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.
- sudden onset ptosis
Assess and exclude acute neurological event including stroke or transient ischemic attack (TIA) prior to referring and consider contacting the nearest on-call stroke service where neurological features are present.
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
- Royal Adelaide Hospital (08) 7074 0000
- The Queen Elizabeth Hospital (08) 8222 6000
Northern Adelaide Local Health Network
- Lyell McEwin Hospital
(08) 8182 9000
Southern Adelaide Local Health Network
- Flinders Medical Centre (08) 8204 5511
Exclusions
- dry eye disease
- cosmetic concerns
- excess or saggy eyelid skin that does not affect visual fields
- internal hordeolum (stye) without suspected preseptal or orbital cellulitis
Triage categories
Category 1 (appointment clinically indicated within 30 days)
- suspected malignancy
- ectropion with incomplete eye closure with keratopathy
- sudden onset of ptosis with- neurological features
- symptomatic entropion with epithelial damage
- internal hordeolum (stye) with suspected preseptal or orbital cellulitis
Category 2 (appointment clinically indicated within 90 days)
- symptomatic ptosis involving visual axis
Category 3 (appointment clinically indicated within 365 days)
- dermatochalasis affecting visual fields
- ptosis involving visual axis without neurological features
- entropion/ectropion causing epiphora
- small protrusions/lumps or bumps on the eyelid that result in damage to the cornea when blinking
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/surgical history
- current medications, allergies
- ocular history, including:
- symptoms and duration of clinical presentation
- surgery and medical management
- diabetes history
- medication management
- other eye conditions, for example unilateral vision
- eye and vision examination both eyes:
- best corrected visual acuity
- check for corneal epithelial damage with fluorescein
- automated visual fields examination
- relevant social information including:
- employment/education associated implications
- carer for partner/family member
- lives alone, unable to manage daily activities due to vision loss
- optometrist report less than 12 months old at time of referral
- photograph – with patient’s consent, where secure image transfer, identification and storage is possible where appropriate
Clinical management advice
Please note that referrals for ectropion/entropion can be managed by the following specialist services:
- ophthalmology
- plastic surgery — Eye/Eyelid Procedures - Adult CPC
Clinical resources
- NSW Health– Eye eye app
- HealthPathways SA - Eye examination in adults
- Patient Info - Ptosis and lid lag
- Patient Info - Conditions affecting the external eye