Specialty: Ophthalmology
Age group: Children
Direct to an emergency department with a neurology service
- Strabismus or nystagmus associated with neurological symptoms (e.g. headaches, vomiting, double vision, unequal pupil size, abnormal pupil reaction to light, abnormal red reflex, or lack of visual response).
Criteria for referral to public hospital service
- Strabismus with or without diplopia (double vision) that has not responded to treatment (spectacles, contact lenses, patching or atropine eye drops)
- Strabismus due to an ocular abnormality (e.g. leukocoria, cataract)
- Nystagmus
- Ocular movement abnormality.
Information to be included in the referral
Information that must be provided
- Child’s age
- Description of onset and duration of symptoms
- Comprehensive eye and vision assessment including cycloplegic refraction and dilated retinal examination (usually performed by an optometrist or ophthalmologist) with best corrected visual acuity (i.e. measured with spectacles or contact lenses) for both eyes or visual behaviour assessment if the child is pre-literate or non-verbal.
Provide if available
- Passport style photograph of the child’s face showing the eye misalignment
- Relevant family history
- Statement about the parent(s) or guardian’s interest in having surgical treatment if that is a possible intervention
- If the child is neurodiverse, gender diverse or has a disability
- If the child identifies as an Aboriginal and/or Torres Strait Islander
- If the child has a preferred language other than English and if they rely on cultural or linguistic support (e.g. Aboriginal cultural support, an interpreter)
- If the child lives in out-of-home care (foster care, kinship care, permanent care or residential care)
- If the child is aged 14-18 years, do they consent that their health information is shared with their parent, guardian or carer.
Additional comments
The Minimum information for referrals to non-admitted specialist services lists the information that should be included in a referral request.
Note there are also statewide referral criteria for Pupil abnormalities.
People experiencing disadvantage or other barriers to accessing eyecare services may be eligible to receive services through the Victorian Eyecare .
Where appropriate and available the referral may be directed to an alternative specialist clinic or service.
Referral to a public hospital is not appropriate for
Not applicable
Reviewed 21 August 2025