Eye (Ophthalmology) Clinic

Scope

To provide medical and surgical evaluation and management of patients with visual or ocular disorders.

Appropriate patients for referral:

• Blurred vision, unexplained (not related to glasses)
• Persistent red eyes greater than 1 week
• ALL red eyes with pain or decreased vision
• Eye pain
• Glaucoma or at-risk patients (Positive family history, race, high myopes)
• Cataracts
• Exophthalmos
• Advancing Pterygia
• Abnormal lid contour (ectropion, entropion)
• Amblyopia for patients over 12 (up to age 12 refer to pediatric ophthalmology via Seton Health Plan prior authorization process)
• Diplopia (double vision)
• Screening for patients taking Plaquenil
• Increased intracranial pressure (Pseudotumor)
• Structural brain abnormalities suspected of impairing visual pathway (e.g. ituitary tumors, A-V malformations, etc.)
• Lid lesions (cancer or Herpes Zoster) – (some cases may require Ocuplastics referral via Seton Health Plan prior authorization process)
• Macular degeneration
• Diabetic patients for retinal screening
• Cornea conditions, cloudy corneas
• Uveitis /scleritis

Please do NOT refer the following patients:

• Sudden change in vision – refer to ED
• Flashing lights and floaters – refer to ED
• Hypertensive patients without ocular symptoms
• Strabismus – refer to Pediatric Ophthalmology specialist via Seton Health Plan prior authorization process
• Patients needing glasses or contact lenses (no refraction is done in the eye clinic)
  • Central Health does not currently cover glasses or contact lenses.

Patients who need prescription glasses can request an eye exam voucher from their primary care team at most clinics that participate in MAP. If a primary care team is not participating in the vision vouchers, email VisionVoucher@communitycaretx.org for a list of participating primary care clinics that can issue a voucher for an eye exam or glasses.

Note: Children failing their vision test at school may also be referred to the Lion’s Club (through the school nurse) where free glasses will be provided.

Documentation required for scheduling an appointment:

• Completed Referral form
• Past Medical History (PMH)
• Current medication list
• Most recent progress note describing condition for which patient is being referred.
• For patients with blurry vision, red eyes, eye pain, decreased vision, cataracts, glaucoma, include an optometrist note with:
  • Description (ie blacked out vision, curtain/veil), duration of issue, diagnosis, any current treatments)
  • For glaucoma, please include complaint at time of PCP visit and why glaucoma is suspected
• For urgent referrals, please provide as much information as possible around vision loss (ie: gradual, sudden onset, etc.).
  • Include desired follow-up time (ie: same day request, within one week, next available)

Please refer to the Central Health Referral Pathways document to determine appropriate ophthalmology provider.