Pterygium

ADULT

Adult

Retinal artery occulsion

Patients with central or branch retinal artery occlusion

Glaucoma

Congenital glaucoma e.g. big eye/s, cloudy cornea, photosensitive, tearing
Angle closure glaucoma (unilateral red eye associated with pain, nausea, loss of vision, photophobia, steamy cornea, hard tender globe, ‘rainbows’ around lights, or sluggish pupil reactions)
Patients with IOP >35mmHg

Adult/paediatric strabismus

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

Other referrals to emergency

Sudden severe visual loss e.g. macular or vitreous haemorrhage, retinal detachment or retinal artery occlusion
Rubeosis iridis (iris new vessels)
Corneal graft rejection
Contact lens keratitis, corneal ulcers
Uveitis/scleritis
Intra ocular pressure (IOP) > 35 mmHg
Signs and/or symptoms of retinal detachment
Acute injury e.g. trauma, burns, chemical exposure, foreign body
Acutely inflamed eye
Preseptal/orbital cellulitis - worsening eyelid oedema, erythema and proptosis
Ocular signs or symptoms of temporal arteritis
Ophthalmology conditions associated with sudden onset neurological signs and/or symptoms e.g. third cranial nerve palsy or optic disc swelling

Paediatric

Leukocoria

White red reflex (refer directly by telephone to the on-call ophthalmology registrar)

Anisocoria (unequal pupil size)

If acute onset and associated with neurological signs

Chalazion/meibomian cyst

Chalazion with an abscess

Reduced visual acuity

Sudden severe vision loss in a child

Elevated optic nerve head

If neurological anomaly signs (vomiting, abnormal pupils, severe headache)
If Retinal haemorrhages or exudates

Other useful information for referring practitioners Not an exhaustive list

Refer to Healthpathways or local guidelines

Medical management

Lubrication/artificial tears
Wear protective sunglasses (wrap around style UV400)
Update spectacles
Consider annual review by private ophthalmologist or optometrist

Minimum Referral Criteria

Category 1
(appointment within 30 calendar days)
- No category 1 criteria
Category 2
(appointment within 90 calendar days)
- Size - 3mm or greater from limbus to apex and visual axis is threatened and/or dysplasia
Category 3
(appointment within 365 calendar days)
- Size - 3mm or greater from limbus to apex

1. Reason for request Indicate on the referral

To establish a diagnosis
For treatment or intervention
For advice and management
For specialist to take over management
Reassurance for GP/second opinion
For a specified test/investigation the GP can't order, or the patient can't afford or access
Reassurance for the patient/family
For other reason (e.g. rapidly accelerating disease progression)
Clinical judgement indicates a referral for specialist review is necessary

2. Essential referral information Referral will be returned without this

BCVA (vision with most recent distance spectacles)
Ophthalmologist or optometrist report which states size of pterygium from limbus to apex

3. Additional referral information Useful for processing the referral

Private ophthalmologist or optometrist report including VA, refraction and impact of symptoms (highly desirable)

4. Request

Patient's 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

Referring Practitioner Details

Relevant clinical information about the condition

Presenting symptoms (evolution and duration)
Physical findings
Details of previous treatment (including systemic and topical medications prescribed) including the course and outcome of the treatment
Body mass index (BMI)
Details of any associated medical conditions which may affect the condition or its treatment (e.g. diabetes), noting these must be stable and controlled prior to referral
Current medications and dosages
Drug allergies
Alcohol, tobacco and other drugs use

Reason for request

To establish a diagnosis
For treatment or intervention
For advice and management
For specialist to take over management
Reassurance for GP/second opinion
For a specified test/investigation the GP can't order, or the patient can't afford or access
Reassurance for the patient/family
For other reason (e.g. rapidly accelerating disease progression)
Clinical judgement indicates a referral for specialist review is necessary

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.)

Notes

Please note that 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 becoming pregnant) may affect the urgency categorisation and should be communicated as soon as possible.
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.

Version: 9
Last updated: 13 September 2022

Except as permitted under the Copyright Act 1968, no part of this work may be reproduced, communicated or adapted without permission from Queensland Health. To request permission email ip_officer@health.qld.gov.au.

Skip links and keyboard navigation

Site header

Site navigation

You are here: