HEYEH Guidance for Acute Referrals

Subspecialty

Immediate phone advice

Urgent email / Advice and guidance within 24h

Glaucoma

Symptoms  / signs of AACG

IOP >38mmHg

IOP >30mmHg

Retinal

Macula-on, or recent (<24h) macula-off retinal detachment (symptomatic – recent shadow, reduced vision +/- floaters photopsia)

Sudden loss of vision – presumed CRAO

Acute loss of central vision / distortion –wet AMD suspected

Significant recent onset floaters  +/- photopsia

Macula-off retinal detachment

Vitreous haemorrhage

Central retinal vein occlusion

Adnexal / Lid

Acute onset proptosis / Rapidly worsening TED

Suspected orbital cellulitis

Suspicious lid lesion – cancer suspected

Periocular infection – eye unaffected, vision and eye movements unaffected – patient otherwise well

General

Pain and reduced vision within 2 weeks of eye injection / surgery

Amaurosis fugax, with or without headache

New onset headache with visual loss or diplopia

Neuro / Strabismus

Acute onset of binocular diplopia

Acute ptosis

Acute Horners or dilated pupil

Ocular Oncology

Mass lesion, suspicious naevus – (if possible with images to nhs.net address)

Cornea

Corneal ulcer – pain, redness, loss of vision, hypopyon

(please see separate advice re contact lens wear during pandemic)

Abrasion – no sign of associated infection / clear cornea

Dendritic ulcer

Paediatrics

Orbital / preseptal inflammation as above

Reduced vision in one eye under 7y

Reduced vision in both eyes