30 lenses could last several months! If you want to wear your lenses more regularly, for example 5 to 7 days a week then a monthly contact lens would be more appropriate ( that is a lens you take out each night and soak in cleaning solution overnight and then insert again the next morning) and can cost less than 50p a day. Book in for a free trial where we can discuss how you want to wear your lenses, what they will cost and can arrange for some lenses for you to try at home.

What is Astigmatism?

Astigmatism (some people say they have a “stigma” in their eyes) – This is when the cornea ( the front surface of your eye) or the crystalline lens ( the lens inside your eye) is an irregular shape, causing objects to appear blurry. A person with this condition may then squint in order to focus on what they are trying to see, which can contribute to the onset of a headache. Astigmatism is easily corrected in most cases with spectacle lenses, or contact lenses.

What is long sightedness?

The clinical term for long-sightedness is hyperopia. Here, an image is focused in effect somewhere behind the eye instead of on the retina ( the back of the eye) . Near objects, phones, tablet screens or other reading materials then appear blurry, meaning a person tends to squint in order to focus on them, which, again, can cause headaches. This is easily correctable with specs or contact lenses.

What is short sightedness?

Short or sometimes called Near-sightedness ( technically called myopia) is an eye condition where light focuses effectively in front of, instead of on, the retina ( the back of the eye). This causes distant objects to be blurry while close objects appear normal. Other symptoms may include headaches and eye strain. Severe near-sightedness is associated with an increased risk of retinal detachment, cataracts, and glaucoma.

What contact lenses are best for me?

There are many types of contact lenses available now from daily single use lenses through to specialist lenses for unusual prescriptions or eye conditions. Basically it depends on how often you want to wear your lenses, for how long per day and what your prescription is. We offer a free trial for contact lenses ( an up to date sight test is required- which you could have had elsewhere- but we can do it for you if required just call us on 0151 280 7777 or book online by clicking the link above) where all these things are discussed and a recommendation is made depending on the way you want to wear your lenses, what your prescription is and what the cost will be so we can keep them affordable for you., and with over 35 years experience in fitting lenses we will get the best lens for you guaranteed!

I have been told I have presbyopia what does that mean?

The natural lens in the eye, which is the flexible element enabling us to see in the distance and near, & enables most young people to see clearly in the distance and up close. Flexibility of this natural lens diminishes with age, and by the mid-forties, even people who have never previously needed spectacles start to need reading glasses, and the people who have previously worn just distance specs now need a pair for distance and near, bifocals or varifocal spectacles or contact lenses.

Allergies and their effect on the eyes

Watery eyes, allergy eyes, itching eyes
Eye allergy symptoms can appear at any time of the year. This can depend upon your location and type of allergy: Seasonal, usually plaguing us for half the year, and perennial, which stay with us year round.
An eye allergy can be caused by many outside elements. Seasonal allergies are brought about by allergens carried in the air outside, such as pollen, ragweed, grass, etc. Perennial allergies have different perpetrators, from pet dander to dust mites.

One important note: If you’re experiencing itchy eyes and other allergy symptoms, it’s a good idea to see your optician for a professional diagnosis. It could be something else with allergy like conditions, such as a stye, which is a swollen gland on your eyelid, or even conjunctivitis, a highly contagious infection.

Treatment for eye allergies
Aside from prescribed medication, there are natural home remedies for allergies that you can try for some relief.
Start with avoiding the cause (if possible). It may sound obvious, but a little planning can pay off in no-sneezing, allergen-relief dividends later.
If you have a seasonal allergy, try to avoid outdoor activities during windy days in the spring and summer. A spring shower can do wonders with pollen, so try to reserve any landscaping jobs for a day after rainfall.
You may also want to consider leaving your shoes outside, so you don’t track in pollen throughout your home.

I have been told I have a blocked tear duct what does that mean?

What causes blocked tear ducts?
Tear ducts become blocked for a variety of reasons.

  • Congenital blockage: As many as 1/5 of infants are born with blocked ducts. This might be because of underdeveloped or abnormal ducts, or because of developmental issues in the structure of the face and skull.
  • Narrowing of ducts with age: As adults age, the openings of tear ducts can narrow, increasing the likelihood of tear duct obstruction.Infection and inflammation: Infections and inflammations of the tear ducts, eyes and nose can all cause blocked tear ducts. Tear duct blockage can itself also cause infection and inflammation.
  • Facial injuries and trauma: Any injuries that affect the tear ducts or the bone structure surrounding them can lead to blocked tear ducts.
  • Tumours, cysts, and stones: Blocked tear ducts can also arise from tumours and other growths.

As you can see, while blocked tear ducts cause a variety of symptoms, they also signal underlying issues. Always consult your optician or doctor about issues with your eyes, so you can get prompt attention and care of any problems.

Blocked tear duct symptoms
A number of symptoms can arise from tear duct obstruction or infections caused by the blockage. These include:

  • Watery eyes and excessive tearing
  • Recurring inflammation and infection (infections are both causes and effects of tear duct blockage)
  • Mucus build-up and discharge
  • Pain and swelling in the inside corner of your eyes
  • Blurry vision
  • Bloody tears
How do you treat a blocked tear duct?

Treatment for blocked tear ducts
The best way to treat blocked tear ducts depends on what’s causing the blockage. Doctors recommend trying the least invasive options first, and will help you assess what’s right for you and when you need to expand your options.
Here are some common methods of treatment for blocked tear ducts.

Blocked tear ducts in infants
With many infants, blocked tear ducts disappear on their own within the first year. However, there are cases where treatment is necessary. The first method of treatment for blocked tear ducts in infants involves dilation (a gentle opening of the duct), probing and irrigation. If this doesn’t work, eye doctors will sometimes insert an expandable balloon to further dilate the ducts.

