Ophthalmology Referral Guide for Community Physicians

Purpose and use of the Referral Guide

The purpose of this guide is to assist referring physicians and optometrists access the most appropriate ophthalmologist for their patient. 

The clinician members of the Department of Ophthalmology and Visual Sciences provide a broad range of eye care services to the community.  Many have received sub-specialty training in one area of ophthalmology and their practices will focus, sometimes exclusively, in this area of expertise. Comprehensive care is provided for urgent care by all ophthalmologists providing on-call coverage.

Primary, secondary and tertiary eye care is most effectively provided when referrals are directed to the eye care provider best suited to render the requested consultation.  In addition to primary care physicians, primary eye care can be provided by optometrists or ophthalmologists.  An ad hoc Eye Care Working Group (ECWG), under the auspices of the DOH approved by both Doctor’s Nova Scotia and the NS Association of Optometrists, has developed referral guidelines for patients with diabetes and various “red eye” conditions (see Appendix A for supporting documents).   The option of a referral to an optometrist may also be indicated as a consensus of the Department of Ophthalmology and Visual Sciences.

This guide will outline various common reasons for referral with a brief description of the condition or presenting complaint.  A list of the ophthalmologists accepting patients in these categories will be provided with their contact coordinates.

Emergent referrals needing assessment and management within 24 hours require a doctor-to-doctor verbal communication.  Examples of some, but not all, emergent referrals would include severe ocular trauma (blunt or penetrating), a ruptured globe, infectious corneal ulceration with a risk of perforation, severe chemical injury (esp. alkali burns), acute glaucoma, endophthalmitis and acute vision loss.  These patients would best be served by calling the on-call Ophthalmologist or Ophthalmology Resident through locating (473-2220 for the QEII HSC, 470-8888 for the IWK) .

Urgent referrals which may need to be seen within 1 week should be clearly marked “URGENT” and sent directly to the office of a specific ophthalmologist.  A phone call is encouraged.  The referral will be triaged appropriately.

All other referral requests should be addressed to individual ophthalmologists with a clearly stated perception of the urgency of the situation.