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Ophthalmology – public patients

Purpose

This page contains information for general practitioners on how to refer patients aged 16 years and over to Ophthalmology services at Mater Hospital Brisbane

Service

Mater Hospital Brisbane's Ophthalmology Service offers a multidisciplinary approach with ophthalmologists, optometrists, orthoptists and skilled nurses offering care individualised to each patient’s needs. 

How to Refer 

If referral for care is indicated please list all of the General Referral Information and reason for request, and essential information as indicated below.

To refer, please fill in the Mater Adult Referral Form, available to download and embed into most major Practice Management software applications.

Referrals can be sent by:

Secure messaging           Medical Objects:   HM4101000R8

                                     HealthLink EDI:     materref                                                                                             

Fax                                07 3163 8548

Emergency

If any of the following are present or suspected, phone 000 to arrange immediate transfer to the emergency department or seek emergency medical advice if in a remote region:
 

View list of conditions

  • Leukocoria
  • Sudden severe visual loss e.g. macular or vitreous haemorrhage, retinal detachment or retinal artery occlusion
  • Rubeosis iridis (iris new vessels)
  • Congenital glaucoma e.g. big eye/s, cloudy cornea, photosensitive, tearing
  • Angle closure glaucoma (unilateral red eye associated with pain, nausea, loss of vision, photophobia, steamy cornea, hard tender globe, ‘rainbows’ around lights, or sluggish pupil reactions)
  • Corneal graft rejection
  • Contact lens keratitis, corneal ulcers
  • Uveitis/scleritis
  • Intra ocular pressure (IOP) > 35 mmHg
  • Signs and/or symptoms of retinal detachment
  • Acute injury e.g. trauma, burns, chemical exposure, foreign body
  • Acutely inflamed eye
  • Sudden onset of constant convergent squint (esotropia) or divergent squint (exotropia) and/or double vision at any age
  • Preseptal/orbital cellulitis - worsening eyelid oedema, erythema and proptosis
  • Ocular signs or symptoms of temporal arteritis
  • Ophthalmology conditions associated with sudden onset neurological signs and/or symptoms e.g. third cranial nerve palsy or optic disc swelling


Scope of Service

Conditions out of scope

The following conditions are not routinely provided at Mater Hospital Brisbane:
 

View list of conditions

  • Laser refractive surgery for cornea
  • Cataract (patients with visual acuity in the affected eye of 6/12 or better will not be accepted unless clinical modifiers apply 
  • Diabetic Retinopathy without confirmation of diagnosis
  • Dry Age Related Macular Degneration (unless the practitioner is concerned about progression to wet AMD)
  • Pterygium less than 3mm from limbus to apex 
  • Lid Lesions for minor cosmetic reasons 
  • Refractive error (prescriptions of spectacles)
  • Mild Dry Eyes
  • Mild Ptosis
  • Paediatric patients requiring public services should be referred to Childrens Health Queensland HHS

 


Conditions in scope
 

Age Related Macular Degeneration

Essential information (Referral will be declined without this)

Additional referral information (useful for processing the referral)

  • Private ophthalmologist or optometrist report including VA, refraction and impact of symptoms
  • OCT results

Other useful information for management (not an exhaustive list)

  • Consider annual review by a private ophthalmologist or optometrist
  • Patients with AMD should eat a healthy balanced diet and avoid smoking
  • Sunglasses may reduce glare and excessive UV light exposure

Categorisation

Available appointments are provided to our patients based on clinical priority. A process of categorisation ensures safety and equity of access.

Category 1 – urgent

Clinically recommended timeframe for initial appointment is 30 days

Category 2 - Priority

Clinically recommended timeframe for initial appointment is 90 days

Category 3 - Routine

Clinically recommended timeframe for initial appointment is 365 days

New onset of reduced central vision and/or distortion due to wet AMD

Referral to continue treatment of wet AMD

 

Recent significant progression of dry AMD

NB: Dry AMD is not routinely seen unless practitioner is concerned about recent significant progression

No Category 3 criteria

 

Allergic Eye Disease

Essential information (Referral will be declined without this)

Additional referral information (useful for processing the referral)

  • Private ophthalmologist or optometrist report including VA, refraction and impact of symptoms

Other useful information for management (not an exhaustive list)

  • Avoid allergens if possible
  • Check for corneal epithelial damage with fluorescein
  • Topical anti-histamines and mast cell stabilisers
  • Oral anti-histamines

Categorisation

Available appointments are provided to our patients based on clinical priority. A process of categorisation ensures safety and equity of access.

