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Referral Guidance & Tips

Checked: 23-10-2023 by 3 Vicky Ryan Next Review: 23-10-2025

Hints for GP Practices on Ophthalmology referrals

  1. Please ensure a separate referral is made for each individual ophthalmology condition: e.g. if a community optometrist is referring for both cataract and glaucoma opinion, please make two separate referrals.
  2. If referring for cataract extraction, please ensure patient wishes to have surgery before making referral (as required by ICB criteria based access policy for cataract surgery). Please consider use of the standardised cataract referral form .
  3. Please ensure the community optometrist’s report is read prior to referring to avoid scenarios where an onward ophthalmology referral has not been requested and either information about secondary care is being requested or the optometrist is asking for GP intervention rather than onward referral.
  4. A proportion of ophthalmology referrals require CBA, PA or IFR in order to proceed. Please ensure if referring for any of these conditions that the appropriate policy is adhered to.                                                     

Criteria Based Assessment (CBA):

Cataract, Ectropion and Entropion Repair Surgery, Raised Intraocular Pressure.

Prior Approval (PA) Funding:

Chalazia (Meibomian cyst), Adult Strabismus or Amblyopia (squint), Blepharoplasty / Brow Lift.

Exceptional Funding Request (EFR):

Cosmetic Contact Lenses, Laser Eye Surgery for Refractive Error, Vitreous Floaters, Multi-focal (non-accommodative) Intraocular Lenses in Treatment of Adults with Cataracts.

5. If the patient is being referred for something that is related to a recent eye procedure that the patient has undergone, please write directly to the provider that carried out the procedure initially if they have yet to be discharged, as this is likely to be related to treatment and follow up care. Consider re-referral via eRS to the same named provider if the patient has already been discharged.

Referral guidance

The service leads at Bristol Eye Hospital have produced Referral Guidance  (updated 12.10.23) for a range of acute ophthalmology conditions giving advice about how urgently to refer. This is not clinical advice

This guide is primarily aimed at local optometrists but GPs might find it helpful to know how urgently various conditions should be referred, particularly those not diagnosed or managed by GPs.



Efforts are made to ensure the accuracy and agreement of these guidelines, including any content uploaded, referred to or linked to from the system. However, BNSSG ICB cannot guarantee this. This guidance does not override the individual responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient, in consultation with the patient and/or guardian or carer, in accordance with the mental capacity act, and informed by the summary of product characteristics of any drugs they are considering. Practitioners are required to perform their duties in accordance with the law and their regulators and nothing in this guidance should be interpreted in a way that would be inconsistent with compliance with those duties.

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