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 nystagmus

Please contact the Ophthalmology 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)

  • child aged under 2 years with congenital or infantile onset nystagmus
  • any child with associated neurological signs and/or systemically

Category 2 (appointment clinically indicated within 90 days)

  • pre-literate child greater than 2 years of age with long standing nystagmus
  • literate child with long standing nystagmus, best corrected visual acuity (BCVA) 6/12 or worse

Category 3 (appointment clinically indicated within 365 days)

  • literate child with long standing nystagmus BCVA better than 6/12

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
    • describe waveform of nystagmus – direction, type, amplitude, frequency and determine if null point exists
  • photograph with patient’s consent, where secure image transfer, identification and storage is possible, where appropriate

Clinical management advice

Nystagmus observed in infants can indicate visual impairment. If nystagmus is congenital or develops during infancy, it is important to refer the child for specialist outpatient service review. Acquired nystagmus is typically not associated with ophthalmic conditions, and referral to a neurologist should be considered.

Clinical resources

Consumer resources