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.

  • complex foreign body, either intraocular or corneal
  • orbital fracture
  • thermal burns to eyelids or eye

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

  • chemical corneal burns, immediately begin continuous irrigation with water or saline
  • blunt trauma to the eye causing:
    • loss of vision
    • distortion of pupil
    • hyphaemia with possible raised intraocular pressure
    • retinal detachment
    • ruptured globe
  • penetrating eye injury
  • corneal laceration
  • retrobulbar haemorrhage
  • contact lens related corneal infections, e.g. bacterial keratitis

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

  • uncomplicated corneal or conjunctival foreign body
  • second opinions

Triage categories

Category 1 (appointment clinically indicated within 30 days)

  • recent blunt trauma with any of the following:
    • abnormal eye movements
    • abnormal intraocular pressure
    • hyphaema
    • pupil changes
    • retinal detachment and/or macular hole
  • recent orbital fracture with:
    • diplopia, and/or
    • changes in orbital appearance
  • persistent corneal staining or opacity more than 36 hours after removal of foreign body

Category 2 (appointment clinically indicated within 90 days)

  • 12 weeks or more after blunt trauma injury with any of the following features:
    • history of hyphaema, and/or
    • persistent pupil changes
  • 12 weeks or more after orbital fracture with any of the following features:
    • persistent diplopia, and/or
    • persistent changes in orbital appearance
    • corneal staining more than 12 weeks after foreign body removal

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 therapy
  • eye and vision examination in both eyes:
    • literate children - visual acuity chart
    • preschool children – picture or letter matching chart
    • pre-literate children - visual behaviour e.g. ability to fix and follow an object of interest
    • pupillary light reactions and red reflexes
    • slit lamp examination of pupil, anterior chamber, intraocular pressure, if possible
    • fundus examination if possible
  • photograph with patient’s consent, where secure image transfer, identification and storage is possible, where appropriate

Clinical management advice

Eye trauma can result from various causes, such as accidents, sports-related injuries, falls, or even intentional harm. Prompt evaluation and appropriate management are essential to prevent further complications and preserve vision.

Clinical resources

Consumer resources