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 unilateral red eye with vision loss
- red eye in previous corneal transplant
Please contact the on-call registrar to discuss your concerns prior to referral.
For clinical advice, please telephone 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
- stable allergic eye disease
- mild allergic eye disease without corneal involvement who have not attempted first line medical management
- acute conjunctivitis without corneal involvement
- recurrent corneal erosions
Triage categories
Category 1 (appointment clinically indicated within 30 days)
- keratoconjunctivitis with corneal involvement
- herpetic eye disease
- acute anterior uveitis
- scleritis
- anterior uveitis with increased intraocular pressure (IOP)
- acute unilateral red eye with vision loss
- off axis corneal ulceration unresponsive to medical/allied health treatment
Category 2 (appointment clinically indicated within 90 days)
- keratoconjunctivitis with corneal involvement
Category 3 (appointment clinically indicated within 365 days)
- mild allergic eye disease without corneal involvement unresponsive to topical anti-histamines, and/or mast cell stabilisers
- recurrent episcleritis
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.
- relevant past medical/surgical history
- sexual history
- gonococcal conjunctivitis
- current medications, allergies
- ocular history, including:
- other eye conditions
- eye trauma
- surgery and medical management
- medications trialled including mast cell stabiliser use and oral/topical anti-histamine administration
- eye and vision examination both eyes:
- visual acuity utilising most recent distance spectacles
- check for corneal epithelial damage with fluorescein
- intraocular pressure (IOP) where appropriate
- pupil examination where appropriate
- optometrist report within 24hours of referral
- photograph with patient’s consent, where secure image transfer, identification and storage is possible where appropriate
Clinical management advice
Many acute red eye presentations can be effectively managed by a therapeutically endorsed optometrist.
Slit lamp examination is crucial in distinguishing between different acute red eye presentations and deciding if hospital-based care is appropriate.
Individuals who have been referred for specialist outpatient service assessment of red eye, should be closely monitored until they are examined by an ophthalmologist to ensure that their condition doesn't worsen. Where clinical signs of deterioration occur, please contact the nearest ophthalmology service to discuss your concerns.
Clinical resources
- Therapeutic Guidelines – Allergic Conjunctivitis Guidelines
- The Royal Victorian Eye and Ear Hospital - Blepharitis
- Royal Australian College of General Practitioners - Acute red eye in children: A practical approach
- American Family Physician - Diagnosis and Management of Red Eye in Primary Care
Consumer 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.