Glaucoma test cost
The puff of air at every sight test is a basic glaucoma screen. A comprehensive glaucoma assessment combines that with OCT scanning and visual field testing, plus careful optic disc evaluation. Cost: free on the NHS if you qualify; £40 to £100 as a private bundle.
The four components of a comprehensive glaucoma test
01 · Tonometry
Intraocular pressure
Non-contact (puff) tonometry at the high street, Goldmann applanation (gold standard) at hospital. Normal range around 10 to 21 mmHg. Raised pressure is a risk factor but not diagnostic on its own.
02 · Optic disc
Ophthalmoscopy or photograph
Assessment of cup-to-disc ratio, neuroretinal rim thinning, disc haemorrhages, peripapillary atrophy. Asymmetry between the two eyes is a red flag.
03 · OCT scan
Retinal nerve fibre layer thickness
Quantifies the thickness of the retinal nerve fibre layer in cross-section. Thinning is one of the earliest detectable signs of glaucoma, often years before pressure changes or visual field loss.
04 · Visual field
Humphrey perimetry or FDT
Automated mapping of your peripheral vision sensitivity. Picks up the functional consequence of nerve damage and tracks disease progression over time.
NICE NG81 (glaucoma diagnosis and management) recommends all four elements together at diagnostic assessment. None of the four is reliable on its own. Combining them is what allows confident diagnosis, classification (open-angle vs angle-closure, primary vs secondary), and ongoing monitoring.
What a comprehensive glaucoma test bundle costs
| Provider | Bundle cost | What it includes |
|---|---|---|
| NHS hospital eye service | Free (referral) | Goldmann tonometry, OCT, Humphrey perimetry, optic disc imaging |
| NHS-eligible at optometrist | Free if NHS-funded test | Standard sight test + private add-on if extras needed |
| Boots Opticians (enhanced) | £54.95 | Sight test + OCT + retinal photo |
| Vision Express (premium) | ~£30 to £60 | Sight test + OCT often included; field add-on £30-£55 |
| Specsavers (with all add-ons) | £25 + £10 OCT + £30-£50 field = £65-£85 | Modular pricing |
| Independent specialist clinic | £80 to £150 | Comprehensive package, longer appointment, often Goldmann |
Should you pay for a comprehensive glaucoma screen
For most people aged under 40 with no family history and no symptoms, the routine tonometry built into every sight test is sufficient. Adding OCT and visual field at significant extra cost has limited yield in low-risk populations.
For people aged 40 or over with a direct family member with glaucoma, the NHS already funds annual sight tests with careful disc examination; the OCT add-on at £10 to £25 is often worth it on top of the NHS test for the additional structural detail.
If a routine sight test raises any concern (high pressure, suspicious disc appearance, family history disclosed), the optometrist refers to NHS hospital eye service for full assessment at no cost to you. Paying privately for the same assessment usually adds little beyond a faster appointment.
Common questions
How much does a glaucoma test cost in the UK?
A basic glaucoma screen (tonometry only) is included in every NHS-funded and private sight test at no extra cost. A more thorough screen combining tonometry, OCT, and visual field testing costs £40 to £100 as a private bundle. The full assessment is free on the NHS if you have a glaucoma diagnosis, are aged 40 or over with a direct relative with glaucoma, are diabetic, or fit another NHS-eligible category.
What does a comprehensive glaucoma test include?
Four elements together: intraocular pressure measurement (tonometry), optic disc examination (ophthalmoscopy or photography), retinal nerve fibre layer scanning (OCT), and visual field testing (automated perimetry). Any single test alone has limited diagnostic value; the combination is what allows reliable diagnosis and monitoring.
Is the test the same as the puff of air at the optician?
The puff of air is non-contact tonometry, one component of glaucoma testing. It measures intraocular pressure. Raised pressure is a risk factor for glaucoma but not sufficient on its own for diagnosis (you can have normal-tension glaucoma, where pressure is normal but optic nerve damage is present). The full glaucoma assessment combines pressure, optic disc, OCT, and visual field findings.
When should I have a glaucoma test?
Routine glaucoma screening is built into every NHS-funded and private sight test, so the answer is essentially every two years (annual if 60+, diabetic, or with glaucoma family history). For a dedicated comprehensive glaucoma assessment beyond routine screening, the NHS funds this when triggered by raised pressure on a routine test, optic disc concern, family history, or symptoms.
Can the optician diagnose glaucoma or only refer?
High street optometrists screen for glaucoma and refer suspected cases to a hospital eye service for confirmation and management. Some optometrists with additional independent prescribing qualifications can manage early or stable cases under NHS shared-care arrangements, but the formal diagnosis pathway typically involves at least one hospital appointment.
What is the difference between OCT and visual field for glaucoma?
OCT measures the structural thinning of the retinal nerve fibre layer at the optic disc. Visual field testing measures the functional consequence, the missing parts of your peripheral vision. Structure usually changes before function. OCT is more sensitive to early disease; visual field shows the impact and tracks disease progression. Both are used together in NICE-recommended glaucoma assessment.
Sources
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