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Ophthalmology outpatient service in Central Adelaide

Ophthalmology Services within Central Adelaide Local Health Network (CALHN)provides sub-specialty services to patients living in the Central Adelaide Local Health Network area. Ophthalmology outpatients services run at the Royal Adelaide Hospital (RAH) and The Queen Elizabeth Hospital (TQEH) Monday to Friday 9.00 am to 5.00 pm.

Services are also provided to patients referred from rural and remote areas.
Children are usually managed by paediatricians with referral to the Women’s and Children’s Hospital or a paediatric ophthalmologist as required.

Contact details - outpatients

Royal Adelaide Hospital (RAH)

  • Clinic fax (for referrals): (08) 7074 6247
  • Appointment enquiries, new case appointments: (08) 1300 153 853
  • Review / change of appointments: (08) 1300 153 853

The Queen Elizabeth Hospital (TQEH)

  • Clinic fax (for referrals): (08) 8222 6233
  • Appointment enquiries, changes, reviews and treatment: (08) 8222 7579
  • Review / change of appointments: (08) 8222 7579

Appointment location

RAH

Level 3 Outpatients, Outpatient Block, Royal Adelaide Hospital, Port Road, Adelaide SA 5000

TQEH

Level 7 Eyes Outpatients, The Queen Elizabeth Hospital, 28 Woodville Road,
Woodville South SA 5015

Services and clinics available

The Ophthalmology departments provides an outpatient service, inpatient consultation service and elective and emergency ophthalmology surgical service.

The RAH and TQEH Ophthalmology outpatient services are multi-disciplinary units which provide assessment, management and treatment for all sub-specialty areas of adult ophthalmology:

RAH Ophthalmology department

  • Oculoplastics and orbital surgery
  • Ocular oncology
  • Neuro-ophthalmology
  • Surgical retinal
  • Medical retinal
  • Corneal and external diseases
  • Glaucoma
  • Cataract
  • Advanced diabetic eye disease
  • Ocular and adnexal trauma

RAH Ophthalmology runs an Emergency Ophthalmology clinic Monday to Friday 9.00 am to 5.00 pm within its outpatient service. This service provides the opportunity for urgent ophthalmology referrals from the RAH Emergency Department or outside.

A variety of sub-specialty clinics are held. Patients are generally seen by a consultant medical officer, either directly or in an overseeing role following inputs from a registrar and / or allied health professional depending on the reason for referral and the patient’s ongoing care needs.

TQEH Ophthalmology department

  • Corneal and external diseases
  • Cataract
  • Refractive surgery
  • Medical retina
  • Oculoplastic surgery
  • Glaucoma
  • Diabetic eye disease
  • Neuro-ophthalmology
  • Adult squint and squint surgery

TQEH Ophthalmology service runs sub-specialty clinics Monday to Friday between 9.00 am and 4.30 pm.

Northern Suburbs Ophthalmology Services:
There is an Ophthalmology service running out of the GP Plus Centre Elizabeth that offers outpatient and elective surgery services in cataract, medical retina and diabetic eye disease. This service operates most Mondays, Tuesdays and Fridays.

Referrals should be faxed to the central referral line: (08) 8182 9499

For all urgent referrals please call before faxing referral: (08) 1300 153 853. All after hours calls will be directed to the CALHN ophthalmology registrar on-call.

