Referral to emergency

If any of the following are present or suspected, please refer the patient to the emergency department (via ambulance if necessary) or seek emergent medical advice if in a remote region.

  • nil

For clinical advice, please telephone the relevant metropolitan Local Health Network switchboard and ask to speak to the relevant specialty service.

Southern Adelaide Local Health Network

Women's and Children's Health Network

Exclusions

  • second opinions

Triage categories

Category 1 (appointment clinically indicated within 30 days)

  • pre-literate child with asymmetrical red reflexes
  • pre-literate child with shadows within the red reflex

Category 2 (appointment clinically indicated within 90 days)

  • pre-literate child with dull symmetrical red reflexes
  • literate child with dull symmetrical or asymmetrical red reflexes, best corrected vision acuity 6/12 or worse
  • literate child with shadows within the red reflex

Category 3 (appointment clinically indicated within 365 days)

  • literate child with dull symmetrical red reflexes, best corrected vision acuity 6/9 or better

For information on referral forms and how to import them, please view general referral information.

Essential referral information

Completion required before first appointment to ensure patients are ready for care. Please indicate in the referral if the patient is unable to access mandatory tests or investigations as they incur a cost or are unavailable locally.

  • identifies as Aboriginal and/or Torres Strait Islander  
  • identify within your referral if you feel your patient is from a vulnerable population, under guardianship/out-of-home care arrangements and/or requires a third party to receive correspondence on their behalf
  • interpreter required
  • under the custody or guardianship of the Chief Executive
  • antenatal, birth, developmental, medical, family history
    • note any developmental or behavioural issues such as autism spectrum disorder (ASD), and attention deficit disorder (ADD), or attention deficit hyperactivity disorder (ADHD)
  • ocular history, including:
    • other eye conditions
    • eye trauma
    • surgery and medical management, including glasses and/or amblyopia therapy
  • eye and vision examination for both eyes:
    • red reflex assessment where possible
    • eye examination – look for nystagmus
    • literate children, visual acuity chart
    • pre-school children, picture or letter matching chart
    • pre-literate children, visual behaviour e.g. ability to fix and follow an object of interest
  • optometrist report within the last 3 months category 2/3 referrals

Clinical management advice

Checking for the pupillary red reflex is an essential practice in infants and young children, and should be assessed at birth, during the 6-week health check, and whenever there is a suspicion of poor vision.A significant disturbance in the pupillary red reflex, such as a complete absence, a white pupil, or a pale, glowing red reflex, or uneven appearance of the pupil colour could indicate serious conditions that could lead to blindness or even a life-threatening condition like retinoblastoma.

Shadows within the red reflex may indicate partial cataracts. A dull red reflex may suggest a considerable refractive error or be attributed to a person's cultural heritage.

Clinical resources