Vision problem referral checklist

Urgency tier

• Immediate ED/stroke or emergency ophthalmology assessment for sudden vision loss, a new field defect or neurologic deficit; urgently evaluate suspected ischemic transient loss even after recovery.
• Emergency ophthalmic assessment for painful red eye with reduced vision, a new curtain/field loss, significant trauma or suspected giant cell arteritis with visual symptoms.
• Routine referral for stable but persistent visual disturbance.

Minimum pre-referral workup

• Emergency transfer must not wait for completion of this checklist.
• Document monocular/binocular pattern, onset, and progression.
• Focused neurologic and ocular symptom screening.
• Baseline function/safety impact (driving/work) assessment.

Referral packet checklist

• Symptom chronology and associated neurologic findings.
• Objective visual observations and relevant tests completed.
• Comorbidity profile and medication summary.

Pre-referral optimization tasks

• Advise immediate safety precautions for reduced vision.
• Reinforce return precautions for sudden worsening.
• Arrange interim follow-up while referral is pending.

References

• Canadian Stroke Best Practices TIA and non-disabling stroke assessment (2022) (opens in a new tab)
• Emergency Care BC Acute vision loss (2018) (opens in a new tab)
• Emergency Care BC Flashes, floaters and visual field deficits (2024) (opens in a new tab)
• Emergency Care BC Giant cell arteritis (2024) (opens in a new tab)
• Emergency Care BC Caustic injuries (2022) (opens in a new tab)

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