Educational draft · awaiting clinical reviewUse Rapid for revision, not patient-care decisions. Check current national and local guidance and the BNF or BNFC before acting.
2 min synopsisUK scopeSources checked 7 Sept 2026Clinical review pending
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A presentation requiring immediate action
Chemical burns, possible penetrating injury, severe painful visual loss, acute neurological visual deficits and sight-threatening postoperative symptoms require emergency assessment rather than a routine electronic referral.
Action: Provide indicated first aid, contact the appropriate emergency eye or stroke service now, agree the destination and transfer, and send the onset time, visual findings and treatment already given.
Synopsis
Select the urgency and destination of an eye referral from the presentation, deliver time-critical first aid and complete a clear handover with accountable follow-up.
Triage the presenting symptoms and risks before deciding how much further examination can safely precede referral.
Record onset, current and baseline vision, pain, photophobia, trauma or chemical exposure, contact lenses and recent operations or injections.
Use direct telephone or agreed urgent electronic pathways with confirmed receipt for time-critical problems, and clarify the actual assessment deadline.
Key red flags
An acutely painful red eye with reduced vision, vomiting, corneal opacity, recent ocular surgery or contact lens exposure needs urgent direct assessment; do not assume conjunctivitis from redness alone.
Investigation priorities
01
Focused visual assessment before handoverFirst step
Establish the severity and laterality of the problem without delaying urgent treatment.
Management branches
Initial triageDecide whether action must start now
A new eye complaint is being assessed at any first point of contact.
Identify chemical exposure, injury, sudden visual loss, severe pain and systemic warning symptoms before proceeding through routine examination.
Start indicated irrigation or eye protection and contact the emergency eye, stroke or acute medical service appropriate to the presentation.
National guidance is shown before implementation-dependent detail. Typical adult dose examples remain subject to patient factors, contraindications and the live BNF or specialist protocol. Source check completed 7 Sept 2026; clinical approval remains outstanding.