What should you send to Eye Clinic and how soon?

A: For Immediate referral to on call ophthalmologist (even out of hours):

1. Dendritic Ulcers
2. Alkali Injuries (inc, wet plaster/cement) – continually irrigate eye(s) until pH is normal
3. Superglue in eye
4. Post-trauma proptosis
5. Periorbital cellulitis
6. Red eye with raised ocular pressure (acute glaucoma)
7. Eye surgery within 1 month
8. Sudden/recent (within 2 weeks) onset of floaters
9. Sudden loss of vision, decreased visual acuity: retina detachment, central retinal artery obstruction
10. Penetrating eye injuries
11. Patients that present with any eye problem that have a history of corneal grafting in that eye

B: Patients suitable for eye clinic referral: 

1. Red eye over 2 weeks duration or already treated with chloramphenicol for more that 5 days
2. Decreased visual acuity over 2 days duration
3. Central corneal abrasion or abrasion occupying more than 50% of the cornea
4. Incomplete removal of foreign body / rust ring
5. Iritis (single red eye, no trauma/foreign body, no discharge, photophobia)
6. Non-alkali (ie acid) injuries that have been irrigated to normal pH
7. Thermal injuries/burns to eye
8. Any other referrals should be discussed with A&E senior grade / ophthalmologist middle grade on call

C: No need for refferal: 

1. Red eye for less that 2 weeks or not having had 5 days of antibiotics for example conjunctivitis
2. Peripheral corneal abrasions that occupy less than 50% of cornea
3. Completely removed foreign bodies, without residual rust rings