Visual disturbance or loss (non-cataract)

This condition is treated in the Ophthalmology (Eye) clinic.

Pre-referral work-up

History

The following condition is not routinely seen at the Royal Hobart Hospital Eye Clinic and may be appropriately managed by the general practitioner, local ophthalmologist or optometrist:

• Asymptomatic Epiretinal Membrane (ERM - stable non-sight threatening retinal disease).

All referrals should comply to the Standard Referral guidelines and include in particular:

History:

• History of visual loss: unilateral/bilateral, sudden/subacute/chronic
• History of associated headache
• History of any field loss or change
• History of red or painful eye or pain on eye movement
• Any history diplopia, ptosis or pupil changes
• Retinal detachment symptoms: flashes/floaters/visual field loss
• Neuro-ophthalmic disorders
• Comorbidities: hypertension, diabetes, heart disease, vascular disease, etc
• Family history of visual loss
• History of trauma

Examination:

• Visual acuity with current distance glasses
• Confrontation visual fields:
  • Red reflex: any white pupil reflex in children, asymmetric red reflex
  • Pupil changes: any relative afferent pupil defect, anisocoria or pupillary light reflex abnormality
• Where available:
  • Slit lamp examination
    • Dilated exam: any significant retinal, vitreous or optic nerve pathology

Interim/GP management

To refer a patient with this condition, please see the Ophthalmology clinic page for the full referral process and templates.

For more information please see the HealthPathways Tasmania website.

Clinic appointments

? Red location flags are clinical indicators of possible serious underlying conditions requiring further medical intervention. They may or may not indicate an emergency.

Emergency

Emergency - ring on call Ophthalmic Registrar to discuss.

? Sudden loss of or reduction in vision

? Suspected optic neuritis

? Suspected retinal detachment

? Painful red eye . Ring on call Ophthalmic Registrar to discuss

? Amarosis fugax. Ring on call Ophthalmic Registrar to discuss

? Giant cell arteritis or other vascular disease

? Sudden onset diplopia

? Sudden onset ptosis

? Suspected papilloedema or raised intracranial pressure

? Sudden field loss associated with ocular signs or symptoms

? Central retinal artery or vein occlusion

? Vitreous haemorrhage

? White pupil reflex in children

If you, or someone else, are experiencing a serious and life-threatening injury or illness call triple zero (000) immediately or go to the nearest Emergency Department.

Learn more about when to access emergency care and non-emergency care options if the injury or illness is not serious or life-threatening.

Urgent (Category 1)

? Children with amblyogenic conditions under the age of 12

? Full thickness macular hole

? Branch retinal vein or artery occlusion.

? Central serous retinopathy with Amsler grid changes

? Suspected intraocular melanoma

Urgent referrals should be accompanied by a phone call to the Consultant/Registrar to organise urgent review and the referral must be faxed.

We will endeavour to see these patients within ten days, or sooner if clinically indicated.

Availability

North

THS Northern Region does not offer a public eye  clinic. See Health Pathways for more information

North West

Unavailable.

South

Wellington Clinics (Level 11)
Phone: 03 6166 0000
Fax: 03 6234 9454