Welcome to our fourth ‘Good Referral of the Month’ – keratoconus. This regular feature highlights and discusses good quality ophthalmic referrals for a range of common conditions. We have also included some guidance from ophthalmologists to help you produce top quality referrals for keratoconus!

1. © Evolutio Care Innovations Limited 2017
Congratulations to Robert
Harris, CLO at Haine &
Smith Opticians in
Marlborough for being
selected for June’s ‘good
referral of the month’.
As a triager I feel this is a good example of a referral for keratoconus. From a clerical
perspective it is typed (handwritten can take up to 6 times longer to read) and the
details of the referrer, GP and patient are very clear. The urgency is clear and
although the clinic type is not specified, it can be easily inferred as ‘cornea’ from
the tentative diagnosis.
The CLO has provided several useful pieces of information including the history,
current refraction, change in astigmatism, V/A, keratometry readings (with a
description of mire quality), absence of specific associated signs and a reference to
family history.
What to include in a referral for suspected keratoconus:
• Symptoms
• Refraction
• VA (D&N)
• Previous VA (if known)
• K readings (including mire quality)
• Retinoscopy reflex description
• Cornea (clarity, irregularity)
• Risk factors (eye rubbing, atopy, sleep apnoea)
• Topography (attached)
• F/H
Christian Dutton BSc(Hons.) MScClinOpt FCOptom
Did you know that you are able to attach anterior segment images, OCT images
and fundus photos to eRefer, our bespoke referral management software? If you
are based in one of our CCG-contracted areas please contact us for a
demonstration and free download.
Practice name, phone, email, website
GP name and address
Date of referral
Dear General Practitioner,
Re: Name: XXXXXX XXXXXX Date of Birth: XXXXXX
Address: XXXXXX XXXXXX XXXXXX XXXXXX XXXXXX XXXXXX XXXXXX XXXXXX
Most Recent RX: XXXXXX/2017
Vision Sph Cyl Axis D Prism VA Add N Prism N V/A
R 6/15+ Plano -1.75 75 6/6
L 6/38 +3.00 -5.50 100 6/6-
XXXXXX, a soft contact lens wearer, attended for both a sight test and CL aftercare today.
His astigmatic refractive error in the left eye appears to be increasing compared to his previous
visits (-1.25 cylinder increase).
Keratometry readings were taken today:
R 7.85 x 7.95 Clear mires
L 8.20 x 7.45 Malaligned/Distorted mires
There are no Vogts straie or Munson sign noted.
He has a family of a high astigmatic correction (mother).
Please refer this patient to either XXXXXX XXXXXX Hospital XXXXXX or XXXXXX XXXXXX for a
routine Ophthalmological assessment to query a diagnosis of progressing Kerataconous and
possible Collagen Cross Linking treatment?
Yours sincerely,
Signed
Name
GOC number
CC: XXXXXX XXXXXX
Good referral
of the Month:
#4