Visual disturbance or loss (non-cataract)

Availability

North South North West Statewide

Pre-referral work-up

History

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

  • Asymptomatic Epiretinal Membrane (ERM – stable non-sight threatening retinal disease).

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

History:
  • History of visual loss: unilateral/bilateral, sudden/subacute/chronic
  • History of associated headache
  • History of any field loss or change
  • History of red or painful eye or pain on eye movement
  • Any history diplopia, ptosis or pupil changes
  • Retinal detachment symptoms: flashes/floaters/visual field loss
  • Neuro-ophthalmic disorders
  • Comorbidities: hypertension, diabetes, heart disease, vascular disease, etc
  • Family history of visual loss
  • History of trauma
Examination:
  • Visual acuity with current distance glasses
  • Confrontation visual fields:
    • Red reflex: any white pupil reflex in children, asymmetric red reflex
    • Pupil changes: any relative afferent pupil defect, anisocoria or pupillary light reflex abnormality
  • Where available:
    • Slit lamp examination
      • Dilated exam: any significant retinal, vitreous or optic nerve pathology

Interim/GP management

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

For more information please see the Tasmanian Health Pathways website.

Emergency

Emergency - ring on call Ophthalmic Registrar to discuss.

Sudden loss of or reduction in vision

Suspected optic neuritis

Suspected retinal detachment

Painful red eye . Ring on call Ophthalmic Registrar to discuss

Amarosis fugax. Ring on call Ophthalmic Registrar to discuss

Giant cell arteritis or other vascular disease

Sudden onset diplopia

Sudden onset ptosis

Suspected papilloedema or raised intracranial pressure

Sudden field loss associated with ocular signs or symptoms

Central retinal artery or vein occlusion

Vitreous haemorrhage

White pupil reflex in children

Urgent / category 1

Children with amblyogenic conditions under the age of 12

Full thickness macular hole

Branch retinal vein or artery occlusion.

Central serous retinopathy with Amsler grid changes

Suspected intraocular melanoma

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