Category 1 – urgent

Clinically recommended timeframe for initial appointment is 30 days

Category 2 - Priority

Clinically recommended timeframe for initial appointment is 90 days

Category 3 - Routine

Clinically recommended timeframe for initial appointment is 365 days

Severe allergic eye disease with corneal involvement

 

 

Severe allergic eye disease without corneal involvement (thickened eyelids, stringy mucoid discharge, severe itch)

Mild allergic eye disease without corneal involvement that is non-responsive to topical anti-histamines or mast cell stabilisers

 

Cataracts

Essential information (Referral will be declined without this)

  • General Referral Information
  • BCVA (vision with most recent distance spectacles) with refraction in the last 12 months
  • Whether first or second eye
  • Symptoms and duration of problem

Additional referral information (useful for processing the referral)

  • Private Ophthalmologist or Optometrist report including VA, refraction and impact of symptoms
  • Professional drivers with specific VA requirements for employment

Other useful information for management (not an exhaustive list)

  • Consider requesting an eye examination with a private ophthalmologist or optometrist to confirm the presence of cataracts and to optimise vision with glasses where possible
  • Control co-morbidities

Categorisation

Available appointments are provided to our patients based on clinical priority. A process of categorisation ensures safety and equity of access.

Category 1 – urgent

Clinically recommended timeframe for initial appointment is 30 days

Category 2 - Priority

Clinically recommended timeframe for initial appointment is 90 days

Category 3 - Routine

Clinically recommended timeframe for initial appointment is 365 days

Documented cataract with significant impact on activities of daily living( ADL) and BCVA worse than 6/36 in both eyes

 

 

 

 

 

Documented cataract with significant impact on ADL and:

BCVA worse than 6/36 in one eye

Or BCVA worse than 6/12 in both eyes

Documented cataract with significant impact on ADL and BCVA worse than 6/12 in either eye

 

Chalazion / Meibomian Cyst

Essential information (Referral will be declined without this)

Additional referral information (useful for processing the referral)

  • No additional information

Other useful information for management (not an exhaustive list)

  • Medical management including:
  • Warm compresses have been applied to the affected eyelid(s) for 15 minutes, 4 times a day
  • Lid massage has been applied to non-inflamed chalazia in an attempt to cause spontaneous discharge
  • Topical antibiotic eye drops or ointment (e.g. chloramphenicol or fusidic acid) if associated infection

Categorisation

Available appointments are provided to our patients based on clinical priority. A process of categorisation ensures safety and equity of access.

Category 1 – urgent

Clinically recommended timeframe for initial appointment is 30 days

Category 2 - Priority

Clinically recommended timeframe for initial appointment is 90 days

Category 3 - Routine

Clinically recommended timeframe for initial appointment is 365 days

No category 1 criteria

 

 

Chalazion associated pyogenic granuloma in a child

Failed maximal medical management of inflammatory eyelid mass (chalazion)

 

Diabetic Retinopathy

Essential information (Referral will be declined without this)

Additional referral information (useful for processing the referral)

  • Private ophthalmologist or optometrist report including VA, refraction and impact of symptoms*
  • Type I or II
  • Previous eye treatment e.g. retinal laser
  • HbA1c (most recent within the last six months and previous three if available)
  • Fasting blood glucose results
  • Fasting lipids results
  • Blood pressure

Other useful information for management (not an exhaustive list)

  • Recommend annual diabetic retinopathy photo-screening (photo-screening should be read by an accredited practitioner)

Categorisation

Available appointments are provided to our patients based on clinical priority. A process of categorisation ensures safety and equity of access.

