Lid lesions
+ Emergency
If any of the following are present or suspected, please refer the patient to the emergency department (via ambulance if necessary) or seek emergent medical advice if in a remote region.
NB - in an emergency of any of the following, its advised to arrange immediate transfer to the emergency department.
- Leukocoria
- Sudden severe visual loss e.g. macular or vitreous haemorrhage, retinal detachment or retinal artery occlusion
- Rubeosis iridis (iris new vessels)
- Congenital glaucoma e.g. big eye/s, cloudy cornea, photosensitive, tearing
- Angle closure glaucoma (unilateral red eye associated with pain, nausea, loss of vision, photophobia, steamy cornea, hard tender globe, ‘rainbows’ around lights, or sluggish pupil reactions)
- Corneal graft rejection
- Contact lens keratitis, corneal ulcers
- Uveitis/scleritis
- Intra ocular pressure (IOP) > 35 mmHg
- Signs and/or symptoms of retinal detachment
- Acute injury e.g. trauma, burns, chemical exposure, foreign body
- Acutely inflamed eye
- Sudden onset of constant convergent squint (esotropia) or divergent squint (exotropia) and/or double vision at any age
- Preseptal/orbital cellulitis - worsening eyelid oedema, erythema and proptosis
- Ocular signs or symptoms of temporal arteritis
- Ophthalmology conditions associated with sudden onset neurological signs and/or symptoms e.g. third cranial nerve palsy or optic disc swelling
+ Other management information
- No other information
+ Minimum referral criteria - Does your patient meet the minimum referral criteria?
Does your patient meet the minimum referral criteria?
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Category 1 If you feel your patient meets Category 1 criteria, please mark "urgent" on your referral |
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| Category 2 (appointment within 90 calendar days) |
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| Category 3 (appointment within 365 calendar days) |
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If your patient does not meet the minimum referral criteria
- Consider other treatment pathways or an alternative diagnosis
- If you still need to refer your patient:
- Please explain why (e.g. warning signs or symptoms, clinical modifiers, uncertain about diagnosis, etc.)
- Please note that your referral may not be accepted or may be redirected to another service
+ Standard referral information To be included in all referrals
Patient's Demographic Details
- Full name (including aliases)
- Date and country of birth
- Residential and postal address including whether patient resides at an aged care facility
- Telephone contact number/s – home, mobile and alternative
- Medicare number (where eligible)
- Name of the parent or caregiver (if appropriate)
- Name of delegate and contact details (Department of Corrective Services)
- Preferred language and interpreter requirements
- Identifies as Aboriginal and/or Torres Strait Islander
- Any special needs, access requirements and/or disability relevant to the referral
Referring Practitioner Details
- Full name
- Full address
- Contact details – telephone, fax, email
- Provider number
- Date of referral
- Signature
- Nominated general practitioner’s details (if known), if the nominated general practitioner is different from the referring practitioner
Relevant clinical information about the condition
- Presenting symptoms (evolution and duration)
- Physical findings
- Details of previous treatment (including systemic and topical medications prescribed) including the course and outcome of the treatment
- All conservative options that have been pursued unsuccessfully prior to referral
- Body mass index (BMI)
- Details of any associated medical conditions which may affect the condition or its treatment (e.g. diabetes, BMI), noting these must be stable and controlled prior to referral
- Any special care requirements where relevant (e.g tracheostomy in place, oxygen required)
- Current medications and dosages
- Drug allergies
- Alcohol, tobacco and other drugs use
- A comprehensive capture of information in relation to MSH Referral Criteria
Reason for request
- To establish a diagnosis
- For treatment or intervention
- For advice and management
- For specialist to take over management
- Reassurance for GP/second opinion
- For a specified test/investigation the GP can't order, or the patient can't afford or access
- Reassurance for the patient/family
- For other reason (e.g. rapidly accelerating disease progression)
- Clinical judgement indicates a referral for specialist review is necessary
Clinical modifiers
- Impact on employment
- Impact on education
- Impact on home
- Impact on activities of daily living functioning – low/medium/high
- Impact on ability to care for others
- Impact on personal frailty or safety
- Identifies as Aboriginal and/or Torres Strait Islander
Other relevant information
- Willingness to have surgery (where surgery is a likely intervention)
- Choice to be treated as a public or private patient
- Compensable status (e.g. DVA, Work Cover, Motor Vehicle Insurance, etc
Essential referral informationWithout this information the referral will be rejected
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+ Additional referral information for referrals
- Pathology result of lesion biopsy
- Private ophthalmologist or optometrist report including VA, refraction and impact of symptoms
- Clinical diagram including size in mm
Out of Catchment
West Moreton Health is responsible for providing public health service to people who reside within its boundaries. Due to high demand it is not possible to accept referrals from outside this catchment area. If your patient lives outside the West Moreton Health area and you wish to refer them to one of our services, inclusion of information regarding their particular medical and social factors will assist with the triaging of your referral.
Last updated: Monday, August 13, 2018
