Sheffield Local Optometric Committee

Sub-foveal wet ARMD

Direct referral system for Sub-foveal wet ARMD
updated on website 6/1/12

Referral Guidelines from Mr Chris Brand

Distortion of the Amsler grid is an indication that dilated stereoscopic (if possible) fundoscopy should be performed.
A thorough search for macular oedema, hemorrhage and or exudates should be performed (visual evidence suggestive of a choroidal neovascular membrane).
If the patient has a v/a less than 6/60 they are not eligible for treatment and therefore referral can be made via the GP. [However be careful with this point: if the changes at the back of the eye have caused a refractive change, and correction of that refractive change brings them back to 6/60 or better, then they would be eligible.] If the effected eye has worn a balance lens for whatever reason (anisometropic amblyopia) it should be refracted and again its fully corrected visual acuity should be recorded and considered.
So a best corrected visual acuity of 6/60 or better with central Amsler distortion and/or visual evidence suggestive of a choroidal neovascular membrane can and should be referred directly to the Med Ret team at the Hallamshire Hospital (Sheffield based Optoms only)

Consideration needs to be given to the following facts:

The commonest cause of Amsler grid distortion is dry ARMD. Referring purely on Amsler grid distortion may lead to false positive referrals.
The commonest cause of macular haemorrhage is diabetic maculopathy. Diabetics with macular haemorrhages should be referred to their specialist in the usual way unless you are quite certain the haemorrhage is secondary to a choroidal neovascular lesion.
The aim is to see patients who need treatment quickly.

Please use this fax Number only to refer suspected wet ARMD within the above guidelines.
Fax to Medical Retina Coordinator – 0114 2713682 (notification posted to the GP)
The receipt of the fax can be confirmed by calling Gail Simpson [ med retina coordinator] on 2268862

Please ensure that full contact details are included in the referral.

The hospital will contact the patient directly to arrange an appropriate appointment.

Patients can be given the Medical retina coordinators contact number but should only be encouraged to phone in if they have not heard anything for at least 2/52.
The hospital will endeavour to reply to all referrals at anappropriate stage in the patient’s assessment / treatment.

Next Meeting:

Copthorne Hotel
Bramall Lane
Sheffield
S2 4SU

at 7.00pm Monday 4th December

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