Oak: Ophthalmology (Optho) Consult Guide

On-Call Ophthalmology Consults for Traumatic Eye Injuries

 

 

During regular business hours, from 8am to 5pm, an Optometrist will take the first call for BCH Oakland patients. The consultant Optometrist will then be responsible for engaging an Ophthalmologist on-call as needed.  Use Voalte messaging/Epic consult order to contact Consult Ped Optho 1st Call. It is the responsibility of the ophthalmology service to arrange for bedside evaluations on patients that are being passed off to oncoming provider

 

 

Phone Consult with Urgent Bedside Consultation (within 4 hours of initial call):

  • Impaired Vision (Sudden loss of vision consider retinal injury) 

  • Known or Suspected Globe Injury 

  • Orbital Floor Fracture w/ Entrapment: 

  • Orbital fracture without entrapment, with abnormal vision 

  • Orbital Compartment Syndrome (Tense Eyelids- Need Tono Pen Reading) 

  • Optic Nerve Impingement (Concern For) 

 

*Trauma Surgeon Discretion for Other Urgent Injuries Not Listed

 

Phone Consult with Bedside Evaluations to be Completed within 24 hours:

  • NAT workups needing child abuse retinal exams 

Phone Consult with Inpatient Evaluation Prior to Discharge:

  • Obtunded/sedated patients with concern for ocular trauma 

Phone Consult with Outpatient follow-up:

  • Superficial Corneal Abrasion (Provider judgement on if a consult needs to be made)

  • Orbital Floor Fracture w/o Entrapment 

  • Any other type of orbital fractures with normal vision

  • Chemical Burns (After aggressive washout, consult because patient will need follow-up)

 

Additional Key Points:

  1. Inferior Rectus entrapment - bradycardia/vomiting when looking up
  2. If patient lives far and will require long distance follow-up, let ophthalmology know and they can see patient at bedside (Emergent vs Non-Emergent).

 

PRINTABLE PAGE

Keywords: eye, optho, ophthalmology