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When to refer

A question we frequently receive from primary care providers is when to refer?

 

We have created a quick reference guide of when to refer. 

When to refer

IMMEDIATE

Contact on call ophthalmologist at your local hospital

  • Acute glaucoma
  • Chemical burn* (Check st PH and irrigate 1 )
  • Corneal laceration
  • Globe perforation
  • Intra ocular FB
  • Hypopyon (pus in anterior chamber)
  • Iris prolapse *Cover with an eye shield
  • Orbital cellulitis
  • Central retinal artery occlusion (less than 8 hours onset)
  • Giant cell arteritis with visual disturbance

WITHIN 24 HOURS

Make appointment via local eye clinic

  • Arc eye
  • Corneal abrasion
  • Corneal F.B
  • Sub tarsal F.B - only if unsure of diagnosis or can’t manage appropriately
  • Blunt trauma
  • Contact lens related problems
  • Corneal graft patients
  • Corneal ulcers or painful / corneal opacities
  • Hyphaema
  • Iritis

WITHIN ONE WEEK

Email or send first class post referral letter to eye clinic

  • Sudden / recent onset of diplopia
  • Sudden / recent onset of distortion in vision or suspected wet AMD
  • Entropion that is painful
  • HZO with eye involvement
  • Episcleritis if can’t manage appropriately
  • Scleritis
  • PVD
  • Bells palsy
  • Optic neuritis
  • Severe infective conjunctivitis

NOT EMERGENCIES

Routine referral if unable to manage in practice

  • Allergic conjunctivitis
  • Mild – mod conjunctivitis
  • Blepharitis
  • Chalazion
  • Dry eyes
  • Ectropion
  • Watery eye
  • Sub conj haemorrhage
  • Non-prolif diabetic retinopathy
  • Squint – gradual onset/longstanding
  • Cataract