Acute Glaucoma

Red, hard, aching eye, hazy cornea and blurred vision

  • Where to refer:
    • Eye Casualty


Primary open angle glaucoma

  • Information to include
    • Optometry referral must indicate disc and/or field defect compatible with glaucoma, or angle at risk of closure. Patients with family history are screened by optometrist
  • How to refer
    • Routine with copy of optometrist referral with info on refraction, IOP, disc and field enclosed if abnormal.
    • Book fields
    • Urgent if IOP >32mmHg
    • If re-referral, refer to current consultant
    • If transfer from another hospital eye service unit include last hospital eye service letter


Ocular hypertension

  • All patients with a pressure of 24 – 29 mmHg should be referred to the HES (Hospital Eye Service)
  • All patients with a pressure of 30 mmHg or higher confirmed by Goldman should be referred urgently to the HES 
  • All other IOP results are within normal limits and the patient can be discharged 
  • Where the patient’s IOP is measured at 35 mmHg or over with symptoms of primary angle closure the patient shall be referred as an emergency to the Hospital Eye Services via email to the Emergency Eye Clinic.
  • Where the patient’s IOP is measured at 35 mmHg or over with no symptoms then an urgent referral to the hospital eye services should be carried out.

(work currently on going to allow direct referrals in the future but not at present)



Date reviewed                     April 2021

Next review due                  April 2022

Contributor                          Mr William Westlake, RCHT



Version No.  3.10