Ophthalmology Community Care

The Department will periodically contact patients waiting for an outpatient clinic appointment via SMS, with a link to an electronic form.  This is part of routine waitlist auditing to ensure patient details are up to date.  If you receive this SMS, please update your details.

The following conditions are not routinely seen at the Royal Hobart Hospital Eye Clinic and may be appropriately managed by the general practitioner or a local ophthalmologist or optometrist until they reach the clinical thresholds identified in these the Ophthalmology referral guidelines.

Age Related Macular Degeneration (AMD)

  • asymptomatic but at risk of  familial AMD
  • retinal pigment epithelial changes (previously called dry AMD) and or drusen with no change in Amsler grid

Cataracts

  • Early or mild
  • Best corrected visual acuity ≥ 6/9 that is asymptomatic
  • Best corrected visual acuity of 6/9 or worse accepted if patient a professional driver

Diabetes

  • Asymptomatic patients
  • Diabetic retinopathy screening in newly diagnosed patients
  • Minimal non-proliferative (background) diabetic retinopathy

Eye Infections/Inflammations

  • Chronic, not severe blepharitis with no corneal or structural lid changes
  • Itchy or burning eyes
  • Recent occurrence of chalazion – should trial heat and gentle massage for three months
  • Conjunctivitis with no other signs or symptoms and no reduction in visual acuity
  • Asymptomatic pterygium
  • Long standing dry eyes with no corneal changes

Glaucoma

  • Asymptomatic patient with family history and no other risk factors

Excess upper eyelid skin

  • Not obscuring line of sight

Refraction

  • Glasses check
  • Refractive laser surgery

Headaches

  • Headache when reading
  • Migraine with no ophthalmic symptoms
  • Tension headache with no ophthalmic symptoms

Retinal

  • Asymptomatic epiretinal membrane (ERM): stable, asymptomatic non-vision threatening retinal disease
  • Floaters: longstanding with no other symptoms

Hydroxychloroquine (plaquenil) screening

Guidelines for Screening for Hydroxychloroquine Retinopathy were published by the Royal Australian and New Zealand College of Ophthalmologists (RANZCO) in 2021.

  • Baseline examination and annual screening after 5 years of use for patients with no risk factors
  • Ophthalmological review will be considered for patients at increased risk i.e. patients:
    • on chloroquine
    • on hydroxychloroquine dose >5mg/kg real weight/day
    • with renal impairment
    • with concomitant Tamoxifen use
    • Patients with concomitant retinal/macular disease
  • Patients who have signs of retinopathy at screening or have equivocal findings should be referred promptly for specialist retinal assessment.