Eyelid Disorders

Availability

North South North West Statewide

Pre-referral work-up

History

The following conditions are not routinely seen at the RHH Eye Clinic and may be appropriately managed by the general practitioner, local ophthalmologist or optometrist:

  • Chalazion: trial of 3 months of conservative treatment (gentle heat and massage) prior to referral
  • Chronic, non-severe blepharitis with no corneal or structural lid changes.
  • Excessive upper eye lid skin not obscuring the line of sight

All referrals should comply to the Standard Referral guidelines and include in particular:

  • Lid lesion: description including size, colour, stability, effect on vision and diagnosis if known
  • Ectropian/entropian: associated ocular signs and symptoms such as pain, epiphora
  • Excessive upper eye lid skin: obscuring the line of sight
  • Ptosis: Unilateral or bilateral. Does it obscure the line of sight?
  • Blepharitis: severe with corneal or structural lid changes
  • Blepharospasm: Intermittent or constant. Bilateral or unilateral. Duration.

Tests

  • Blepharitis: Referral if severe with corneal or structural lid changes.
  • Optometrist or ophthalmologist report required if referral not urgent.

Interim/GP management

To refer a patient with this condition, please see the Ophthalmology clinic page for the full referral process and templates.

Chalazion: Trial of three months of conservative treatment (gentle heat and massage) prior to referral.

Ocular surface exposure or dry eye: Commence ocular lubricants.

Blepharitis: Commence lid care and lubricants. Consider course of oral doxycycline if unresponsive. Referral if severe with corneal or structural lid changes. Optometrist or ophthalmologist report required if referral not urgent.

For more information please see the Tasmanian Health Pathways website.

Emergency

Emergency - ring on call Ophthalmic Registrar to discuss.

Sudden onset ptosis

Sudden inability to close eyelids/facial nerve palsy

Corneal ulceration associated with lid malpositions

Preseptal cellulitis

Urgent / category 1

Lid lesions if increasing in size or changing colour

Corneal changes and/or ocular pain associated with lid malpositions

Ptosis in a child

Red flags are clinical indicators of possible serious underlying conditions requiring further medical intervention. They may or may not indicate an emergency.

Emergency:

Proceed to Emergency Department (ED). Please contact ED Medical Officer in Charge:
LGH ED
– Phone: (03) 6777 6405  Fax: (03) 6777 5201
MCH ED
– Phone: (03) 6478 5120  Fax: (03) 6441 5923
NWRH ED
– Phone: (03) 6493 6340  Fax: (03) 6464 1926
RHH ED
– Phone: (03) 6166 6100  Fax: (03) 6173 0489

Urgent:

Urgent referrals should be accompanied by a phone call to the Consultant/Registrar to organise urgent review and the referral must be faxed.

We will endeavour to see these patients within ten days, or sooner if clinically indicated.

Semi-urgent:

We will endeavour to see these patients within 12 weeks

Routine:

Next available appointment