Optician flagged my eye pressure and I nearly binned the referral letter because my sight is fine

Went for an eye test because my reading glasses had stopped working, expected to walk out with a new prescription, walked out with a referral instead.

The optometrist did the puff test, did it again, then did a different pressure test with a little probe and drops that made everything sting. Then she took photos of the back of my eye and went quiet in the way you don't want a professional to go quiet. Pressures were up in both eyes, and there was something about the optic disc she wanted a second opinion on. Referral to the hospital eye service, six to eight weeks.

Here is my confession. The letter sat on the kitchen counter for four days and I seriously considered doing nothing with it, because I can SEE. I read the number plate, I read the small print on tins, my vision is the one part of me that has never given me trouble. It felt like being referred for a problem I don't have.

My wife has since made it clear that the letter is going nowhere near the bin. But I'd like to hear from anyone who has been down this road, mostly so I stop telling myself it's a fuss about nothing.

Please go. I say that as the daughter of someone who did exactly what you were tempted to do.

Mum was told her pressures were high in her fifties, felt completely fine, didn't follow it up because feeling fine is very convincing. She was diagnosed properly about seven years later and the field test showed she'd already lost a chunk of the outer edges of her vision on one side. She had genuinely never noticed, because you don't look at your peripheral vision, you look through it, and the brain patches over the missing bits so smoothly it's almost a party trick. What she's on now protects what's left. It cannot bring back what went.

The thing I'd want someone to have said to her: "my sight is fine" is not evidence in this particular argument. It's the expected finding at the stage they're trying to catch you.

Also worth saying so you're not sitting on the wrong worry for six weeks: raised pressure is not the same as glaucoma. Plenty of people have higher than average pressures and never develop any nerve damage, they just get monitored. And confusingly it runs the other way too, some people develop glaucoma at pressures that look perfectly normal, which is why she took the photos of the disc rather than just reading you a number.

So the referral isn't a diagnosis, it's someone saying "two of my measurements disagree with each other and I want a specialist to settle it". That's the whole of it.

gregor_runs said:

raised pressure is not the same as glaucoma

Right, that's already more than the leaflet told me. The leaflet was mostly about parking.

dgb, "I nearly binned it because I feel fine" is the sentence this whole site exists because of, so I'm going to be a bit personal about it.

My version was a blood pressure cuff at a workplace screening I nearly skipped. No symptoms, no clues, a decade of unremarkable results behind me that I'd read as proof nothing was happening. The number was high, it stayed high on repeat visits, and it had been high for a while with me feeling exactly as fine as you feel now. What I learned from it, and what I keep learning writing this site, is that the conditions worth screening for are specifically the ones that do not announce themselves. If it announced itself we would call it a symptom and there'd be no need for the test.

The eye version has the same shape, and it's why our guide to vision and hearing checks argues that the eye test is not really a sight test at all. The letters on the chart are the least interesting part. The pressures, the optic nerve, the retinal photograph, those are looking for things in progress.

I'm not a clinician and I'm not going to guess at what your appointment will find, and honestly nobody here can. What I'd say is that six to eight weeks of not knowing is genuinely uncomfortable, several of us on this board have done a version of that wait, and it is still a much better place to be than the version where you never went. Take your wife's line on the letter.

Practical bit nobody mentioned to me: if they do a visual field test, it's the one where you stare at a dot and click when you see faint lights in the corner of your eye. It is boring and weirdly stressful and everyone comes out convinced they've failed it because you sit there thinking "was that a light or did I imagine that". Apparently that's normal and they account for it. Don't read anything into how it felt.

Update, eight and a half weeks later.

Seen. Repeated pressures, proper imaging of the nerve, and the field test Nathan warned me about, which was every bit as annoying as advertised. Outcome: pressures are up but the nerve looks intact so far and the field test came back clean. Not glaucoma. What I've got is a label meaning "higher pressure, no damage yet", and a monitoring appointment every year, plus they want my siblings to know because it runs in families.

So the referral turned out to be a nothing, in the sense that nothing is wrong today. It also turned out to be a something, in that I'm now in a system that will notice if that changes, which is the opposite of what would have happened if the letter had gone in the bin. Consider me converted, and slightly annoyed that it took my wife and a forum of strangers to do it.