​​​​​​​​​​​​Emergency

If any of the following are present or suspected, please refer the patient to the emergency department (via ambulance if necessary) or seek emergency medical advice via phone to on-call consultant/registrar:

  • centre-involving macular oedema in pregnancy
  • proliferative diabetic retinopathy (PDR)
  • retinal detachment
  • severe non-proliferative diabetic retinopathy (NPDR) in pregnancy
  • sudden loss of vision
  • vitreous haemorrhage.

When public outpatient services are not routinely provided

  • Mild non-proliferative diabetic retinopathy (NPDR) without macular oedema: these patients should have an optical coherence tomography (OCT) or fundus photography by their local eye health professional. Refer to RANZCO Guidelines for timeframes.
  • Routine referral for screening: refer to local eye health professional for fundus photography.

Pregnant patients with ​any diabetic retinopathy should be referred.

Criteria to access public outpatient services

CategoryCriteria
Category 1
Recommended to be seen within 30 calendar days
  • Diagnosis of diabetes and any of the following are present:.
    • severe non-proliferative diabetic retinopathy (NPDR)
    • centre-involving macular oedema
    • non-centre involving macular oedema in pregnancy.

Definition of centre-involving diabetic macular oedema is thickening within 500 microns of the foveal centre associated with microaneurysms, haemorrhages or hard exudates.

Category 2
Recommended to be seen within 90 calendar days
  • Moderate non-proliferative diabetic retinopathy (NPDR).
  • Mild NPDR seen at first trimester screening in pregnancy (should be reviewed by ophthalmologist between 16 to 20 weeks gestation).
  • Non-centre involving macular oedema.

Information to include within a referral

Required

  • Reason for referral.
  • Details of the presenting condition including symptoms and impact on activities of daily living.
  • Provisional diagnosis.
  • Retinal assessment including Best Corrected Visual Acuity (BCVA), digital fundus photography and refraction with optometrist, orthoptist or ophthalmologist.
  • If the patient requires an interpreter (if so, list preferred language).

If available

  • Patient health summary (such as relevant medical history, relevant investigations, current medications and dosages, immunisations, allergies and/or adverse reactions).
  • Optical coherence tomography (OCT) results.
  • Type of diabetes and duration of disease.
  • Previous eye treatment (e.g. retinal laser).
  • HbA1c (most recent within the last 6 months and previous 3 results).
  • Blood pressure.
  • Lipid profile.
  • Recent eGFR.
  • Professional driver with specific visual acuity requirements for employment.
  • Driving status.
  • If the patient is at increased risk of falling.
  • If the patient identifies as Aboriginal and/or Torres Strait Islander.
  • If the patient is considered ‘at risk’ and/or among a vulnerable, disadvantaged or priority population.
  • If the patient is willing to have surgery (where clinically relevant).
  • If the patient is suitable for virtual care or telehealth.
  • If the patient has special needs or requires reasonable adjustments to be made.

Important information for referring health professionals

If there is a change to a patient’s condition while waiting for their appointment, referring health professionals may further investigate and manage the situation, or send an updated referral to the outpatient service. Where there are significant concerns about a patient's condition, referring health professionals may check HealthPathways for urgent/same day advice or contact the relevant clinical team.

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Current as at: Sunday 12 May 2024
Contact page owner: System Purchasing