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Giant cell arteritis/temporal arteritis (Ophthalmology) Referral Access Criteria

Giant cell arteritis/temporal arteritis (Ophthalmology) Referral Access Criteria

Referrers should use this page when referring patients to public adult ophthalmology outpatient services for giant cell arteritis/temporal arteritis.
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):
  • Temporal tenderness, jaw claudication, blurring of vision
  • Burning or craniofacial pain or tenderness or superficial temporal arteries refer for immediate review
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).
  • New onset of headaches (usually unilateral)
  • Fatigue
  • Weight loss
  • Tender scalp or temples
  • Sudden vision loss, blurred or double vision
  • Jaw claudication
  • Dizziness
  • Poor coordination and balance
  • Persistent sore throat
  • Dysphagia
  • Fevers and sweats
  • Dry cough
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
  • Relevant history, onset and duration of symptoms, including:
    • Age of onset of symptoms greater than 50 years,
    • Onset and time since onset of headaches, visual disturbance, jaw claudication, scalp tenderness
  • Details and duration of previous treatments including if steroid exposure             
Examination
  • Nil
Investigations
  • FBC
  • LFTs
  • ESR
  • CRP
Highly desirable
History
  • Nil            
Examination
  • Nil
Investigations
  • Most recent optometrist or private ophthalmologist report
  • Temporal artery biopsy histology
  • Bone mineral density
  • Other screening previously performed including: HepB, HepC, HIV, QuantiFERON Gold (QFG)
  • PET CT, CXR or USS
Indicative clinical urgency category

Category 1

Appointment within 30 days

  • Suspected new onset and/or active giant cell arteritis  

Category 2

Appointment within 90 days

  • No defined category 2 criteria            

Category 3

Appointment within 365 days

  • No defined category 3 criteria
Exclusions
  • Nil
Useful information

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