Category 1 – urgent

Clinically recommended timeframe for initial appointment is 30 days

Category 2 - Priority

Clinically recommended timeframe for initial appointment is 90 days

Category 3 - Routine

Clinically recommended timeframe for initial appointment is 365 days

Diagnosis of diabetes and any of the following:

  • proliferative diabetic retinopathy (PDR)
  • assessment of diabetic retinopathy in pregnancy
  • vitreous haemorrhage

 

 

 

 

Diagnosis of diabetes and any of the following:

  • diabetic macular edema
  • severe non-PDR

Diagnosis of diabetes and mild to moderate non-PDR

 

NB Routine referral for screening without evidence of diabetic retinopathy will not be accepted.

 

Ectropion

Essential information (Referral will be declined without this)

Additional referral information (useful for processing the referral)

  • Private ophthalmologist or optometrist report including VA, refraction and impact of symptoms

Other useful information for management (not an exhaustive list)

  • Check for corneal epithelial damage with fluorescein
  • Lubrication/artificial tears

Categorisation

Available appointments are provided to our patients based on clinical priority. A process of categorisation ensures safety and equity of access.

Category 1 – urgent

Clinically recommended timeframe for initial appointment is 30 days

Category 2 - Priority

Clinically recommended timeframe for initial appointment is 90 days

Category 3 - Routine

Clinically recommended timeframe for initial appointment is 365 days

No category 1 criteria

 

Severe ectropion with tarsal exposure

Symptomatic ectropion

 

Entropion

Essential information (Referral will be declined without this)

Additional referral information (useful for processing the referral)

  • Private ophthalmologist or optometrist report including VA, refraction and impact of symptoms

Other useful information for management (not an exhaustive list)

  • Check for corneal epithelial damage with fluorescein
  • Teach how to evert lower lid and tape in the everted position
  • Lubrication/artificial tears

Categorisation

Available appointments are provided to our patients based on clinical priority. A process of categorisation ensures safety and equity of access.

Category 1 – urgent

Clinically recommended timeframe for initial appointment is 30 days

Category 2 - Priority

Clinically recommended timeframe for initial appointment is 90 days

Category 3 - Routine

Clinically recommended timeframe for initial appointment is 365 days

Symptomatic entropion with significant corneal epithelial damage

 

Symptomatic entropion

No category 3 criteria

 

Epiphora (Watery Eyes)

Essential information (Referral will be declined without this)

Additional referral information (useful for processing the referral)

  • Private ophthalmologist or optometrist report including VA, refraction and impact of symptoms

Other useful information for management (not an exhaustive list)

  • Eyelid hygiene if epiphora secondary to blepharitis
  • Lubricants or artificial tears if epiphora secondary to dry eyes/blepharitis

Categorisation

Available appointments are provided to our patients based on clinical priority. A process of categorisation ensures safety and equity of access.

Category 1 – urgent

Clinically recommended timeframe for initial appointment is 30 days

Category 2 - Priority

Clinically recommended timeframe for initial appointment is 90 days

Category 3 - Routine

Clinically recommended timeframe for initial appointment is 365 days

No category 1 criteria

 

 

No category 2 criteria

Symptomatic epiphora due to obstruction of the nasolacrimal system

 

Epiretinal Membrane

Essential information (Referral will be declined without this)

Additional referral information (useful for processing the referral)

  • Optical coherence tomography report

Other useful information for management (not an exhaustive list)

  • No other information

Categorisation

Available appointments are provided to our patients based on clinical priority. A process of categorisation ensures safety and equity of access.

Category 1 – urgent

Clinically recommended timeframe for initial appointment is 30 days

Category 2 - Priority

Clinically recommended timeframe for initial appointment is 90 days

Category 3 - Routine

Clinically recommended timeframe for initial appointment is 365 days

No category 1 criteria

 

 

 

 

Epiretinal membrane with BCVA worse than 6/12

Symptomatic epiretinal membrane with BCVA 6/12 or better

NB: asymptomatic epiretinal membranes with good BCVA should not be referred

 

 

Fuch's (Endothelial) Dystrophy

Essential information (Referral will be declined without this)

Additional referral information (useful for processing the referral)

  • No additional information

Other useful information for management (not an exhaustive list)

  • Request an eye examination by private ophthalmologist or optometrist to optimise vision with glasses

Categorisation

Available appointments are provided to our patients based on clinical priority. A process of categorisation ensures safety and equity of access.

