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Referral Guidance

Checked: 23-10-2021 by Vicky Ryan Next Review: 23-10-2022

Paediatric Ophthalmology Service at Bristol Eye Hospital

Please see the Adults section for information about Urgent Ophthalmology Referrals.

Bristol Eye Hospital (BEH) are experiencing severe delays in seeing routine paediatric ophthalmology referrals and at present are managing a 12 month back log for new appointments as urgent referrals take priority. They would be grateful if GPs could manage the expectations of parents accordingly when discussing referrals and consider whether a community based Optometrist may be able to examine and advise the patient instead. They are continuing to schedule referrals according to clinical priority.

As a guide BEH would ask that you do not refer the following routine cases if at all possible:

a) Sticky eyes unless the vision is reduced or possible nasolacrimal duct obstruction in an infant less than 12 months of age, or if there is a concern about ophthalmia neonatorum (within first month of life);

b) Meibomian cysts unless special funding has already been obtained for surgical excision from the CCG;

c) Allergic eye disease or itchy eyes where the eye is white and the vision is normal and the patient does not have underlying systemic health conditions, unless you have tried a mast cell stabiliser and/or antihistamines without benefit;

d) Children with a slightly blurred optic disc margin in one eye (generally picked up at a routine sight test) where the child is otherwise asymptomatic and in good health unless there is also a visual field defect;

e) Children with the odd spot or colourless swirl/‘worm-shape’ in their vision with otherwise normal eyesight and no history of trauma, blood clotting disorder or diabetes;

They hope to update this guidance early in the New Year but in the meantime please continue to refer urgent cases in the usual way and consider Paediatric Ophthalmology A&G where appropriate.

If you are seeking specific advice about the guidance please contact: gail.winstone@uhbw.nhs.uk.

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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