Ophthalmology (Eye Department)
GP and Optometrist referrals
Contact: (0191) 282 5446 - Eyeline Fax to Glaucoma Consultant
How to make acute and urgent referrals
(Eye Casualty or on-call ophthalmologists out of hours)
Acute Angle Closure Glaucoma or any IOP >40mmHG: High IOP in a blind eye with rubeotic glaucoma could be faxed in rather than referral to Eye Casualty.
Non urgent referrals
- Choose and Book to the Glaucoma Service (Nurse Screening clinic)
- Referral by letter or fax to glaucoma consultant
Please try and indicate referrals for possible narrow angles, or patients with poor vision or cognitive difficulties who will be seen directly in consultant clinic.
Referral criteria for use by Optometrists
- IOP alone : (i.e. Normal fields and disc appearance)
- 30 mm of Hg
- 25 mm with family history
- Visual Fields (VF):
Normal: If disc suspicious or cupped and high IOP
Abnormal: If suspicious disc and/or high IOP
If normal disc and IOP : repeat field : only refer if repeatable
- Disc Appearance:
- Pathological cupping
- Disc haemorrhage
- Disc Asymmetry only with high IOP and/ or Visual Field loss
- High IOP and anterior segment signs of secondary glaucoma eg pseudoexfoliation
- Suspect narrow angle glaucoma
- Subacute attacks
- Closeable angle and high IOP
Who can be discharged back to monitoring by their optometrist?
- Ocular hypertension with IOP < 30mm Hg or < 25mmHg with family history
- Untreated normal tension glaucoma with IOP < 18mm Hg in elderly patients.
Annual follow up by optometrist with VF. Follow up without VF acceptable if unable to do reliable fields in elderly with NTG.
