Go to whole of WA Government Search
Eyelid procedures Referral Access Criteria

Eyelid procedures Referral Access Criteria

Referrers should use this page when referring patients to public adult plastics and reconstructive surgery outpatient services for eyelid procedures.
Emergency referral
If any of the following are present or suspected, refer the patient to the emergency department or seek emergency medical advice if in a remote region.
  • Acute eyelid injury e.g. burns, chemical exposure, foreign body, eyelid lacerations 
  • Acute visual impairment (e.g. double vision, tunnel vision, esotropia)
Immediate referral
Orange exclamation mark in triangle: orange alertImmediately contact the on-call registrar or service to arrange an immediate plastic and reconstructive surgery assessment (seen within 7 days): 
  • Nil
Clinical indications for outpatient referral
If any of these issues are present, refer to outpatient services through the Central Referral Service (CRS).
  • Excess or saggy upper eyelid skin affecting visual fields
  • Ptosis
  • Ectropion (watery eyes, red eyelid, and irritation)
  • Suspected malignancy
  • Blepharochalasis
Mandatory information
Referrals missing 'mandatory information' with no explanation provided may not be accepted by site. If 'mandatory information' is not included, the explanation must be provided in the body of the referral (e.g. patient unable to access test in regional or remote areas or due to financial reasons). This information is required to inform accurate and timely triage.

If unable to attach reports, please include relevant information/findings in the body of the referral and advise where (provider) investigation/imaging was completed.
History
  • Relevant history, onset, duration and severity of symptoms
  • Degree of functional impairment (e.g. impact on mobility/exercise tolerance/ADLs/ability to work/quality of life)
  • Details of previous treatment and outcome
  • Current medication list
  • Any known allergies
Examination
  • Nil
Investigations
  • Nil
Highly desirable
History
  • Details of smoking and/or vaping (containing nicotine) status
  • Advise whether or not your patient is taking any anti-platelets or anti-coagulants
    • if so, state the indication
Examination
  • BMI
  • Confrontation visual field
  • Photograph of the eye
  • For ptosis and ectropion:
    • Best Corrected Visual Acuity BCVA (vision with most recent distance spectacles)
    • most recent optometrist or private ophthalmologist report including visual acuity, refraction, and impact of symptoms
Investigations
  • Nil
Indicative clinical urgency category

Category 1

Appointment within 30 days

  • Suspected malignancy
  • Sudden onset of ptosis

Category 2

Appointment within 90 days

  • Symptomatic ptosis involving visual axis
  • Symptomatic ectropion with incomplete eye closure leading to corneal irritation
  • Symptomatic ectropion

Category 3

Appointment within 365 days

  • Symptomatic ptosis not involving visual axis
  • Blepharochalasis which obstructs the visual field
Exclusions
Useful information
  • Patients should have seen an optometrist within 12 months to exclude pressure problems, dry eye, and other contraindications
  • Symptomatic ectropion and some other listed conditions can be referred to any of the following specialties:
    • Plastic and Reconstructive Surgery
    • Ophthalmology

Feedback

If you would like to submit feedback on the contents of the Referral Access Criteria, please complete this form.

Last reviewed: 15-08-2025
wa.gov.au