1:30min
To improve and streamline referrals to public ophthalmology departments, most states and territories have now produced guidelines or criteria on what conditions should and shouldn’t be referred, as well as what is mandatory or highly desirable to include in referrals.
In Victoria, State-Wide Referral Criteria have been developed for AMD, Cataracts, corneal conditions, diabetic eye disease and glaucoma. You can read the full documents here.
With regards to glaucoma, the criteria state that referrals are not appropriate for “Requests for the diagnosis or ongoing management of glaucoma suspect, ocular hypertension or stable early and moderate glaucoma”. Referrals in scope include for the management of “advanced glaucoma and for unstable, progressive glaucoma” as well as “acute angle closure.”
To assist members, Optometry Australia has developed a concise summary on the Victorian State-Wide Referral Criteria for glaucoma. Download it here.
We have also developed a reference document outlining each specific hospital referral process as of April 2025. Download this resource here.
Key recommendation
It is still legally required that you provide a referral to an ophthalmologist or ophthalmology service within 4 months of diagnosing glaucoma and keep a record of this referral. Current guidelines are on the Optometry Board of Australia’s website here.
If the patient has not yet been seen by an ophthalmologist, you should document this and the reason for this on the patient’s clinical record. In such circumstances, if it is within your competence and scope of practice, you should continue to manage and treat the patient, and provide a new referral as clinically required.
If glaucoma diagnosis and management is NOT within your current scope of practice or there are cases you are unsure about AND the patient has not yet seen an ophthalmologist, then you must ensure that the patient is referred to another practitioner that can provide appropriate care.
In this situation, referral to another community optometric practice, such as an OA Credentialled Advanced Practitioner or someone who has indicated they provide glaucoma co-management services should be considered – both can be identified from this list. If this is not appropriate, referral to either ACO Eye Health or the Melbourne Eyecare Clinic at the University of Melbourne may be a good option for your patient.
We encourage Victorian optometrists to build or enhance existing community glaucoma collaborative care and telehealth pathways with local ophthalmologists. To assist with this, Optometry Australia is currently working with RANZCO to develop a process for formalising community collaborative care arrangements. More details on this will be released shortly.
We are here to help. Should you have additional concerns or wish to engage with our team for further support as you implement this advice, please reach out to the Optometry Advisor Help Desk at national@optometry.org.au, or on 03 9668 8500.