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:
- acute loss of vision
- retinal detachment
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
- Flinders Medical Centre (08) 8204 5511
Women's and Children's Health Network
- Women’s and Children’s Hospital (08) 8161 7000
Exclusions
- child aged 3 to 5 years failed screening test, vision 6/12 or better, repeat test in 6 months
- child aged 3 to 5 years failed child and family health service (CAFHS) screening test, follow existing CAFHS referral pathway
- second opinions
Triage categories
Category 1 (appointment clinically indicated within 30 days)
- child between the ages of 3 months - 3 years unable to fix and follow, either or both eyes
- best corrected visual acuity 6/36 or worse, either or both eyes
Category 2 (appointment clinically indicated within 90 days)
- pre-literate child with suspected poor vision in either or both eyes
- literate child with visual acuity in either eye 6/12 or worse, better than 6/36
Category 3 (appointment clinically indicated within 365 days)
- literate child with mildly reduced visual acuity either eye 6/9.5
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)
- history of vision loss
- monocular v binocular
- central v peripheral
- associated features e.g. headache, pain, red eye, floaters
- 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:
- pupil reactions
- cover or corneal light reflex test for strabismus
- fundus examination, if possible
- literate children:
- visual acuity chart
- pinhole vision
- preschool children:
- picture or letter matching chart
- objective refraction/pinhole vision
- visual behaviour e.g. ability to fix and follow an object of interest and retinoscopy
- literate children:
- optometrist report within the last 3 months
Additional information to assist triage categorisation
- literate children, retinoscopy/subjective refraction
- pre-literate children, retinoscopy
Clinical management advice
Referrals from child and family health service (CAFHS) service clinicians are advised to follow the current referral pathway.
Clinical resources
- American Academy of Ophthalmology - Visual Acuity Assessment in Children
- Colour Vision Screening (Ishihara Test)
- Western Australia Community Health - Clinical Nursing Manual: Distance vision (Snellen)
- Western Australia Community Health - Clinical Nursing Manual: Distant Vision Testing (Lea Symbols Chart)