Thyroid associated orbitopathy Referral Access Criteria
Thyroid associated orbitopathy Referral Access Criteria
| Referrers should use this page when referring patients to public adult ophthalmology outpatient services for thyroid associated orbitopathy. |
| 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. |
- Ophthalmology conditions associated with sudden onset neurological signs and/or symptoms – diplopia or vision loss with other neurology signs or symptoms, cranial nerve palsies, optic neuropathies, papilledema
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| Immediate referral |
 Immediately contact on-call registrar or service to arrange immediate ophthalmology assessment (seen within 7 days):
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- Contact lens keratitis, corneal ulcers – H/o contact lens wear with reduced vision or epithelial defect, trauma, pain
To contact the relevant service, see Clinician Assist WA: Acute Ophthalmology Assessment (external site)
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| Clinical indications for outpatient referral |
If any of these issues are present, refer to outpatient services through the Central Referral Service (CRS).
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- Proptosis, irritation, conjunctival irritation, swelling eyelids, double vision
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| Mandatory information |
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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.
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| History |
- Detail of patient’s thyroid disorder
- Relevant history, onset and duration of symptoms
- Details of previous treatment and outcome
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| Examination |
- Best corrected visual acuity (BCVA) - vision with most recent distance spectacles
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| Investigations |
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| Highly desirable |
| History |
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| Examination |
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| Investigations |
- Any relevant/previous investigations or imaging
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| Indicative clinical urgency category |
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Category 1
Appointment within 30 days
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Suspected compressive optic neuropathy
- Failing vision
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Category 2
Appointment within 90 days
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- Recent onset double vision
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Category 3
Appointment within 365 days
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- Any patient with suspected thyroid eye disease
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