Diabetic retinopathy

Ophthalmology

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Useful Management Information

RANZCO guidelines suggest rescreening in one year for patients with mild Non-proliferative Diabetic Retinopathy (NPDR)
Recommend annual diabetic retinopathy photo-screening (photo-screening should be read by an accredited practitioner)
Please consider clinical modifiers and note (as applicable)
- Impact on employment
- Impact on education
- Impact on home
- Impact on ADLs
- Ability to care for others
- Personal frailty or safety
- Identifies as Aboriginal and/or Torres Strait islander

Clinical resources

RANZCO Screening and Referral Pathway for Diabetic Retinopathy

Patient resources

RANZCO diabetic retinopathy

Minimum Referral Criteria

Category 1	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) Clinical resources RANZCO Screening and Referral Pathway for Diabetic Retinopathy Patient resources RANZCO diabetic retinopathy
Category 2	Diagnosis of diabetes and any of the following: moderate Non-proliferative Diabetic Retinopathy (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	No category 3 criteria NB: Routine referral for screening without evidence of diabetic retinopathy, or for mild NPDR, will not be accepted.
If your patient doesn't meet the minimum referral criteria If the patient does not meet the criteria for referral but the referring practitioner believes the patient requires specialist review, a clinical override may be requested: Please explain why (e.g. warning signs or symptoms, clinical modifiers, uncertain about diagnosis, etc.) Please note that your referral may not be accepted or may be redirected to another service

Standard Referral Information

Reason for request

To establish a diagnosis
For treatment or intervention
For advice and management
For specialist to take over management
Reassurance for GP/second opinion
For a specified test/investigation the GP can't order, or the patient can't afford or access
Reassurance for the patient/family
For other reason (e.g. rapidly accelerating disease progression)
Clinical judgement indicates a referral for specialist review is necessary

Relevant clinical information about the condition

Presenting symptoms (evolution and duration)
Physical findings
Details of previous treatment (including systemic and topical medications prescribed) including the course and outcome of the treatment
All conservative options that have been pursued unsuccessfully prior to referral
Body mass index (BMI)
Details of any associated medical conditions which may affect the condition or its treatment (e.g. diabetes, BMI), noting these must be stable and controlled prior to referral
Any special care requirements where relevant (e.g tracheostomy in place, oxygen required)
Current medications and dosages
Drug allergies
Alcohol, tobacco and other drugs use

Patient's Demographic Details

Full name (including aliases)
Date and country of birth
Residential and postal address including whether patient resides at an aged care facility
Telephone contact number/s – home, mobile and alternative
Medicare number (where eligible)
Name of the parent or caregiver (if appropriate)
Name of delegate and contact details (Department of Corrective Services)
Preferred language and interpreter requirements
Identifies as Aboriginal and/or Torres Strait Islander
Any special needs, access requirements and/or disability relevant to the referral

Referring Practitioner Details

Full name
Full address
Contact details – telephone, fax, email
Provider number
Date of referral
Signature
Nominated general practitioner’s details (if known), if the nominated general practitioner is different from the referring practitioner

Other relevant information

Willingness to have surgery (where surgery is a likely intervention)
Choice to be treated as a public or private patient
Compensable status (e.g. DVA, Work Cover, Motor Vehicle Insurance, etc.)

Essential Referral Information

Best Corrected Visual Acuity (BCVA) (vision with most recent distance spectacles)
Date diagnosed/duration

If a specific test result cannot be obtained due to access, financial, religious, cultural or consent reasons a clinical override may be requested. This reason must be clearly articulated in the body of the referral.

Additional Referral Information

Private ophthalmologist or optometrist report including VA, refraction and impact of symptoms (highly desirable)
Optical coherence tomography (OCT) results
Type of diabetes and duration of disease
Previous eye treatment e.g. retinal laser
HbA1c (most recent within the last six months and previous three if available)
Fasting blood glucose results
Fasting lipids results
Blood pressure

Send Referrals To

Smart Referrals

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Internal Referrals

Ophthalmology (E-blueslips), Ophthalmology Paediatrics (E-Blueslips)

Fax

5687 4497

Post

Booking and Referral Centre
Gold Coast University Hospital
1 Hospital Boulevard
Southport QLD 4215

Enquiries

1300 559 083

Service Availability

Facilities

Gold Coast University Hospital

If you would like to send a named referral, please address it to the specialist listed above, who will allocate a suitably qualified specialist to see the patient. Alternatively, you can view a full list of our specialists.