Ophthalmology Referral Guidelines including Out of Hours guidance for GPs

WEEKDAYS 09:00 to 17:00 hours (but excluding Public Holidays) phone Eye Clinic on 01463 705523. Senior Ophthalmology Nurses 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.eyecasualtyraigmore@nhs.scot

OUT OF HOURS - from 08:00 to 09:00 and 17:00 to 20:00 on weekdays or 08:00 to 20:00 Saturday and Sunday - discuss very urgent cases with the on-call Ophthalmologist. 

OVERNIGHT (20:00 to 08:00) follow the Ophthalmology Emergency Protocols

For cases which need soon Ophthalmology involvement (but not out of hours) use e-mail referral:

• Complete the Ophthalmology Referral Form
• E-mail completed Referral along with copy of clinical notes to nhsh.eyecasualtyraigmore@nhs.scot
• Keep copy of Ophthalmology Referral Form with Clinical Notes
• Remember and document time of E-mail

Please note the e-mail is not checked on Saturday or Sunday mornings. Therefore if a patient is seen overnight on Friday or Saturday and requires an Ophthalmology review the following morning please:

• Send the patient with paperwork to Raigmore Eye Clinic at 10.30am (if possible) the following morning

Click here for the referral form

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.

• Endophthalmitis – immediate transfer to A&E Raigmore
• Orbital Cellulitis – D/W Raigmore ENT On-call
• Angle Closure Glaucoma – consider immediate transfer to Raigmore A&E (but shouldn’t require air evacuation from Orkney or WIH)
• 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 Raigmore 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

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 via A&E Raigmore [consider initiating treatment for suspected Temporal Arteritis (steroid), Angle Closure Glaucoma (Acetazolamide) or Orbital Cellulitis (antibiotic) if likelihood of delay in transfer]