Blocked tear ducts in adults
Blocked tear ducts in adults are usually a sign of narrowing or other issues that don’t resolve on their own. The first course of treatment is the same as that for babies: dilation, probing and irrigation.
Stenting and intubation, where a tube is inserted to keep the lacrimal duct open, is a surgical option for cases that don’t respond to less invasive treatment.
As always, make sure to check with your optician if you have symptoms or concerns. His or her job is to test your eyes regularly to keep an eye out for issues, but also to assess problems that arise between regularly exams and to help you identify your best treatment options.

I have been told I have floaters. What are they?

While most floaters are normal, some can be a sign of underlying problems that you should address with your optician. Here are some things to know about floaters and how to respond.

What are eye floaters-and what are they doing in my eye?
Eye floaters appear as little irregularities that drift slowly across your field of vision. Floaters often look like:
Little darkish spots or specks
Threads or strings
Fragments of cobwebs
Floaters in the eye aren’t optical illusions. They’re little bits of debris floating around in your vitreous(the jelly-like filling of your eyeball that helps keep its shape). Sometimes, as these floaters move around, they cast shadows on your retina. This is what you see.

What causes eye floaters?
Most of the time, age-related changes in your vitreous are the cause of eye floaters. As your eyes get older, the vitreous jelly deteriorates: it becomes more liquid, starts to sag and pull away from the inside of your eyeball, and some of the former gel clumps. The shadows of these stringy bits are what you see.
Floaters can also occur when the vitreous detaches from the surface of your retina. The stimulation of the retina during this process will often cause flashes in the eye. The moment the vitreous pulls away from the head of your optic nerve, it can make a ring-shaped floater appear temporarily.
Occasionally, this detachment will pull a bit of your retina with it. This retinal detachment leaks blood into your vitreous, which appears as a scatter of small dots and needs immediate attention from an eye doctor.
Bleeding and inflammation in the eye, from retinal tears, blood vessel problems or other injuries, tends to cause floaters in general. Floaters can also be small specks of protein and other material that was trapped in your eye as it was forming before birth.

When to call a doctor
Eye floaters and flashes in the eye are an urgent matter for your eye doctor, especially if they appear suddenly. They often signal retinal detachments, which could cause blindness.
You should always mention any vision changes or eye problems, whether floaters or something else, to your optician during your regular examinations. Floaters are occasionally only visible during eye examinations, especially if they are close to your retina.

Treatment for eye floaters
Most eye floaters don’t need to be treated. While learning to cope with them costs some time and frustration, many people are able to ignore them more easily over time. When floaters are so large or so numerous they impair your vision, your eye doctor may recommend surgery or laser therapy to remove them.

Laser therapy for eye floaters
In laser therapy, your doctor aims a laser at the debris in your vitreous in order to break them up and make them smaller and less apparent.
Laser therapy for floaters is still experimental and not widely used. While some people see improvement after laser therapy, others see little to no difference, and the laser can damage the retina if it’s aimed incorrectly.

Surgery for eye floaters
Vitrectomy is a surgery where your doctor removes the vitreous in your eye through a small incision, replacing it with a solution to maintain your eye’s shape. Your body naturally creates new vitreous that will gradually replace this solution.
Vitrectomy doesn’t always remove eye floaters completely. New floaters can still form afterward, especially if the surgery itself causes bleeding and retinal tears. While most floaters are harmless, the sudden onset of floaters and flashes can be an urgent warning sign from your eyes.
Regular eye examinations are important for keeping your optician up to date on any changes, and so they can help detect floaters and other abnormalities in your eye.

I have been told I have Keratoconus. What is it?

Keratoconus (pronounced ‘kair-uh-toe-CONE-us’), is a condition where the cornea protrudes outward like a cone. The name comes from Greek (keratokonus) where it literally means ‘cornea cone’.

Keratoconus symptoms
It’s unclear why keratoconus arises in certain individuals, but we do know that it causes symptoms because of both the deformed shape of the cornea and the scarring that occurs at the high points of deformation.
Keratoconus symptoms generally start as a normal blurred vision, not unlike the blurriness from more common refractive errors or astigmatism.
The hallmark symptom of keratoconus, however, is a scattering of ghost images around an object. This can also appear as streaking or flaring distortions, and is often accompanied by sensitivity to bright lights and occasional itchiness.
Keratoconus also generally causes poor night vision. Visual distortions and blurriness are more pronounced in low light conditions, because the pupil opens to capture more light, and in doing so exposes more of the irregular surface of the cornea.

Treatment for keratoconus
Glasses and normal, soft contact lenses can help with the mildest cases, successfully correcting visual acuity problems. As the diseases progresses, rigid gas permeable (RGP) lenses are often fitted to correct for visual acuity, partly by conforming less to the changing shape of the cornea. Lenses for keratoconus correct the visual problems, but don’t delay the progression of the disease.
As the disease worsens, special contact lenses and surgery become the most effective corrective options.

Surgery and cornea transplants
Corneal transplants, also known as keratoplasty, are common, safe and effective. Patients do, however, often still need some type of normal visual correction. In transplanting a cornea, a surgeon removes the patient’s cornea and grafts a replacement cornea from a donor. Because the cornea doesn’t have its own direct blood supply, donor corneas don’t need to be blood-type matched.
Visual outcomes are generally great, regardless of the severity of the disease, surgical technique and other factors.
If you’re worried about possible or worsening keratoconus, talk to your optician or doctor. They are your allies in assessing your visual health and your treatment options, and can do a thorough diagnosis for keratoconus.
Regular eye examinations are also a great way for your optician to monitor your eyes and vision to keep them healthy as long as possible.

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