Category 1 – urgent

Clinically recommended timeframe for initial appointment is 30 days

Category 2 - Priority

Clinically recommended timeframe for initial appointment is 90 days

Category 3 - Routine

Clinically recommended timeframe for initial appointment is 365 days

Fuch’s Endothelial dystrophy and Corneal decompensation with bullae

 

Fuch’s Endothelial dystrophy and BCVA worse than 6/36

Fuch’s Endothelial dystrophy and BCVA worse than 6/12

 

Glaucoma

Essential information (Referral will be declined without this)

  • General Referral Information
  • BCVA (vision with most recent distance spectacles)
  • Private ophthalmologist or optometrist report including VA, IOP, visual fields & disc assessment

Additional referral information (useful for processing the referral)

  • Optical coherence tomography
  • Refraction, gonioscopy, pachymetry

Other useful information for management (not an exhaustive list)

  • Recommend ongoing review by a private ophthalmologist or optometrist until seen in ophthalmology outpatients department

Categorisation

Available appointments are provided to our patients based on clinical priority. A process of categorisation ensures safety and equity of access.

Category 1 – urgent

Clinically recommended timeframe for initial appointment is 30 days

Category 2 - Priority

Clinically recommended timeframe for initial appointment is 90 days

Category 3 - Routine

Clinically recommended timeframe for initial appointment is 365 days

Refer directly to emergency if clinically indicated:

  • patients with IOP > 35 mmHg

Likely diagnosis of glaucoma and any of the following:

  • IOP 30-35 mmHg
  • severe disc damage
  • severe field loss

 

 

 

Likely diagnosis of glaucoma and any of the following:

  • signs of early disc damage or field loss consistent with glaucoma
  • IOP 26-29 mmHg without disc damage or field loss
  • suspicion of narrow iridocorneal angles with risk of angle closure glaucoma

Ocular hypertension with IOP 22‑25 mmHg without disc damage or field loss

 

 

Retinal Vein Occlusion

Essential information (Referral will be declined without this)

Additional referral information (useful for processing the referral)

  • Private ophthalmologist or optometrist report including VA, refraction and impact of symptoms
  • Recent IOP
  • Recent blood tests including cholesterol FBC ELFT or known thrombotic disorders
  • Recent blood pressure measurement

Other useful information for management (not an exhaustive list)

No other information

Categorisation

Available appointments are provided to our patients based on clinical priority. A process of categorisation ensures safety and equity of access.

Category 1 – urgent

Clinically recommended timeframe for initial appointment is 30 days

Category 2 - Priority

Clinically recommended timeframe for initial appointment is 90 days

Category 3 - Routine

Clinically recommended timeframe for initial appointment is 365 days

All central retinal vein occlusions

Branch retinal vein occlusion with recent decrease in vision

 

Branch retinal vein occlusion without recent decrease in vision

No category 3 criteria

 

Intraocular Melanoma

Essential information (Referral will be declined without this)

Additional referral information (useful for processing the referral)

  • Private ophthalmologist or optometrist report including VA, refraction and impact of symptoms

Other useful information for management (not an exhaustive list)

  • No other information

Categorisation

Available appointments are provided to our patients based on clinical priority. A process of categorisation ensures safety and equity of access.

Category 1 – urgent

Clinically recommended timeframe for initial appointment is 30 days

Category 2 - Priority

Clinically recommended timeframe for initial appointment is 90 days

Category 3 - Routine

Clinically recommended timeframe for initial appointment is 365 days

Proven or suspected intraocular melanoma

 

No category 2 criteria

No category 3 criteria

 

Keratoconus

Essential information (Referral will be declined without this)

Additional referral information (useful for processing the referral)

  • No additional information

Other useful information for management (not an exhaustive list)

  • Request an eye examination by private ophthalmologist or optometrist to confirm the presence of keratoconus and to optimise vision with glasses or contact lenses

Categorisation

Available appointments are provided to our patients based on clinical priority. A process of categorisation ensures safety and equity of access.

