Referral to emergency

If any of the following are present or suspected, please refer the patient to the emergency department (via ambulance if necessary) or seek emergent medical advice if in a remote region.

  • 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
  • patients with intra ocular pressure (IOP) greater than 35mmHg
  • painful red eye on which previous glaucoma surgery has been conducted

Please contact the on-call registrar to discuss your concerns prior to referral.

For clinical advice, please telephone the relevant metropolitan Local Health Network switchboard and ask to speak to the relevant specialty service.

Central Adelaide Local Health Network

Northern Adelaide Local Health Network 

Southern Adelaide Local Health Network

Category 1 (appointment clinically indicated within 30 days)

  • suspected glaucoma and any of the following:
    • intra ocular pressure (IOP) between greater than 30 30-35 mmHg, in one or both eyes
    • iris neovascularisation/rubeosis
    • significant damage or injury to the optic nerve head
    • severe visual field loss including:
      • loss of peripheral vision
      • tunnel vision

Category 2 (appointment clinically indicated within 90 days)

  • suspected glaucoma and any of the following:
    • IOP greater than 28mmHg and less than 30mmHg, in one or both eyes without optic disc damage or visual field loss
    • early disc damage or field loss consistent with glaucoma
    • suspicion of narrow iridocorneal angles with risk of angle closure glaucoma as assessed by an optometrist
  • pre-existing glaucoma diagnosis requesting transfer of care

Category 3 (appointment clinically indicated within 365 days)

  • IOP equal to or greater than 22mmHg but less than 28mmHg with any of the following:
    • corneal thickness of less than 555
    • high risk medication use such as steroids
    • history of trauma
    • pseudo exfoliation
    • pigment dispersion
    • very high myopia
    • family history

For more on outpatient referrals, see the general referral information page.

Essential referral information

Completion required before first appointment to ensure patients are ready for care. Please indicate in the referral if the patient is unable to access mandatory tests or investigations as they incur a cost or are unavailable locally.

  • identifies as Aboriginal and/or Torres Strait Islander
  • relevant social history, including identifying if you feel your patient is from a vulnerable population and/or requires a third party to receive correspondence on their behalf
  • interpreter required
  • relevant past medical and surgical history including family history
  • current medications, allergies
  • ocular history, including:
    • symptoms and duration of clinical presentation
    • surgery and medical management, including glasses and/ or amblyopia therapy
    • medication management
    • other eye conditions for example, unilateral vision
  • eye and vision examination both eyes:
    • best corrected visual acuity
    • retinal and optic nerve examination
    • slit lamp examination where possible
    • visual field assessment
    • refraction
  • relevant social information including:
    • employment/education associated implications
    • carer for partner/family member
    • lives alone, unable to manage daily activities due to vision loss
  • optical coherence tomography (OCT) where possible
  • optometrist report less than 6 months old at time of referral
  • photograph – with patient’s consent, where secure image transfer, identification and storage is possible

Additional information to assist triage categorisation

  • eye and vision examination
    • gonioscopy, pachymetry

Clinical management advice

Evidence strongly supports a screening approach that targets individuals at higher risk of developing glaucoma, rather than the general population. High risk groups may include:

  • people aged greater than 50 years of age
  • familial history of glaucoma
  • diabetes
  • presence of myopia

Those referred for glaucoma must continue community monitoring for progression of disease until hospital care is received and re-referred if they require more urgent care.

Clinical resources

Consumer resources