Glaucoma (chronic open angle glaucoma) – Adult

Emergency and immediate referrals

Referral to Emergency Department:

  • Nil

Immediate Referral (seen within 7 days):

  • Acute 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)
  • Congenital glaucoma e.g. big eye/s, cloudy cornea, photosensitive, tearing
  • Patients with intraocular pressure (IOP) >35mmHg
  • Patients with elevated IOP of 25-35 mmHg with accompanying signs (e.g. uveitic glaucoma)
  • Uveitic glaucoma, neovascular, lens related glaucoma, unstable secondary glaucoma

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

Presenting symptoms
  • Suspected or known glaucoma
Mandatory referral information (referral will be returned if this information is not included)
  • Details and duration of treatments
  • Severity of symptoms
  • Family history
  • Most recent optometrist or private ophthalmologist report including:
    • Visual acuity
    • Refraction
    • Intraocular pressure (IOP)
    • Gonioscopy
    • Pachymetry
    • Visual fields
    • Disc assessment
  • 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)
  • Retinal nerve fibre layer results
  • Optic disc photos
Indicative triage category
Indicative triage category
Cat 1
Appointment within 30 days

Likely diagnosis of glaucoma and any of the following:

  • IOP 30-35 mmHg
  • severe disc damage
  • severe field loss 
Cat 2
Appointment within 90 days

Likely diagnosis of glaucoma and any of the following:

  • signs of early disc damage or field loss consistent with glaucoma
  • IOP >28mmHg <30mmHg without disc damage or field loss
  • suspicion of narrow iridocorneal angles with risk of angle closure glaucoma 
Cat 3
Appointment within 365 days

IOP ≥22mmHg < 28mmHg WITH any of the following:

  • central corneal thickness <555
  • high risk medicine (e.g. steroids)
  • history of trauma
  • pseudo exfoliation
  • pigment dispersion
  • very high myopia
  • family history 
Excluded ophthalmology services

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

Condition Details (where applicable)
Stable, mild glaucoma
Useful Information for referring practitioners

More information