Find out what to expect when you come to hospital for your ophthalmology appointment.

Before your appointment

We aim to see and treat all patients within 18 weeks of referral by their GP.

Your appointment letter will have anything specific you need to bring to your appointment. In general, please bring a list of your medications and a copy of your glasses prescription if available to the appointment. If you wear glasses, please bring them with you to the appointment.

You are welcome to bring a relative, close friend or carer with you to your appointment.

Please note, you may be given eye drops at your appointment to dilate your pupils. As these will blur your vision for up to four hours you are advised to take public transport or to arrange a lift to and from your appointment. 

During your appointment

Please note that we are a teaching hospital, so medical students may be present for some appointments. If you do not wish to have them in the room please let the nurse or doctor know and the students will be asked to step outside.

Please be aware our waiting times can vary from 10 minutes to two to three hours depending on the number of staff present and demand on the service. Once called in, your appointment will take 10 to 15 minutes.

Tests are often required prior to seeing the doctor. These can include but are not limited to:

  • testing your vision
  • measuring the pressure in the eye
  • scans of various parts of the eye as applicable

Patient information leaflets

  • Adenoviral conjunctivitis
  • Adult Squint Surgery leaflet
  • AMBLYOPIA AND OCCLUSION THERAPY
  • Anterior uveitis (Iritis)
  • ATROPINE OCCLUSION FOR CHILDREN
  • Bacterial conjunctivitis

    Blepharospasm (eyelid spasm)

    This leaflet has been designed to give you information about Blepharospasm.

    We hope it will answer some of the questions that you or those who care for you may have at this time. This leaflet is not meant to replace the discussion between you and your medical team but aims to help you understand more about what is discussed. If you have any questions about the information below contact us using the details on the back page.

    What is blepharospasm?
    Blepharospasm is a condition in which the eyelid(s) develop twitching, blinking and close in an uncontrolled manner.
    The spasm can last from a few seconds up to several minutes and may make it difficult to see during this time. It may be made worse by bright lighting conditions.
    Hemifacial spasm is a condition with a similar presentation where the involuntary movement occurs on one side of the face and this can affect the mouth and cheek area too. Sometimes after Bell’s Palsy (temporary weakness or lack of movement affecting one side of the face) recovery of the facial nerve can cause twitching or spasms around the eye area. You may hear your doctor call this an aberrant regeneration.

    Treatment
    Botulinum toxin injection, more often known as Botox is an effective way to control the symptoms caused by eyelid spasm and other eye lid problems. The injections are known to work well in the majority of affected individuals. However, the effect is temporary and it is not a cure. For continued relief from symptoms repeated injections will
    need to be given. Occasionally, surgery can help patients whose symptoms are not helped with botulinum toxin or where its effectiveness diminishes over time.

    Please note: A botulinum toxin injection is not a suitable treatment if you are pregnant or trying for a baby or breast feeding.

    Risks
    As with many procedures there may be some risks involved including:

    failure to work effectively

    double vision

    droopy eyelid

    bruising

    Any side effects of the toxin usually last for two to four months then completely wear off. There is no risk that they will be permanent. However, there is no effective treatment to make the side effects go away more quickly.

    What can I expect to happen on the day?
    You will be seen by an ophthalmologist at the outpatient clinic for an

    initial assessment, including your medical history and a full eye and eyelid examination. The first treatment will usually be performed at the same time as the initial assessment. Once booked into the toxin clinic the injections will be administered by a practitioner.
    The practitioner will note any changes to your medical history and any allergies. New patients will need to sign a consent form which will be valid for all future injections. However, we will remind you of the risks and benefits at each visit.

    Generally, all patients are given a standard dose to treat the condition at the first appointment. After your first visit you are normally reviewed a few weeks later to see whether any top up injections are required or whether you have experienced any side effects and the dose needs to be reduced. Once we have established the correct dose of injection you need then the appointments are usually spaced between three and six monthly intervals.

    During the procedure
    Depending on the severity of the eyelid spasm, small doses of botulinum toxin are injected just under the skin at different sites around the eyelids.
    The injections are given without the use of an anaesthetic.
    You do not need to fast before your botulinum toxin injections
    The exact doses and the sites of injections may be varied depending on your response to previous treatments. The effect (weakness of the eyelid muscles and reduction in spasm) is apparent after three to four days and last for approximately two to four months.

    What must I be aware of after the procedure?
    You will be able to return home after the procedure. Most people who have the botulinum toxin injections resume normal activities immediately.

    do not rub your eye

    you may eat, drink and undertake daily activities as normal

    You can wash your face and hair as normal and do not require the eye to be covered

    before you leave the clinic make sure you have been given an appointment slip so you can book your next appointment
    You should seek an emergency review if your eye itself becomes red and painful or your vision deteriorates

    Who can I contact for more information?
    If you have any questions or concerns please call:

    Ophthalmology emergency department: 020 3312 3245<>
    Western Eye Hospital eye clinic:
    020 3312 3236

    Charing Cross Hospital eye clinic:
    020 3311 0137

    You can download this leaflet - BLEPHAROSPASM (EYELID SPASM)

  • BLEPHARITIS AND EYELID HYGIENE TREATMENT
  • Botulinum toxin treatment for squint
  • Cataract surgery 
  • Chalazion
  • CHRONIC OPEN ANGLE GLAUCOMA 
  • CHILDREN'S EYE CARE SERVICE
  • CONVERGENCE EXERCISES
  • Corneal cross-linking
  • Corneal transplants 
  • DACRYOCYSTORHINOSTOMY
  • Diabetic retinopathy
  • Drainage operation lacrimal bypass using a Lester Jones tube

Further online resources

Information available from patient.info

Please click the relevant link for more information

Information from NHS Choices

This is also a great resource for in-depth information. Please click below for relevant information 

NICE Guidance

The National Institute of Clinical Excellence regularly publishes information for the public as well as for eye care professionals related to various ophthalmic techniques and interventions. 

Click here to see information related to ophthalmic interventions.