Urgent advice line: 01708 435 000 Ext. 6662
Please fill in the urgent eye care referral form [docx] 17KB and email it to bhrut.urgenteyecare@nhs.net
Resident doctor strike
From Wednesday 17 to Monday 22 December, resident doctors (formerly known as junior doctors) will be taking strike action. During this time, our services will be under increased pressure.
Getting the right care
Please help us make sure emergency care is available for those who need it most:
- Only attend A&E in life-threatening emergencies.
- For non-urgent issues, please contact your GP, your local pharmacy, or NHS 111 (online or by phone).
Appointments and planned care
- If your appointment is affected, we will contact you directly.
- If you do not hear from us, please attend your appointment as planned.
Summary of urgency referrals
This list is intended to be guidance about which conditions require emergency or urgent referral.
Emergency referral (within 24 hours), symptoms or signs suggesting:
- Acute glaucoma
- Acute dacryocystitis in children, or in adults if severe
- Cellulitis (preseptal or orbital)
- Corneal foreign body penetrated into stroma, or with presence of a rust ring (unless optometrist is specifically trained in rust ring removal)
- CRAO
- Endophthalmitis
- Facial palsy, if new or with loss of corneal sensation
- Herpes zoster ophthalmicus with acute skin lesions (emergency referral to GP for systemic anti-viral treatment with urgent referral to ophthalmology if deeper cornea involved)
- Hyphaema
- Hypopyon
- IOP>/40mmHg (independent of cause)
- Microbial keratitis
- Orbital cellulitis
- Papilloedema
- Penetrating injuries
- Pre-retinal haemorrhage, although a pre-retinal haemorrhage in a diabetic patient with known proliferative retinopathy who is already being actively treated in the HES would not need an emergency referral
- Retinal detachment unless this is long-standing and asymptomatic
- Scleritis
- Sudden severe ocular pain
- Suspected temporal arteritis
- Symptomatic retinal breaks and tears
- Third nerve palsy with pain
- Trauma (blunt or chemical), if severe
- Unexplained sudden loss of vision
- Uveitis
- Vitreous detachment symptoms with pigment in the vitreous
- Viral conjunctivitis if severe (e.g. presence of pseudomembrane)
Urgent referral (within one week):
- Acute dacryocystitis, if mild
- Acute dacroadenitis
- Atopic keratoconjunctivitis with corneal epithelial macro-erosion or plaque
- Chlamydial conjunctivitis (refer to GP)
- CMV and candida retinitis
- Commotio retinae
- Corneal hydrops if vascularisation present
- CRVO with elevated IOP (40mmHg refer as emergency)
- Herpes zoster ophthalmicus with deeper corneal involvement – urgent referral to ophthalmology, but refer to GP as an emergency for systemic anti-viral treatment
- IOP>35 mm Hg (and <40mmHg) with visual field loss
- Keratoconjunctivitis sicca if Stevens-Johnson syndrome or ocular cicatricial pemphigoid are suspected
- Retinal detachment if not an emergency, see above
- Retrobulbar/optic neuritis
- Ocular rosacea with severe keratitis
- Rubeosis
- Squamous cell carcinoma
- Steroid induced glaucoma
- Sudden onset diplopia
- Unilateral blepharitis, if carcinoma suspected
- Vernal keratoconjunctivitis with active limbal or corneal involvement
- 'Wet’ macular degeneration/choroidal neovascular membrane, according to local fast-track protocol.