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Diabetic retinopathy/diabetic eye disease Referral Access Criteria

Diabetic retinopathy/diabetic eye disease Referral Access Criteria

Referrers should use this page when referring patients to public adult ophthalmology outpatient services for diabetic retinopathy/diabetic eye disease.
Emergency referral
If any of the following are present or suspected, refer the patient to the emergency department or seek emergency medical advice if in a remote region.
  • Nil
Immediate referral
Orange exclamation mark in triangle: orange alertImmediately contact on-call registrar or service to arrange immediate ophthalmology assessment (seen within 7 days):
  • Sudden severe visual loss e.g. vitreous haemorrhage, retinal detachment or retinal vascular occlusion
To contact the relevant service, see Clinician Assist WA: Acute Ophthalmology Assessment (external site)
Clinical indications for outpatient referral
If any of these issues are present, refer to outpatient services through the Central Referral Service (CRS).
  • Proliferative diabetic retinopathy (PDR)
  • Assessment of severe non-proliferative diabetic retinopathy threatening vision
  • Macular oedema
  • Vitreous haemorrhage in a person with diabetes
Mandatory information
Referrals missing 'mandatory information' with no explanation provided may not be accepted by site. If 'mandatory information' is not included, the explanation must be provided in the body of the referral (e.g. patient unable to access test in regional or remote areas or due to financial reason).

This information is required to inform accurate and timely triage. If unable to attach reports, please include relevant information/findings in the body of the referral and advise where (provider) investigation/imaging was completed.
History
  • Date diagnosed/duration (or estimated if unknown)
  • Diabetes type, duration and HbA1c
  • Details of previous treatment and outcome
Examination
  • Best corrected visual acuity (BCVA) - vision with most recent distance spectacles 
Investigations
  • Nil
Highly desirable
History
  • Previous eye treatment e.g. retinal laser
Examination
  • Nil
Investigations
  • Most recent optometrist or private ophthalmologist report including:
    • Refraction
    • Retinal examination
    • Optical coherence tomography (OCT)
  • BP
  • Fasting BGL
  • Fasting lipids
Indicative clinical urgency category

Category 1

Appointment within 30 days

  • Diagnosis of diabetes and any of the following:
    • proliferative diabetic retinopathy (PDR)
    • vitreous haemorrhage
    • severe non-proliferative diabetic retinopathy (NPDR)
    • assessment of diabetic retinopathy in pregnancy
    • centre involving diabetic macular oedema (Definition: thickening within 500 microns of the foveal centre associated with microaneurysms, haemorrhages or hard exudates)             

Category 2

Appointment within 90 days

  • Diagnosis of diabetes and any of the following:
    • moderate NPDR
    • non-centre involving diabetic macular oedema (Definition: thickening within 2-disc diameters (but not within 500 microns) of the foveal centre associated with microaneurysms, haemorrhages or hard exudates).           

Category 3

Appointment within 365 days

  •  No defined category 3 criteria
Exclusions
  • Nil
Useful information

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