Key points

  • Always be aware of local protocols for referral of eye diseases and how to ensure a patient is seen in the appropriate time, whether that be an emergency, a condition that needs to see a specialist as soon as possible (‘fast-track’), or a routine referral.
  • Dedicated pathways exist for routine referrals of conditions, such as cataract and suspect glaucoma, and ocular hypertension – make sure you know how each pathway relevant to your practice operates.
  • Emergency referrals include conditions causing severe pain (acute angle closure glaucoma, microbial keratitis), imminent threat to vision (suspect detachment) or threat to life (papilloedema, arterial occlusions).
  • If in doubt, telephone the appropriate secondary care unit – record any advice and the name of the person who offered it.
  • Fast-track pathways are designed to direct the patient for urgent care by the appropriate specialist. Where there is no dedicated pathway (such as for wet AMD), contacting the secondary care unit is appropriate where urgent specialist care is needed (such as proliferative retinopathy, suspect malignancy, macular oedema).