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.
- nil
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
- second opinions
Triage categories
Category 1 (appointment clinically indicated within 30 days)
- pre-literate child with asymmetrical red reflexes
- pre-literate child with shadows within the red reflex
Category 2 (appointment clinically indicated within 90 days)
- pre-literate child with dull symmetrical red reflexes
- literate child with dull symmetrical or asymmetrical red reflexes, best corrected vision acuity 6/12 or worse
- literate child with shadows within the red reflex
Category 3 (appointment clinically indicated within 365 days)
- literate child with dull symmetrical red reflexes, best corrected vision acuity 6/9 or better
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.
- 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 for both eyes:
- red reflex assessment where possible
- eye examination – look for nystagmus
- literate children, visual acuity chart
- pre-school children, picture or letter matching chart
- pre-literate children, visual behaviour e.g. ability to fix and follow an object of interest
- optometrist report within the last 3 months category 2/3 referrals
Clinical management advice
Checking for the pupillary red reflex is an essential practice in infants and young children, and should be assessed at birth, during the 6-week health check, and whenever there is a suspicion of poor vision.A significant disturbance in the pupillary red reflex, such as a complete absence, a white pupil, or a pale, glowing red reflex, or uneven appearance of the pupil colour could indicate serious conditions that could lead to blindness or even a life-threatening condition like retinoblastoma.
Shadows within the red reflex may indicate partial cataracts. A dull red reflex may suggest a considerable refractive error or be attributed to a person's cultural heritage.
Clinical resources
Reason for request
- to establish a diagnosis
- for treatment or intervention
- for advice and management
- for specialist to take over management
- for a specified test/investigation the General Practitioner cannot order
- for other reason (e.g. rapidly accelerating disease progression)
- transfer of care from another tertiary service
- clinical judgement indicates a referral for specialist review is necessary.
Patient demographic details
- full name, including aliases
- date of birth
- residential and postal address
- telephone contact number/s – home, mobile and alternative
- Medicare number, where eligible
- name of the parent or caregiver, if appropriate
- preferred language and interpreter requirements
- identifies as Aboriginal and/or Torres Strait Islander
Clinical modifiers
- impact on employment
- impact on education
- impact on home
- impact on activities of daily living
- impact on ability to care for others
- impact on personal frailty or safety
- identifies as Aboriginal and/or Torres Strait Islander
Other relevant information
- Willingness to have surgery, where surgery is a likely intervention.
- Choice to be treated as a public or private patient.
- Compensable status, e.g. DVA, Work Cover, Motor Vehicle Insurance, etc.
- Relevant social history, including identifying 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.
- Triage of a specialist outpatient referral is based on clinical decision making to allocate an appropriate urgency categorisation.
- Where appropriate and where available, the referral may be streamed to an associated public allied health and/or nursing service. Access to some specific services may include initial assessment and management by associated public allied health and/or nursing, which may either facilitate or negate the need to see the public medical specialist.
- A change in patient circumstance (such as condition deteriorating or pregnancy) may affect the urgency categorisation and should be communicated as soon as possible.
- All new referrals will be triaged by a consultant and appointment times scheduled according to clinical urgency.
Adolescents transitioning from paediatric to adult specialist services require a formal handover from paediatric specialist clinician to adult specialist clinician as well as a formal referral from the referring specialist to ensure initial transfer of care is completed.
The General Practitioners role in this process is to provide support to patients as part of holistic care. All ongoing referrals to specialists can subsequently be provided by the General Practitioner once the transfer of care has occurred.