RAH

Day Clinic Ophthalmologist Conditions seen
Monday Emergency
Glaucoma
General
Cat and primary
Eye care
Corneal and external diseases /cataract
Oculoplastics
Minor ops
Uveitis
Macular
Optical coherence tomography (OCT)
Resident
Prof Robert Casson (alt)
Dr Anna Galanopoulos
Dr Gavin McNeil
Dr Francis Nathan
Dr Aanchal Gupta (alt)
Prof Dinesh Selva (alt)
Oculoplastics fellow (1:4)
A/Prof Jagjit Gilhotra (1:4)
Medical retinal fellow
Clinical photographer
Emergency referrals
Cataract
Glaucoma
Corneal and external disease
Cataract
Lid malposition / tumours
Orbital lesions
Macular degeneration
Diabetic eye disease
Uveitis
Tuesday Emergency
Retinal
Cataract and primary eye care
Diabetes
FFA
HFA
Resident
A/Prof Henry Newland
Dr Grant Raymond
Dr Stephen McGovern (3:4)
Dr George Pietris (alt)
Registrar
Photographer
Nursing
Emergency referrals
Macular degeneration
Diabetic eye disease
Retinal detachment
Epiretinal membrane
Macular hole
Cataract
Glaucoma
Wednesday Emergency
Oculoplastics
Neuro-ophthalmology
Orthoptist
Laser
Corneal and external diseases
Clinical trials
Resident
Oculoplastic fellow
Prof John Crompton
Prue Hall
VR fellow (alt)
Dr Nadia Wittles
Relevant ophthalmologist involved in trials.
Emergency referrals
Strabimus
Ocular motor palsies
Optic nerve dysfunction
Retinal detachment
Cornel and external disease
Cataract
Glaucoma
Epiretinal membrane and macular hole
Lid malposition/tumour
Orbital lesions
Thursday Emergency
Oculoplastics
Minor operations
Glaucoma
Medical retinal
Laser
Avasitn
Clinical trials
Resident
Dr Garry Davis (1:4)
Oculoplastic fellow
Prof Robert Casson (alt)
Dr Timothy Gray
Medical retinal fellow (alt)
Medical retinal fellow (alt)
Relevant ophthalmologist involved in trials.
Emergency referrals
Lid malposition / tumour
Orbital lesions
Glaucoma
Cataract
Macular degeneration
Diabetic eye disease
Friday Emergency
Cataract and primary eye care
Retinal
Neuro-ophthalmology
Oculoplastics
Ocular oncology
Corneal and external diseases
Diabetes
Optical coherence tomography (OCT)
Resident
Dr Stephen McGovern (alt)
Dr Grant Raymond
A/Prof Jagjit Gilhotra
A/Prof John Crompton
Prof Dinesh Selva
Dr Garry Davis
Dr James Muecke (3:4)
Dr Mark Chehade (3:4)
Registrar
Photographer
Emergency referrals
Strabismus
Ocular motor palsies
Optic nerve dysfunction
Retinal detachment
Cataract
Glaucoma
Epiretinal membrane and macular hole
Lid malposition / tumour
Orbital lesions
Ocular oncology
Corneal and external disease
Macular degeneration
Diabetic eye disease

The Queen Elizabeth Hospital (TQEH)

Day Clinic Ophthalmologist Conditions seen
Monday Cataract and primary eye care
Medical retinal
Corneal and external disease
Dr Richard Fleming (1:4)
Dr Shane Durkin Medical retinal fellow
Dr Aanchal Gupta (1:4)
Emergency referrals
Cataract
Glaucoma
Lid malposition
Corneal and external disease
Macular degeneration
Diabetic eye disease
Retinal vascular disease
Corneal and external disease
Pterygium
Cataract
Tuesday Cataract and primary eye care
Cataract and primary eye care
Refractive surgery
Corneal and external disease
Dr Joanna Black (3:4)
Dr Michael Goggin
Dr Aanchal Gupta (1:4)
Emergency referrals
Cataract
Glaucoma
Lid malposition
Cataract
Corneal and ocular surface disease
Refractive surgery tertiary refs.
Glaucoma
Corneal and external disease
Pterygium
Cataract
Wednesday Medical retina
Corneal and external disease
Medical retina
Neuro-ophthalmology and adult strabismus, cataract
A/Prof Jagjit Gilhotra (alt) Medical retinal fellow
VR fellow
Dr Aanchal Gupta (1:4)
Dr Sumu Simon (4:4)
Emergency referrals
Macular degeneration
Diabetic eye disease
Retinal vascular disease
Cataract
Corneal and external disease
Pterygium and cataract
Macular degeneration
Diabetic retinopathy, adult squints,
Neuro-ophthalmology, cataracts
Thursday Cataract and primary eye care and refractive surgery
Medical retina
Neuro-ophthalmology and adult strabismus, cataract
Dr Michael Goggin (1:4)
Dr Sumu Simon (2:4)
Emergency referrals
Cataract
Corneal and ocular surface disease
Refractive surgery tertiary refs.
Glaucoma
Pterygium
Macular degeneration
Diabetic retinopathy, Adult squints,
Neuro-ophthalmology, Cataract
Friday Cataract and primary eye care
Medical retina
Neuro-ophthalmology adn adult strabismus, cataract
Dr Darcy Economos (alt)
Dr Sumu Simon (2:4)
Emergency referrals
Cataract
Glaucoma
Lid malposition
Corneal and external disease
Pterygium
Macular degeneration
Diabetic retinopathy, adult squints,
Neuro-ophthalmology, cataract

