What criteria should I use to decide when to refer a patient with dry eye syndrome to an ophthalmologist?

As an Admin in General Practice, you should consider referring a patient with dry eye syndrome to an ophthalmologist based on the following criteria:

• Urgent Ophthalmology Same-Day Assessment:
  • If the patient has red flag symptoms or signs that may indicate a serious or sight-threatening cause for their symptoms ¹.
  • If a serious complication is suspected ¹.
• Urgent Referral to Ophthalmology (within one week):
  • If a serious underlying cause is suspected, such as Stevens-Johnson syndrome or ocular cicatricial pemphigoid ¹.
• Referral to Ophthalmology or an Appropriate Specialist (urgency depending on clinical judgement):
  • If there is an uncertain diagnosis, especially if a child has unexplained symptoms or suspected corneal changes ¹.
  • If a suspected underlying systemic condition is present, such as Sjögren’s syndrome ¹.
  • If the patient has abnormal lid anatomy or function ¹.
  • If persistent or severe symptoms do not respond to primary care management after 4–12 weeks, depending on clinical judgement ¹.