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.

  • sudden onset of any of the following:
    • constant convergent squint (esotropia) or
    • divergent squint (exotropia) or
    • double vision at any age

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

Northern Adelaide Local Health Network 

Southern Adelaide Local Health Network

Exclusions

  • asymptomatic/longstanding strabismus

Triage catergories

Category 1 (appointment clinically indicated within 30 days)

  • new onset diplopia

Category 2 (appointment clinically indicated within 90 days)

  • previously diagnosed diplopia associated with thyroid orbitopathy
  • decompensated previous strabismus (squint) with diplopia
  • intermittent diplopia

Category 3 (appointment clinically indicated within 365 days)

  • long standing strabismus (squint) without diplopia

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 and surgical history
  • current medications, allergies 
  • smoking and vaping history
  • history of strabismus
    • acute versus longstanding
    • intermittent versus constant
    • unilateral versus alternating
    • horizontal versus vertical
    • convergent versus divergent
    • associated features, for example ptosis, abnormal head posture
  • ocular history, including:
    • symptoms and duration of clinical presentation
    • surgery and medical management, including glasses and/ or amblyopia therapy
    • medication management
    • other eye conditions, for example unilateral vision
  • eye and vision examination both eyes:
    • best corrected visual acuity
    • check for nystagmus/abnormal involuntary eye movements
    • check for pupillary reflexes
    • cover or corneal light reflex test for strabismus
    • ocular motility
    • stereo-acuity if possible
    • fundus examination if possible
    • slit lamp examination where possible
  • relevant social information including:
    • employment/education associated implications
    • carer for partner/family member
    • lives alone, unable to manage daily activities due to vision loss
  • optometrist report less than 12 months old at time of referral
  • photograph with patient’s consent, where secure image transfer, identification and storage is possible where appropriate