Glaucoma (chronic open angle glaucoma) – Adult
Glaucoma (chronic open angle glaucoma) – Adult
Emergency and immediate referrals
Referral to Emergency Department:
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
Email: DOHSpecialistRAC@health.wa.gov.au