Category 1 – urgent

Clinically recommended timeframe for initial appointment is 30 days

Category 2 - Priority

Clinically recommended timeframe for initial appointment is 90 days

Category 3 - Routine

Clinically recommended timeframe for initial appointment is 365 days

Keratoconus with hydrops

 

 

Keratoconus with signs of progression

Keratoconus with stable findings

 

Lid Lesions

Essential information (Referral will be declined without this)

Additional referral information (useful for processing the referral)

  • Pathology result of lesion biopsy
  • Private ophthalmologist or optometrist report including VA, refraction and impact of symptoms
  • Clinical diagram including size in mm

Other useful information for management (not an exhaustive list)

  • No other information

Categorisation

Available appointments are provided to our patients based on clinical priority. A process of categorisation ensures safety and equity of access.

Category 1 – urgent

Clinically recommended timeframe for initial appointment is 30 days

Category 2 - Priority

Clinically recommended timeframe for initial appointment is 90 days

Category 3 - Routine

Clinically recommended timeframe for initial appointment is 365 days

Proven or suspected eyelid squamous cell carcinoma or melanoma

 

 

 

Proven or suspected eyelid basal cell carcinoma

Benign eyelid lesions affecting vision or causing functional deficit

NB: minor cosmetic eyelid lesions should not be referred

 

Macular Hole

Essential information (Referral will be declined without this)

Additional referral information (useful for processing the referral)

  • Optical coherence tomography

Other useful information for management (not an exhaustive list)

  • No other information

Categorisation

Available appointments are provided to our patients based on clinical priority. A process of categorisation ensures safety and equity of access.

Category 1 – urgent

Clinically recommended timeframe for initial appointment is 30 days

Category 2 - Priority

Clinically recommended timeframe for initial appointment is 90 days

Category 3 - Routine

Clinically recommended timeframe for initial appointment is 365 days

No category 1 criteria

 

Full thickness macular hole

No category 3 criteria

 

Posterior Capsular Opacity

Essential information (Referral will be declined without this)

Additional referral information (useful for processing the referral)

No additional information

Other useful information for management (not an exhaustive list)

No additional information

Categorisation

Available appointments are provided to our patients based on clinical priority. A process of categorisation ensures safety and equity of access.

Category 1 – urgent

Clinically recommended timeframe for initial appointment is 30 days

Category 2 - Priority

Clinically recommended timeframe for initial appointment is 90 days

Category 3 - Routine

Clinically recommended timeframe for initial appointment is 365 days

No category 1 criteria

 

 

No category 2 criteria

Documented posterior capsular opacity and significant impact on ADL

 

Pterygium

Essential information (Referral will be declined without this)

Additional referral information (useful for processing the referral)

  • Private ophthalmologist or optometrist report including VA, refraction and impact of symptoms

Other useful information for management (not an exhaustive list)

Medical management

  • Lubrication/artificial tears
  • Wear protective sunglasses (wrap around style UV400)
  • Update spectacles
  • Consider annual review by private ophthalmologist or optometrist

Categorisation

Available appointments are provided to our patients based on clinical priority. A process of categorisation ensures safety and equity of access.

Category 1 – urgent

Clinically recommended timeframe for initial appointment is 30 days

Category 2 - Priority

Clinically recommended timeframe for initial appointment is 90 days

Category 3 - Routine

Clinically recommended timeframe for initial appointment is 365 days

No category 1 criteria

 

 

Size - 3mm or greater from limbus to apex and visual axis is threatened and/or dysplasia

Size - 3mm or greater from limbus to apex

 

Ptosis

Essential information (Referral will be declined without this)

Additional referral information (useful for processing the referral) 

  • Private ophthalmologist or optometrist report including VA, refraction and impact of symptoms

Other useful information for management (not an exhaustive list) 

  • Private ophthalmologist or optometrist report including VA, refraction and impact of symptoms

Categorisation

Available appointments are provided to our patients based on clinical priority. A process of categorisation ensures safety and equity of access.

