Thyroid associated orbitopathy – Adult

Emergency and immediate referrals

Referral to Emergency Department:

  • Ophthalmology conditions associated with sudden onset neurological signs and/or symptoms – diplopia or vision loss with other neurology signs or symptoms, cranial nerve palsies, optic neuropathies, papilledema

To contact the relevant service, please refer to HealthPathways Ophthalmology Advice (external site). 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):

  • Contact lens keratitis, corneal ulcers – H/o contact lens wear with reduced vision or epithelial defect, trauma, pain

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

Presenting symptoms
  • Proptosis, irritation, conjunctival irritation, swelling eyelids, double vision
Mandatory referral information (referral will be returned if this information is not included)
    Detail of patient’s thyroid disorder
  • Duration of symptoms
  • Best corrected visual acuity (BCVA) - vision with most recent distance spectacles
  • Details, duration and response to treatment/s to date 
Highly desirable referral information
  • Any relevant/previous investigations or imaging
Indicative triage category
Indicative triage category
Cat 1
Appointment within 30 days
  • Suspected compressive optic neuropathy
  • Failing vision 
Cat 2
Appointment within 90 days
  • Recent onset double vision
Cat 3
Appointment within 365 days
  • Any patient with suspected thyroid eye disease

More information

Email: DOHSpecialistRAC@health.wa.gov.au