Free eye test for glaucoma
Two NHS routes apply. Diagnosed glaucoma or ocular hypertension patients qualify for annual NHS-funded sight tests at any age. People aged 40 or over with a parent, sibling, or child who has been treated for glaucoma also qualify under the family history rule. Both routes unlock annual rather than two-yearly NHS funding.
The two qualifying routes
Route 1 · Diagnosed
Current diagnosis at any age
Glaucoma, suspected glaucoma (under specialist monitoring), or ocular hypertension all qualify. Bring a consultant or optometrist letter, or your current eye drop prescription (often containing the diagnosis on the dispensing label).
Route 2 · Family history
Aged 40+ with a direct relative
Direct relative means parent, sibling, or child (no others). Self-declaration is accepted; the optometrist records the relationship on the GOS1 form. Eligibility continues for life from age 40.
Both routes give you the same NHS entitlement: a full sight test once a year (rather than once every two years), fully funded by the NHS Business Services Authority, at any high street optician with a General Ophthalmic Services contract. The optometrist confirms eligibility on the day; no advance NHS approval is needed.
What the sight test checks that matters for glaucoma
The standard NHS sight test includes three measurements that are first-line glaucoma indicators. None of them is conclusive on its own; combined they let the optometrist decide whether you need referral to a hospital eye service for full glaucoma assessment.
Intraocular pressure (tonometry)
A puff of air (non-contact tonometer) or a contact tonometer measures the pressure inside the eye in millimetres of mercury. Normal range is roughly 10 to 21 mmHg. Pressures above 21 mmHg are flagged for further assessment. Repeat measurement and Goldmann applanation tonometry (the gold standard) usually follow at the hospital if the initial reading is high.
Optic nerve head examination
The optometrist looks at the back of your eye through an ophthalmoscope (or slit lamp with a hand-held lens) and assesses the optic disc. Glaucoma causes characteristic changes: thinning of the neuroretinal rim, enlargement of the central cup, and changes in the cup-to-disc ratio. Asymmetry between the two eyes is a particular red flag.
Visual field screening
A confrontation visual field test (the optometrist asks you to identify fingers in your peripheral vision) is part of the standard exam. Many opticians upgrade this with a Humphrey or FDT machine if glaucoma is suspected. See the visual field test cost guide for the upgrade pricing.
Whether to pay for OCT on top of the free test
An OCT scan images the retinal nerve fibre layer at the optic disc in cross-section. Thinning of that layer is one of the earliest measurable signs of glaucoma, often detectable years before pressure changes or visual field loss. For people in either qualifying category above, an OCT is the single most useful private upgrade you can pay for at the high street optician.
Pricing: Specsavers £10, Boots Opticians £25 (as part of the £54.95 enhanced test), Vision Express often includes it free in the standard test. Independent opticians range £20 to £40. See the full OCT scan cost comparison for chain-by-chain detail.
For diagnosed glaucoma patients already under hospital follow-up, OCT is usually included as part of the NHS hospital review, so the private OCT at the optician is less essential. For people qualifying under the family history rule, who are not yet under specialist care, the private OCT adds genuine diagnostic value beyond the standard NHS-funded sight test.
If you are diagnosed: what NHS hospital follow-up looks like
A glaucoma diagnosis usually means transfer of ongoing eye care from your high street optometrist to a hospital eye service (glaucoma clinic). Routine review intervals depend on severity and stability, typically every 6 to 18 months. Standard NICE guidance recommends combined assessment of pressure, optic disc (OCT), and visual field at each review.
Treatment is most commonly eye drops to reduce intraocular pressure (prostaglandin analogues, beta blockers, alpha agonists, carbonic anhydrase inhibitors). If drops are inadequate or not tolerated, selective laser trabeculoplasty (SLT) or surgical options follow. All of this is NHS-funded under hospital outpatient care.
The high street NHS sight test remains useful alongside hospital care: it covers refraction (your glasses prescription, which can change), general eye health, and other conditions that the hospital glaucoma clinic does not screen for. The annual entitlement at the optician continues for life once you have a diagnosis on record.
Common questions
Who qualifies for a free NHS eye test under the glaucoma rules?
Two groups. First, anyone with a current glaucoma or ocular hypertension diagnosis (at any age) qualifies for an annual NHS-funded sight test. Second, anyone aged 40 or over with a direct relative (parent, sibling, or child) who has been treated for glaucoma also qualifies for an annual NHS-funded sight test under the family history rule.
What counts as a direct relative for the family history rule?
Parent, sibling, or child only. Grandparents, aunts, uncles, cousins, in-laws, step-relatives, and half-siblings do not count under the NHS rule. The rationale is that first-degree relatives have around four times the population risk of developing glaucoma; that elevated risk does not extend reliably beyond first-degree relatives.
How do I prove a family member has glaucoma?
Self-declaration to the optometrist. They record the relationship and the relative's name on the GOS1 form. There is no requirement to provide your relative's medical records. If the relative is happy to confirm, a screenshot of their eye drop prescription label or a clinic letter is the easiest evidence; the optometrist rarely asks for any.
Why does the family history rule start at 40 and not earlier?
Primary open-angle glaucoma, the most common form, is rare before 40 and rises sharply with age. Setting the eligibility at 40 targets the age at which routine screening becomes cost-effective for the at-risk population. People with strong family history can still pay for private screening at any age, and the optometrist can recommend earlier monitoring on clinical grounds.
Does the free sight test include an OCT scan if I am at risk of glaucoma?
Not automatically. The NHS sight test covers visual acuity, refraction, intraocular pressure (tonometry), and ophthalmoscopy of the optic disc, all of which are first-line glaucoma indicators. An OCT scan, which images the retinal nerve fibre layer at the optic disc, is a private upgrade at most opticians (£10 at Specsavers, £25 at Boots, often included at Vision Express). For monitored glaucoma patients, hospital eye services typically include OCT as part of NHS follow-up.
What is the difference between glaucoma and ocular hypertension?
Ocular hypertension means raised intraocular pressure without yet any optic nerve damage or visual field loss. Glaucoma means raised pressure (or sometimes normal pressure) combined with optic nerve damage. Ocular hypertension is a risk factor for developing glaucoma; not everyone with raised pressure progresses. Both diagnoses qualify for the annual NHS-funded sight test.
Sources
Related guides
Glaucoma test cost
Tonometry + OCT + visual field bundle pricing.
OCT scan cost
When the upgrade is genuinely worth paying for.
Visual field test cost
Humphrey perimetry and FDT pricing.
Am I eligible for a free eye test?
The full 11-category NHS register.
Free eye test over 60
Annual from 70; many qualify on multiple grounds.
Free eye test for diabetes
Diabetes also raises glaucoma risk.