Referral process

Immediate referral process

Patients requiring assessment within 24-48 hours must be discussed with the ophthalmology resident between 8.30 am and 5.00 pm or the ophthalmology registrar if after hours, via RAH switchboard (08) 7074 0000 or TQEH switchboard (08) 8222 6000. A written referral marked URGENT should then be faxed to RAH (08) 7074 6247 or TQEH (08) 8222 6233 or sent with the patient if urgent assessment arranged.  

If the condition is life-threatening, the patient should be sent to the nearest emergency department.

Less urgent referrals

Preferred method of referral is by fax or letter.
Fax number: RAH (08) 7074 6247 or TQEH (08) 8222 6233

All referrals including those urgently requiring consultation must be in writing and a named referral is preferred. Please fax written referral to RAH (08) 7074 6247 or TQEH (08) 8222 6233.

Non-urgent referrals will be allocated to the next available appointment. Non-urgent referrals may incur a wait. The waiting time for appointment will vary and be dependent on the demand for this sub-specialty service and the medical urgency of the patient’s condition.

Ophthalmology problems not considered high priority (see eligibility and referral criteria) may wait a longer time for an appointment. Please consider other options and do not refer to multiple providers regarding the same presenting complaint.

Should changes occur to a patient’s medical condition during the waiting time for an appointment, referrers should send updated clinical information or if urgent, contact the ophthalmology resident or registrar via the RAH switchboard (08) 7074 0000 or TQEH switchboard (08) 8222 6000.

Clinical features indicative of potentially serious pathology

  • Trauma - surgical trauma to the lids, orbit, ocular structures, penetrating eye injury, foreign bodies, hyphaema, chemical burns
  • Sudden loss of vision - ischaemic ocular conditions such as temporal arteritis, central retinal artery or vein occlusion, retinal detachment, posterior uveitis, optic neuritis.
  • Extremely inflamed and highly painful eye socket, swollen lids: orbital cellulitis
  • Floaters / flashers with field loss - posterior vitreous detachment, retinal detachment, vitreous haemorrhage
  • Red eye if vision decreased / pain  /photophobia / corneal staining / perilimbal injection
  • Ptosis if with sudden headache - intracranial aneurysm
  • Painful acute diplopia
  • Glaucoma-related signs and symptoms – acute angle closure

Referrals unlikely to be offered an appointment

For further information on eligibility and referral processes see the outpatient referral process page.

Alternate care options / health information for low priority conditions while waiting for an appointment or if no appointment is made

Not all patients with non-urgent conditions can be offered timely appointments in the CALHN ophthalmology clinics due to limited resources.
In most cases, the key to appropriate management is a detailed history and examination. Options for obtaining further information regarding various eye conditions and to provide guidance for assessment, investigations and management are listed under ophthalmology clinical information sheets below. In some instances, links to fact sheets have been included in the table which outlines clinical criteria for referral.

