Ptosis – Adult

Emergency and immediate referrals

Referral to Emergency Department:

  • Ophthalmology conditions associated with sudden onset neurological signs and/or symptoms – ptosis, diplopia or vision loss with other neurological signs or symptoms, cranial nerve palsies, optic neuropathies, papilledema
  • Sudden onset of any of the following: constant convergent squint (esotropia), divergent squint (exotropia), double vision at any age, acute trauma related strabismus, acute esotropia +/or acute leukocoria

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):

  • Nil

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

Presenting symptoms
  • Symptomatic – drooping of one or both eyelids with interference with vision
  • Frontal headaches with brow overaction
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 and impact of symptoms 
  • Details and duration of treatments
  • Most recent optometrist or private ophthalmologist report including:
    • Visual acuity
    • 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
Indicative triage category
Indicative triage category
Cat 1
Appointment within 30 days
  • Suspected neurologic condition
  • Sudden onset ptosis
  • Ptosis in association with diplopia
Cat 2
Appointment within 90 days
  • Symptomatic ptosis involving visual axis
Cat 3
Appointment within 365 days
  • Symptomatic ptosis not involving visual axis
Excluded ophthalmology services

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

Condition Details (where applicable)
Mild ptosis Patients with involutional ptosis who are asymptomatic or do not want surgery will not be accepted
Useful Information for referring practitioners

More information