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Urgent Ophthalmology Referrals

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

Overview

Referral Guidance

There is no specific Rapid Access Clinic for ophthalmology at the eye hospital. The following page should help clinicians to decide on appropriate use of the eye hospital A and E department and referral routes for their patients.

There is detailed guidance on Remedy regarding a variety of eye conditions with advice on the most appropriate route of referral.

Please also see the Ophthalmology Referral Guidance & Tips page which includes a Referral Guidance document, which should help to determine urgency of referral.

Ophthalmology Emergencies

For Emergency conditions, the Bristol Eye Hospital Emergency Department has a walk-in service (for adults and children). Discussion is not required beforehand if the referral is appropriate (see guidelines). Please see the Eye Casualty service page or below for opening times:

8.30am to 4.30pm, seven days a week - including bank holidays.
Outside of these times contact the nearest general A&E department.

Urgent Referrals

Where A&E attendance is not appropriate, GPs can refer urgently using eRS to the medical retinal, neuro-ophthalmology or glaucoma services and mark urgent. Urgent requests to these services are triaged daily and passed on for action within the appropriate time scale. Please note there is no general ophthalmology option for referrals.

Opticians who have concerns can refer directly to the eye hospital (they do not have access to eRS).

Medically unstable patients

The Ophthalmic unit is a standalone eye hospital with extremely limited general medical coverage. Medically unstable patients should be referred through other routes with ophthalmology advice and review arranged by the receiving general Emergency Department.

Useful numbers

BEH Emergency Department: 0117 342 4613 (08:30-16:30 only)

On-Call (via switchboard): 0117 923 0000

Please be aware that the BEH ED is not funded to operate a phoneline for triage or guidance. This means that when they are busy, they do not have the staff to adequately answer this phoneline. Please do not call about emergency conditions listed in the referral guidance document, just send them to the department. If wishing to arrange for urgent review of a patient out of hours, please liaise with the On-call team.

Fast track Referrals

There is currently no formal Urgent Suspected Cancer (2WW) referral pathway for ophthalmology (Update October 2024 - this has been under review and we hope a dedicated pathway will be developed).

Suspected skin malignancy near the eye

Patients with suspected malignancy of the eyelid or near to the eye should be referred using the Skin USC pathway

Suspected intraocular or orbit malignancy

Patients with suspected ocular or orbit malignancy should be referred via eRS and marked urgent or discussed with the on call registrar if there are more immediate concerns.

Alternatively the Head & Neck - USC pathway can be used. There is no tick box for ophthalmological malignancy on this form but concerns can be free texted and referrals should be accepted via this route.

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.

Information provided through Remedy is continually updated so please be aware any printed copies may quickly become out of date.