Acute onset or progressive blurred vision – Adult

Emergency and immediate referrals

Referral to Emergency Department:

  • Acute injury e.g. trauma, burns, chemical exposure, foreign body
  • Ophthalmology conditions associated with sudden onset neurological signs and/or symptoms – diplopia or vision loss with other neurological signs or symptoms, cranial nerve palsies, optic neuropathies, papilledema

To contact the relevant service, please refer to HealthPathways Ophthalmology Advice.

Otherwise, please refer the patient to the emergency department (via ambulance if necessary) or seek urgent medical advice if in a remote region.

Immediately Referral (seen within 7 days):

  • Post ophthalmic surgery suspected endophthalmitis or other complications – recent Hx surgery or intraocular injection, sudden vision loss, or sudden onset of pain and/or inflammation
  • Ocular signs or symptoms of giant cell temporal arteritis – temporal tenderness, jaw claudication, blurring of vision, burning or craniofacial pain or tenderness of superficial temporal arteries (consider immediate high dose steroids)
  • Retinal artery occlusion – patients with central or branch retinal artery occlusion
  • Sudden severe visual loss e.g. vitreous haemorrhage, retinal detachment or retinal vascular occlusion
  • Corneal graft rejection – if seen on examination
  • Contact lens keratitis, corneal ulcers – H/o contact lens wear with reduced vision or epithelial defect, trauma, pain
  • Uveitis/scleritis – pain, photophobia, circum-corneal congestion +/- vision loss
  • Intraocular pressure (IOP) > 35 mmHg
  • Signs/symptoms of retinal detachment – flashing lights, floaters, curtain/waterfall across vision or shadow of missing vision
  • Acutely inflamed eye – with pain/photophobia/discharge (unless obviously secondary to chalazion)
  • Preseptal/orbital cellulitis – worsening eyelid oedema, erythema and proptosis, restricted globe movements/diplopia
To contact the relevant service, please refer to HealthPathways Acute Ophthalmology Assessment (seen within 7 days)
Presenting symptoms
  • Blurred central vision
  • Macular hole diagnosed by optometrist/ophthalmologist
Mandatory referral information (referral will be returned if this information is not included)
  • Best corrected visual acuity (BCVA) -vision with most recent distance spectacles
  • Description of symptoms
  • Details and duration of treatments
  • Most recent optometrist or private ophthalmologist report including:
    • Refraction
    • Impact of symptoms
  • If unable to attach reports please include relevant information/results in the referral
  • Referrer to state reason if not able to include in referral

Note: This information is required to triage accurately, within a clinically suitable timeframe

Highly desirable referral information
  • Other relevant optometrist or ophthalmologist report/results if available and where providing it will not delay care:
    • Optical coherence tomography (OCT)
Indicative triage category
Indicative triage category
Cat 1
Appointment within 30 days
  • Full thickness macular hole
Cat 2
Appointment within 90 days
  • Vitreomacular traction with/without impending macular hole
  • Lamellar macular hole with BCVA worse than 6/12
Cat 3
Appointment within 365 days
  • Lamellar macular hole with BCVA of 6/12 or better
Useful Information for referring practitioners

More information