Acute visual distortion – Adult

Emergency and immediate referrals

Referral to Emergency Department: 

  • Acute injury e.g. trauma, burns, chemical exposure, foreign body

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.

Immediate 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
  • Retinal artery occlusion – patient 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 >35 mmHg
  • Signs/symptoms of retinal detachment – flashing lights, floaters, curtain/waterfall across vision or shadow of missing vision

To contact the relevant service, please refer to HealthPathways Acute Ophthalmology Assessment (seen within 7 days).

Presenting symptoms
  • Long standing distortion / kinking of lines (ensure not new onset of distortion)
Mandatory referral information (referral will be returned if this information is not included)
  • Best corrected visual acuity (BCVA) – vision with most recent distance spectacles
  • 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 reports/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
  • Epiretinal membrane with BCVA worse than 6/12
Cat 3
Appointment within 365 days
  • Symptomatic epiretinal membrane with BCVA 6/12 or better
Excluded ophthalmology services

Referral to public ophthalmology outpatient services is not routinely accepted for the following conditions:

Condition Details (where applicable)
Asymptomatic epiretinal membrane with good BCVA BCVA (6/9+)
Useful Information for referring practitioners

More information