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:

  • signs of congenital glaucoma in a child under 2 years of age including:
    • hazy cornea
    • enlarged eye
    • excessive tearing with photophobia

Please contact the on-call 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

  • second opinions

Triage categories

Category 1 (appointment clinically indicated within 30 days)

  • children with suspected glaucoma and corneal haze or asymmetrical eye growth

Category 2 (appointment clinically indicated within 90 days)

  • suspected glaucoma
  • screening in children with a family history of glaucoma
  • medical conditions that may lead to the development of glaucoma
  • child at high risk of developing glaucoma as a result of prescribed medication/s

Category 3 (appointment clinically indicated within 365 days)

  • transfer of care (previously diagnosed glaucoma) requiring ongoing management

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), 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 in both eyes:
    • intraocular pressures, if possible
    • pupillary light reactions and red reflexes
    • corneal haze
    • asymmetry of eye size or growth
    • slit lamp examination of cornea and iris, if possible
    • 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
  • visual field assessment, if possible
  • optical coherence tomography (OCT)
  • optometrist report within the last 3 months
  • photograph – with patient’s consent, where secure image transfer, identification and storage is possible, where appropriate

Clinical management advice

Glaucoma is not commonly found in children, but it can pose a significant risk to their vision. It is crucial to refer children with glaucoma early on to improve their long-term prognosis. Glaucoma can cause rapid deterioration of eyesight and have lasting effects on the vision of infants and young children. Glaucoma that occurs during infancy or at birth can lead to accelerated eye growth in children under 2 years old and may present with the following symptoms:

  • eyes appearing different from one another
  • excessive tearing of the eye
  • cloudiness of the cornea
  • sensitivity to light

Clinical resources

Consumer resources