Triage Rules for Pediatric Eye and Adult Strabismus Clinics

1. Patient issue needs to be addressed the same or next day

1. Patient needs to be seen the same day and is in the ED or hospital

1. Patient issues that are non-urgent (e.g. glasses/prescription requests, follow-up questions)

1. Patient is new to the peds service and has a question or the patient is being referred and there is a question about when/with whom to schedule.
2. This includes patients seen on call by a non-peds ophthalmologist.

Trauma:

• Penetrating/perforating
  • Metal on metal
  • Severe blunt trauma
  • Mild blunt trauma with ocular symptoms

• If the patient has multiple injuries or is not being referred by a physician, they should report to the nearest Emergency Room

• Red Swollen Eye
• Blood IN eye associated with vision symptoms
• Chemical burn or cleaner splashed in eye - If the patient has multiple injuries or is not being referred, they should report to the nearest Emergency Room, chemical burns need copious irrigation with water immediately.
• Postoperative patient with increased redness, pain or swelling
• Sudden loss of vision

• White pupil
• Absent red reflex
• Cataract in a baby
• Red eye
• Eye pain with tearing, and/or photophobia, eye surface swelling, lid swelling
• Headache associated with pain and double vision
• Cloudy cornea

• Sudden onset of strabismus or diplopia in a child
• Eyes that are constantly misaligned
• One pupil larger than the other– new onset.
• Blood on the eye (subconjunctival hemorrhage)

• Child not tracking well
• Eyes bobbing (nystagmus )
• Droopy eye lid
• Chalazion

• Longstanding Strabismus, Adults
• Headaches without visual symptoms
• Eyestrain when reading
• Sits to close to TV
• Excessive blinking
• Difficulty when reading
• Abnormal head position/Head Tilt
• Failed vision screening unless more urgent problem above

• ALL appointment cancelling, and rescheduling calls should go through the ROP coordinator