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.

For the following symptoms, contact the ophthalmology registrar prior to referring to the emergency department:

  • cataract in baby under 6 months of age
  • cataract with associated features including:
    • white pupil
    • acute loss of vision
    • recent trauma
    • red eye
    • corneal opacity
    • glaucoma

For urgent referral, please call contact the ophthalmology registrar to discuss your concerns prior to referral.

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

  • screening in a literate child with family history/associated conditions or on medication which may cause cataract
  • second opinions

Triage categories

Category 1 (appointment clinically indicated within 30 days)

  • pre-literate child aged less than 4 years with concerns of reduced vision due to cataract

Category 2 (appointment clinically indicated within 90 days)

  • pre-literate child aged 4 years or over, with concerns of reduced vision due to cataract
  • literate child with visual acuity 6/12 or worse due to cataract
  • pre-literate child with family history, associated systemic conditions or on medications which may cause cataract e.g. steroids for examination
  • child aged less than 8 years with past history of cataract surgery

Category 3 (appointment clinically indicated within 365 days)

  • literate child with cataract, visual acuity 6/9 or better
  • child aged greater than 8 years with past history of cataract surgery

For more on outpatient referrals, see the 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
  • antenatal, birth, developmental, medical, family history. Note any developmental or behavioural issues such as autism spectrum disorder (ASD), attention deficit disorder (ADD), and 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 in both eyes:
    • abnormality of cornea or iris
    • inflammation
    • signs of glaucoma (corneal haze, asymmetrical eye growth, raised intraocular pressure)
    • literate children using a visual acuity chart
    • preschool children using a picture or letter matching chart
    • pre-literate children using a visual behaviour e.g. ability to fix and follow an object of interest
  • optometry report less than 6 months - category 2 and 3 only

Clinical management advice

Identifying and treating severe cataracts in young children at an early stage can effectively prevent substantial and permanent vision loss. Prompt referral and intervention increase the likelihood of improved outcomes.If a literate child has a family history of cataracts, associated medical conditions, or is taking medications that may lead to cataract formation, it is advisable for them to undergo annual screening with an optometrist.

Clinical resources

Consumer resources