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Ptosis Referral Access Criteria

Ptosis Referral Access Criteria

Referrers should use this page when referring patients to public adult ophthalmology outpatient services for ptosis.
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 – ptosis, diplopia or vision loss with other neurological signs or symptoms, cranial nerve palsies, optic neuropathies, papilledema
  • Sudden onset of any of the following: constant convergent squint (esotropia), divergent squint (exotropia), double vision at any age, acute trauma related strabismus, acute esotropia +/or acute leukocoria
Immediate referral
Orange exclamation mark in triangle: orange alertImmediately contact on-call registrar or service to arrange immediate ophthalmology assessment (seen within 7 days):
  • Nil
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).
  • Symptomatic – drooping of one or both eyelids with interference with vision
  • Frontal headaches with brow overaction            
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
  • Details of previous treatment and outcome
Examination
  • Best corrected visual acuity (BCVA) - vision with most recent distance spectacles
Investigations
  • Nil
Highly desirable
History
  • Nil            
Examination
  • Nil
Investigations
  • Most recent optometrist or private ophthalmologist report including:
    • Visual acuity
    • Refraction
    • Impact of symptoms
Indicative clinical urgency category

Category 1

Appointment within 30 days

  • Suspected neurologic condition
  • Sudden onset ptosis
  • Ptosis in association with diplopia             

Category 2

Appointment within 90 days

  • Symptomatic ptosis involving visual axis 

Category 3

Appointment within 365 days

  • Symptomatic ptosis not involving visual axis 
Exclusions
  • Nil
Useful information

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