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.

  • acute onset red eye associated with:
    • change in pupil shape
    • corneal opacity
    • haemorrhagic or membranous conjunctivitis
    • intraocular cells (anterior uveitis/iritis) or
    • loss of vision
    • neonate
    • past history of herpes keratitis
    • raised intraocular pressure, more than 22mmhg
    • severe pain, photophobia or watering

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

  • anterior uveitis/iritis or hypopyon, acute or chronic
  • contact lens wearer, acute onset red eye with
    • corneal opacity
    • discharge, or
    • vision loss

For urgent referrals please 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

  • second opinions

Triage categories

Category 1 (appointment clinically indicated within 30 days)

  • chronic red eyes with vision loss including:
    • vernal/allergic keratoconjunctivitis
    • blepharitis with conjunctivitis
  • screening for chronic anterior uveitis in children with:
    • rheumatological conditions
    • connective tissue disorders

Category 2 (appointment clinically indicated within 90 days)

  • chronic red eyes unresponsive to conservative management, including
    • vernal/ allergic keratoconjunctivitis
    • blepharitis with conjunctivitis
  • chronic red eyes in children following a bone marrow transplant

Category 3 (appointment clinically indicated within 365 days)

  • nil

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 therap
    • history of any topical facial medicines or eye drops
  • eye and vision examination in both eyes
    • literate children use the visual acuity chart
    • preschool children use the picture or letter matching chart
    • pre-literate children use the visual behaviour e.g. ability to fix and follow an object of interest
  • optometrist report within the last 4 weeks
  • photograph with patient’s consent, where secure image transfer, identification and storage is possible

Clinical management advice

Outpatient specialist review is not necessary for the most common causes of red eye. It is essential to start treatment for conditions like allergies, conjunctivitis, or dry eye before contemplating a referral for outpatient assessment. It is important to ensure that first-line medical management has been attempted and a therapeutically-endorsed optometrist has conducted a review before considering a referral.

Clinical resources

Consumer resources