Category 1 – urgent

Clinically recommended timeframe for initial appointment is 30 days

Category 2 - Priority

Clinically recommended timeframe for initial appointment is 90 days

Category 3 - Routine

Clinically recommended timeframe for initial appointment is 365 days

No category 1 criteria

 

Symptomatic ptosis involving visual axis

Symptomatic ptosis not involving visual axis

 

Retinal Artery Occlusion

Essential information (Referral will be declined without this)

Additional referral information (useful for processing the referral)

  • Private ophthalmologist or optometrist report including VA, refraction and impact of symptoms
  • Recent blood tests including cholesterol, FBC ELFT ESR or other known thrombotic disorders
  • Imaging of carotid arteries (USS or angiography)
  • Echocardiogram and ECG results
  • Recent blood pressure measurement

Other useful information for management (not an exhaustive list)

  • Management of cardiovascular risk factors

Categorisation

Available appointments are provided to our patients based on clinical priority. A process of categorisation ensures safety and equity of access.

Category 1 – urgent

Clinically recommended timeframe for initial appointment is 30 days

Category 2 - Priority

Clinically recommended timeframe for initial appointment is 90 days

Category 3 - Routine

Clinically recommended timeframe for initial appointment is 365 days

Refer directly to emergency if clinically indicated:

  • patients with central or branch retinal artery occlusion

 

Incidental finding of branch retinal artery occlusion or retinal arteriole cholesterol embolus (Hollenhorst plaque)

No category 3 criteria

 

Strabismus (Squint)

Essential information (Referral will be declined without this)

Additional referral information (useful for processing the referral)

  • Private ophthalmologist or optometrist report including VA, refraction and impact of symptoms

Other useful information for management (not an exhaustive list)

  • No other information

Categorisation

Available appointments are provided to our patients based on clinical priority. A process of categorisation ensures safety and equity of access.

Category 1 – urgent

Clinically recommended timeframe for initial appointment is 30 days

Category 2 - Priority

Clinically recommended timeframe for initial appointment is 90 days

Category 3 - Routine

Clinically recommended timeframe for initial appointment is 365 days

Refer directly to emergency if clinically indicated:

  • sudden onset of constant convergent squint (esotropia)
  • divergent squint (exotropia)
  • double vision at any age

New onset diplopia associated with thyroid orbitopathy

 

Long standing diplopia associated with thyroid orbitopathy

Decompensated previous strabismus with diplopia

Long standing squint without diplopia

 

Other Ophthalmology Condition

Essential information (Referral will be declined without this)

  • General Referral Information
  • Visual acuity and best corrected visual acuity with glasses for both eyes 
  • Relevant condition information
  • Relevant pathology and imaging reports

Categorisation

Available appointments are provided to our patients based on clinical priority. A process of categorisation ensures safety and equity of access.

Category 1 – urgent

Clinically recommended timeframe for initial appointment is 30 days

Category 2 - Priority

Clinically recommended timeframe for initial appointment is 90 days

Category 3 - Routine

Clinically recommended timeframe for initial appointment is 365 days

 

 

Our Specialists 

Dr Brendan Cronin

Director of Ophthalmology

Dr Andrew Carroll

Ophthalmologist

Dr Jason Cassar

Ophthalmologist

Dr Roxanne Kempster

Ophthalmologist

Dr Anthony Kwan

Ophthalmologist

Dr Graham Lee

Ophthalmologist

Dr Rowan Porter

Ophthalmologist

Dr Phung Vu

Ophthalmologist

Dr Sunil Warrier

Ophthalmologist

 

Bulk Billed Clinics

Mater Health offers patients the opportunity to attend bulk billed clinics. To provide your patient with the opportunity to attend a bulk billed clinic, please provide a named referral to one of the specialists listed above.

Contact Us

If you would like to discuss a referral, including clinical criteria, or update the status of a current patient please contact our priority GP phone line on 07 3163 2200 

Current Waiting Time for Appointments

We provide up to date data on how long patients are waiting for their first appointment by specialty here.

Referral Guideline Development

These Mater Referral Guidelines align with standardised best practice tools for referral to publicly funded specialist outpatient services developed in Queensland through the Clinical Prioritisation Criteria project. 

 

Content last reviewed: 26/10/2017