Ophthalmology referral guidelines, including Out of Hours (Guidelines)

TAM (Treatments and Medicines) NHS Highland
NHS Highland

Audience

  • Highland Health and Social Care Partnership
  • Primary and Secondary Care

Introduction

WEEKDAYS 09:00 to 17:00 hours (but excluding Public Holidays):

  • Phone Eye Clinic on 01463 709111 or 0800 111 4526. 
  • Senior Ophthalmology Clinicians will triage the referral and offer a suitable appointment or provide management advice.
  • If given an appointment email the completed Ophthalmology Referral Form to:  nhsh.eyecasualtyntch@nhs.scot

OUT OF HOURS from 08:00 to 09:00 and 17:00 to 20:00 on weekdays (16.00 to 20.00 on Fridays) or 08:00 to 20:00 Saturday and Sunday (plus Public Holidays):

  • Discuss very urgent cases with the on-call Ophthalmologist. 
  • For other referrals email an Ophthalmology Referral Form as above to nhsh.eyecasualtyntch@nhs.scot.

OVERNIGHT (20:00 to 08:00):

The vast majority of cases seen Out of Hours or Overnight will need SOON rather than URGENT Ophthalmology involvement.

  • Email the Ophthalmology Referral Form to nhsh.eyecasualtyntch@nhs.scot and the Ophthalmology triage clinicians will contact the patient the following morning to arrange review.

There are very occasional patients who don’t require admission but do need to be seen urgently by Ophthalmology the following morning, eg, definite Retinal Detachments.

  • As well as emailing the Ophthalmology Referral Form and a copy of their clinical notes, these patients should be given a paper copy of the Ophthalmology Referral Form and asked to attend the Eye Clinic at 09.00 (weekdays) or 10.00 (Sat/Sun/Public Holidays) the following day.
Please note that the Eye Clinic is at the National Treatment Centre-Highland, NOT Raigmore Hospital.

Ophthalmology Referral form

Click here for the referral form

Printable Visual Acuity Chart (and instructions)

SNELLEN EYESIGHT CHART (3M, A4)

The below chart should be printed onto A4 paper.

Instructions:

  • Use with patient’s distance (“driving” or “TV”) glasses
  • Hold chart 3 metres from patient
  • Ensure chart well lit
  • Test each eye individually

Please click here to view and print the Snellen Chart.

Ophthalmology Emergencies OOH: Peripheral Hospitals

  • Endophthalmitis – immediate transfer to National Treatment Centre
  • Orbital Cellulitis – D/W Raigmore ENT On-call
  • Angle Closure Glaucoma/Ocular penetration/Retinal detachment/Chemical injury/Lid trauma – Admit to peripheral hospital, follow Ophthalmology Emergency Protocols overnight then send patient with Ophthalmology referral form first thing (to arrive at NTC Eye Clinic 09.00 if possible)
  • Suspected Temporal Arteritis with visual loss – Admit to peripheral hospital, follow Ophthalmology Emergency Protocols overnight and D/W On call Ophthalmologist following morning

 

Ophthalmology Emergencies OOH: GPs

Management will depend whether GP is seeing patient in a peripheral hospital or in the community AND distance from Raigmore:

  1. If patient being seen in a peripheral hospital OR being seen in the community a long distance from Raigmore but close to a peripheral unit, follow Peripheral Hospital advice above
  2. If patient being seen closer to Raigmore, admit to Raigmore Hospital or NTC Ophthalmology as appropriate [consider initiating treatment for suspected Temporal Arteritis (steroid), Angle Closure Glaucoma (Acetazolamide) or Orbital Cellulitis (antibiotic) if likelihood of delay in transfer]

Editorial Information

Last reviewed: 10/05/2024

Next review date: 28/02/2026

Author(s): Ophthalmology Review Group.

Version: 2.2

Approved By: TAM subgroup of the ADTC

Reviewer name(s): Dr T Leslie, Consultant Ophthalmologist.

Document Id: TAM429