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.
- new onset of reduced central vision and/or distortion due to exudative (wet) age-related macular degeneration (AMD)
- new fluid on a macular optical coherence tomography (OCT) scan consistent with wet AMD
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.
Central Adelaide Local Health Network
- Royal Adelaide Hospital (08) 7074 0000
- The Queen Elizabeth Hospital (08) 8222 6000
Northern Adelaide Local Health Network
- Lyell McEwin Hospital
(08) 8182 9000
Southern Adelaide Local Health Network
- Flinders Medical Centre (08) 8204 5511
Exclusions
- non-exudative (dry) age-related macular degeneration (AMD)
- asymptomatic epiretinal membranes
Triage categories
Category 1 (appointment clinically indicated within 30 days)
- full thickness macular hole
- reduced central vision and/or distortion due to exudative (wet) AMD
Category 2 (appointment clinically indicated within 90 days)
- vitreomacular traction without lamellar macular hole if visual symptoms and vision diminished to <6/9
Category 3 (appointment clinically indicated within 365 days)
- vitreomacular traction without lamellar macular hole without visual symptoms
- lamellar macular hole
- symptomatic epiretinal membrane
For more on outpatient referrals, see the general referral information page.
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
- relevant social history, including identifying if you feel your patient is from a vulnerable population and/or requires a third party to receive correspondence on their behalf
- interpreter required
- relevant past medical/surgical history
- current medications, allergies
- smoking / vaping history
- ocular history including:
- best corrected visual acuity (BCVA) both eyes
- refraction
- retinal examination
- optical coherence tomography (OCT) if possible
Clinical management advice
- If a patient presents with any of the following symptoms or complains of a sudden change in their central vision, it is important to refer them for clinical assessment. Symptoms of a macular hole may include:
- blurred or distorted vision, particularly in the central field of vision
- a dark spot or blind spot in the centre of the visual field
- difficulty seeing fine details or reading small print
- visual disturbances such as flashing lights or floaters
- Regular eye examinations to assess and monitor the condition are imperative to slow disease progression and manage symptoms.
- Patients referred for macular disorders must continue community monitoring by an optometrist for progression of disease until hospital care is received and re-referred if they require more urgent care.
Clinical resources
- American Academy of Ophthalmology - Macular hole
- Royal Australian and New Zealand College of Ophthalmologists – Referral Pathway for AMD Management
- NSW Health– Eye emergency app
- NSW Health - Ophthalmology State-Wide Referral Criteria for NSW Public Outpatient Services(PDF 494KB)