Many people still assume an eye test is mainly about updating glasses. And yes, that is part of it.
But a modern eye examination can also tell us a great deal about retinal health, macular changes and the optic nerve – often before symptoms become obvious. That is why we have upgraded our diagnostic equipment across both practices.
At Eyediology Styling Opticians on Commercial Street, East London, we use OCT and Optomap imaging as part of a thorough clinical assessment. At Blackheath Eyecare, we have also upgraded diagnostics, including axial length measurement for detailed monitoring when it is clinically useful.
One thing that matters to us is that imaging is not treated like a quick add-on. If we are scanning, we are doing it properly. We show you the images during the appointment, explain what we are looking at as we go and give you time to ask questions.
What is an OCT scan, in plain English?
OCT (optical coherence tomography) lets us see the layers inside the eye. It is not just a photograph – it is more like a cross-section view, which is why it is so useful for the macular and optic nerve.
In day-to-day practice, OCT is most helpful in two areas.
Macular health (central vision)
The macula is responsible for sharp, detailed vision – reading, driving, screens, faces.
OCT can reveal and monitor macular changes that help explain symptoms like distortion, blur that comes and goes, or that feeling that your eyes are working harder than they should. We also use it to check for early changes that may not show up in a simple sight test, especially if someone is noticing something subtle but persistent.
Optic nerve monitoring (glaucoma risk and long-term change)
Glaucoma can be quiet early on. People often expect pain or sudden blur, but that is not usually how it starts.
OCT gives us a far clearer view of the optic nerve and the surrounding nerve fibre layers than a standard sight test alone. It helps us build a baseline, and it helps us monitor for change over time in a way that is much more objective than relying on memory or symptoms.
We particularly value baseline OCT imaging for patients over 40, higher prescriptions, strong family history of glaucoma, diabetes, or anyone noticing a change that glasses alone do not quite explain.
What is an Optomap scan?
Optomap is an ultra-wide retinal image. It gives a broad view of the retina in one capture, which is helpful for spotting changes away from the centre.
It does not replace the rest of the examination, but it adds context quickly. It is also one of the easiest ways to show patients what we are talking about, because you can actually see the shape and layout of the retina rather than trying to picture it.
What can OCT and Optomap scans help detect or monitor?
Macular and optic nerve assessment are probably the areas where imaging makes the biggest day-to-day difference in practice. That said, these scans can also reveal or indicate signs linked to a wider range of eye health concerns.
Depending on your eyes, your history and what we find in the exam, imaging can be useful when assessing or monitoring things like diabetic eye changes, high myopia related retinal changes, and general retinal health.
In many cases, the most useful outcome is confirming that the retina and optic nerve look healthy and stable. That reassurance matters too, especially if someone has been worrying about a symptom for months.
Not all scans are equal – and this is where people get caught out
Here is the honest bit: having a scan is not the same as having it interpreted properly.
We do see patients who have had imaging done elsewhere but were never shown the results, or were told “all fine” without any explanation of what was checked, what looked healthy, or what should be monitored. That is not a criticism of other practices – it is just what patients tell us, and it is usually why they still feel uncertain afterwards.
The value comes from combining good image quality with clinical judgement, proper context and enough appointment time to actually explain the findings properly. A scan is a snapshot. The appointment is where it becomes meaningful.
The value comes from combining good image quality with clinical judgement, proper context and enough appointment time to actually explain the findings properly. A scan is a snapshot. The appointment is where it becomes meaningful.
Our Standard – Why we recommend imaging for most people
If you only ever scan eyes when there is already a problem, you miss the whole point of modern eye care.
Yes, there are the obvious groups where imaging is widely known to be recommended – over 40s, higher prescriptions, strong family history of glaucoma, diabetes, sudden distortion, new floaters, headaches with visual change, post-cataract surgery checks, and so on.
But our view is simpler.
Prevention is better than cure. Advanced clinical monitoring should not need a dramatic symptom or a big scare to be worth doing. It should be part of a proper eye health check.
That is why we invest in diagnostic equipment and why we include OCT and Optomap imaging as part of our advanced examinations as standard. It is our personal standard of practice.
People choose to come to us because we are positively different. We care about your long-term eye health, not just what your eyes look like on the day you happen to come in.
Why baseline scans become more valuable over time
A single OCT scan can be useful. Where it becomes genuinely valuable is when we can compare today’s scan with one from a couple of years ago, especially if someone has risk factors or symptoms that come and go.
That comparison is often what lets us say, with confidence, “this has not changed”, or “this has shifted slightly and we should keep a closer eye on it”. It also makes follow-up decisions simpler, because you are not starting from scratch each time.
“The most valuable part of OCT is comparison over time,” says Ravi, Optometrist and Director. “A scan today is helpful. A scan compared with previous years is where trends become clearer.”
A case we see all the time
A fairly common situation is someone in their 40s or 50s saying:
“My prescription hasn’t changed much, but night driving feels more tiring.”
“My prescription hasn’t changed much, but night driving feels more tiring.”
Or: “Words look slightly warped on my Kindle.”
Or:“I keep cleaning my glasses but they never feel crisp.”
Sometimes the scan is completely reassuring and we end up focusing on lenses, dryness, lighting, screen habits, or just making sure the prescription and measurements are properly dialled in. Other times, OCT helps us spot subtle macular changes that explain why the symptoms feel bigger than the prescription change suggests. Sometimes optic nerve imaging tells us we should monitor more closely. That does not automatically mean glaucoma. It means we are being sensible, building a stronger baseline and watching for change rather than waiting for someone to notice a problem.
What happens in the room (what we actually do)
If OCT or Optomap imaging is clinically appropriate, we take the images and bring them up on screen during your appointment. We talk you through what we are looking at – macula, optic nerve, retina – and what looks healthy, what we are monitoring and why.
If anything needs follow-up or referral, we explain the next steps clearly. If everything looks stable, we will say that too, and we will explain what “stable” means in your case.
And honestly, that is a very common outcome – most appointments are about confirming things look healthy, then keeping a sensible record so we can compare properly in future.
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FAQ: OCT and Optomap scans:
Are OCT and Optomap scans safe?
Yes. They are non-invasive imaging tests and they do not touch the eye.
Do I need these scans if my vision seems fine?
Nobody is forced to have scans they don’t want but they are included in our exams because of all the eye health monitoring positives. So our personal viewpoint is often, yes. Eye health changes do not always announce themselves early, and baseline imaging is useful later even if everything looks healthy today. You’re welcome to opt out if you wish but it wont change the eye test fee. After all we can only care for your eyes as much as you’ll allow us to.
Will you show me the scans?
Yes. We show clients the scans on screen during the appointment and explain what we are seeing as we go.
Can these scans detect macular degeneration?
They can reveal and monitor macular changes. If we see anything that needs monitoring or referral, we will explain it clearly and talk through next steps.
Can these scans detect glaucoma?
OCT is one of the best tools we have for optic nerve monitoring. Glaucoma assessment is never based on one test alone, which is why a thorough exam matters.
I’ve had a scan elsewhere and was told “it’s fine”. Should I still worry?
Not necessarily. But if you were not shown the scan, you still have symptoms, or you just left feeling unsure, it is reasonable to get a second opinion.
Can you do this even if I mainly came in for glasses?
Yes. A lot of our patients care about eyewear and eye health. We are set up for both – a curated eyewear selection, and the clinical kit and experience to properly assess what is going on.
