2.2.6 Makes an appropriate judgement regarding referral and understands referral pathways

Question 1

What needs referred emergency (same day)?

Answer 1

➢ AACG
➢ Chemical Injuries
➢ CRAO
➢ Hyphaemia
➢ Hypopyon
➢ IOP> 45mmHg
➢ Orbital cellulitis
➢ Papilloedema
➢ Penetrating injuries
➢ Retinal Detachment
➢ Sight threatening Keratitis
➢ Sudden severe ocular pain
➢ Suspected temporal arteritis
➢ symptomatic retinal tear
➢ 3rd CN Palsy and pain
➢ unexplained pre-retinal haemorrhage
➢ unexplained sudden loss of vision
➢ uveitis
➢ vitreous detachment with pigment in vitreous

Question 2

What needs referred urgently (within 1 week)?

Answer 2

• Acute dacrocystitis
• Candida retinitis
• CRVO with raised IOP
• Disc Haemorrhage in Px without glaucoma
• IOP >35 but <45
• RD macula off
• Retrobulbar optic neuritis
• Rubeosis
• Scleritis
• SCC
• sudden onset diplopia
• Wet AMD/ CNV according to local fast track protocol

Question 3

What needs referred routinely (within 3 months)?

Answer 3

• Cataract
• Glaucoma

Question 4

What needs included in referral letter?

Answer 4

• RFV
• VA
• Ant/Post eye
• IOP
• BV
• VF
• Reason for referral
• GH
• Meds
• Urgency