Post discharge guidelines and information

If the patient or their general practitioner is concerned about a deterioration in the medical condition (see clinical information sheets and table of clinical features indicative of potentially serious pathology at the end of this web page) and ophthalmic assessment is required earlier than planned, a phone call to the ophthalmology unit via RAH switchboard on (08) 7074 0000 or TQEH (08) 8222 7579 will allow this to be discussed with one of the ophthalmologists.
Patients whose medical condition has stabilised or resolved and for whom no further appointment has been made will be formally discharged. If ophthalmic assessment is required again, a new referral should be faxed to the ophthalmology units - RAH (08) 7074 6247 or TQEH (08) 8222 6233.

Examples of conditions by urgency category and referral process

Priority Examples (not an exhaustive list) Referral process
Immediate priority (emergency) Acute angle closure glaucoma
Central retinal artery occlusion
Chemical injury
Conjunctivitis >1/52
Conjunctivitis with pain
Corneal ulceration
Flashers / floaters with field loss, retinal detachment
Orbital cellulitis / acute dacryocystitis
Periocular herpes simplex / herpes zoster infection
Post-operative / post intra-ocular injection inflammation
Pupil changes
Red eye in contact lens wearer
Sudden loss of vision or diplopia
Sudden onset of blurred vision with headaches
Suspected penetrating eye injury
TIA / amauroisis fugax
Trauma to eye / orbit
Uveitis
Must contact the Ophthalmology registrar or the on-call ophthalmology registrar if after hours, via RAH switchboard on (08) 7074 0000 or TQEH switchboard (08) 8222 6000.
Urgent  (category 1)
Condition has the potential to require more complex or emergency care if assessment is delayed.
Condition has the potential to have significant impact of quality of life if care is delayed.
Acute dacryoadenitis
Acute loss of visual field
Diabetes if with recent visual loss
Distortion or vision loss in ARMD patient.
Elevated intraocular pressure ≥ 30 mmHg
Eye pain
Flashes / floaters without field loss
Proptosis with visual changes
Ptosis if pupil occluded
Severe light sensitivity
Sudden onset of double vision
Squint if red reflex abnormal or lack of visual response
Referrals should be faxed to (08) 7074 6247 (RAH) or
(08) 8222 6233 (TQEH).  
The referral will be assessed and triaged and referrer and patient informed.
Semi-urgent  (category 2)
Condition is unlikely to require more complex care if assessment is delayed.
Condition has the potential to have some impact of quality of life is care is delayed.
Age related macular degeneration without visual distortion.
Cataract with vision <6/12 in better eye
Elevated Intraocular pressure <30 mmHg
Eye discharge without redness
Eyelid problems: ectropion / entropion / ptosis.
Eyelid tumours
Glaucoma suspects high risk (high cup-disc ratio, glaucomatous visual field defect, shallow anterior chamber).
Known diabetic with drop in vision
Proptosis without visual issues (Thyroid eye disease)
Severe dry eyes (Sjogren’s, Rheumatoid arthritis
Referrals should be faxed to (08) 7074 6247 (RAH) or
(08) 8222 6233 (TQEH).  
The referral will be assessed and triaged and referrer and patient informed.
Non-urgent (category 3)
Low priority
Annual chronic disease review
Blepharitis/dry eye
Cataracts with vision better than 6/12 in better eye
Drug related side effects
Glaucoma suspects low risk (normal cup-disc ratio, family history)
Keratoconus
Other eyelid lumps
Referral for ongoing care from elsewhere
Screening for eye disease
Systemic eye disease
Vision <6/12 for any reason other than refractive
Watery eyes
Referrals should be faxed to (08) 7074 6247 (RAH) or
(08) 8222 6233 (TQEH).  
Low priority for appointment.

Note

It is important to note these guidelines indicate what is clinically desirable, not what is always feasible in terms of delivery which is dependent on size and staffing of the hospital department.

Ophthalmology clinical information sheets

The following information sheets about presentations commonly seen in Ophthalmology outpatients provide the minimum information required for assessing a referral.

Other clinical resources to consider:
Visit: www.ranzco.edu/index.php/ophthalmology-and-eye-health/eye-conditions -information for further links to fact sheets.

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