Glory Eyecare Optometrists

Referrals

​Last updated 5 Apr 2025

A1.  Why Full Eye Exams Are Needed for Referrals?

Short answer: Full exams find hidden problems & meet medical requirements for referrals.

✔ Eye health screenings for prescriptions aren't full exams – not enough for diagnosis and management of eye conditions
✔ Medicare/insurance rules – Requires documented medical need
✔ Early detection saves sight – Finds glaucoma, diabetes, retinal issues
✔ Better specialist care – Provides complete health data for treatment

Thorough exams protect your vision and health.

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​A2.  Eye Health Screening vs. Full Optometric Exam

Short answer: Eye health screenings focus on prescriptions and are limited in their ability to detect diseases and diagnose issues. Full optometric exams provide a thorough eye health assessment and ensuring proper treatment or referrals.

                                                      Vision Tests & Eye Health Screening                                               Full Optometric Exam

Purpose                                        Quick check, often for prescriptions                             Comprehensive eye and vision health evaluation

Duration                                                          15–30 minutes                                                                           30–60 minutes

Includes Prescription?              Yes, typically for glasses or contacts                   Yes, with detailed refraction to determine exact prescription

Checks for Diseases?                                   Limited or none                                                 Yes — glaucoma, cataracts, retinal issues, etc.

Pupil Dilation?                                                          No                                                                  Often, to examine internal eye structures

Medical History?                                              Not typically                                                      Yes, full health and vision history considered

Diagnostic Capability                                         Minimal                                                      Full diagnosis and management of eye conditions

Follow-up/Plan?                                              Not provided                                                  Yes, with tailored treatment or management plans

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A3.  Why Different Eye Exams Are Needed for Different Eye Conditions?

Short answers: Your eyes need different tests to protect different parts and functions of your vision.

1.  Different Problems in Different Places

• Glaucoma harms the optic nerve (back of eye)

• Macular diseases damage central retina

• Diabetes affects blood vessels

2.  Each Needs Special Detection Tools

• Glaucoma - Eye pressure, optic nerve scans & side vision tests

• Macular diseases - Central retinal scans & grid tests

• Diabetic damage - Dilated exam & retinal imaging

3.  Early Detection is Critical

• Glaucoma: 40% of vision can be lost before you notice

• Macular: Treatment works best before symptoms start

• Diabetes: Changes begin 5-10 years before vision problems

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A4.  Why Optometrists Must Follow Government and Professional Guidelines?

Short answer: Law + Safety + Trust.

1. Legally must – AHPRA registration, laws & Medicare billing.

2. Patient safety – Correct diagnoses & care

3. Quality care - Medicare/PBS standards.

4. Trust - Professional ethics & reputation

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A5.  Benefits to Patients When Optometrists Follow Guidelines

Short answer: Healthier eyes, proper care, lower costs & confidence.

1. Accurate care – Fewer errors in diagnosis/prescriptions

2. Quality treatment – Proven methods for eye conditions

3. Privacy protected – Secure handling of health data

4. Affordable access – Smooth Medicare/PBS claims

5. Trustworthy service – Nationally approved standards

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A6.  Risks of Ignoring Optometrist's Advice

• Permanent vision loss

• Worsening eye disease

• Chronic discomfort

• Costlier treatments

• Missed health warnings

Protect your sight - follow professional advice.​​​​

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​​​​Glaucoma​

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B1.  Why are Complete Exams for Glaucoma needed for Initial and Ongoing Management?

​1. Early Detection is Critical
Glaucoma often progresses without symptoms. A full glaucoma workup is the only way to catch it before vision is lost permanently.

What We Check:

1. Eye pressure (tonometry) ~ 5–10 mins

2. Optic nerve health (OCT or special imaging) ~10 mins

3. Side vision (visual field test) ~10 mins

2. Medicare/Insurance Requirements
Valid referrals must include:

1. Exact eye pressure readings

2. Images of the optic nerve

3. Visual field test results

4. Comparisons from previous visits

3. Ongoing Care is Key
Glaucoma can change over time. Regular full exams help us:

• Track how fast it’s progressing

• See if treatment is working

• Adjust care when needed

4. Helps Your Eye Specialist Help You
Complete information allows specialists to:

• Quickly see how urgent your case is

• Plan the best treatment

• Focus on what matters most for your eyes

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B2.  Process for Glaucoma Referral

Glaucoma referral by an optometrist in Australia follows a structured process but keep on evolving. The number of visits can vary depending on the case.

Visit 1 – Initial General Exam
Optometrist checks:

• Eye pressure (tonometry)

• Optic nerve (ophthalmoscopy; OCT if time allows)

• Visual field (1st test if time allows)
  If findings are suspicious, they may:

• Flag as a glaucoma suspect

• Refer emergency cases immediately; schedule additional tests for non-emergency cases.

Visit 2 – Glaucoma Workup
May include:

• Repeat eye pressure

• Repeat visual field (1st or 2nd test)

• OCT scan if not done

• Gonioscopy (if available) ~ 15 mins

Visit 3 – Confirmatory Testing & Referral

May include:

• Repeat eye pressure

• Repeat visual field (2nd or 3rd tests)

• Analyse all the information and make a decision for referral or monitoring 

• Visit 4 might be needed to repeat the 3rd visual field (Medicare changes from 1 March 2025)

Helps confirm risk and reduce false positives.

If glaucoma is confirmed or still suspected:

• Referral to ophthalmologist (urgent, semi-urgent, or routine based on severity)

🔁 Summary:

• Minimum visits before referral: 1 (emergency cases)

• Typical: 2–4 visits before referral (non-urgent and glaucoma suspect cases)

• Referral to: Ophthalmologist, often through shared care

💡 Notes:

• Medicare covers repeat visits if clinically needed

• Even with a referral, specialists may do more tests

• Confirmed cases often continue in shared care between optometrist and ophthalmologist

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Fees​​

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C1.  Why Optometrists Charge for Referrals After Bulk-Billed Eye Tests (Australia)?

1.  Medicare Restrictions

• Bulk billing (Items 10910/10911) covers medically necessary exams—not routine vision checks or referral documentation.

2.  Separate Services

• Bulk-billed: Eye health check (e.g., glaucoma screening)

• Private fee: Referral-related work like OCT, visual fields, reports, and clinical interpretation

3.  Supported by Optometry Australia

• Charging a reasonable fee for non-Medicare services reflects professional time, expertise, and equipment use.

4.  Patient Benefits

• More accurate referrals

• Helps avoid unnecessary specialist costs

• Provides detailed info to ophthalmologists for better care

“We bulk-bill what Medicare allows and charge fairly for the additional care needed.”

Good to Know: Early detection often reduces overall costs—and protects your sight.

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C2.  Optometry Referral Fees in Australia

(Source: Optometry Australia & MBS 2024)

 

1. Medicare vs Private Services

• Bulk-billed (covered):

  • Item 10910: Medical eye exam (e.g., for glaucoma, diabetes)

  • Item 10918: Follow-up review

• Privately charged (not covered): Market rates

  • Routine vision test: $60–$70

  • Referral prep: $80–$180 (depends on complexity)

    • Includes OCT (10 mins), visual fields (10 mins), interpretation and specialist reports (15mins)

2. Fair Fee Guidelines (Market Rate)

• Based on ~$250–$300/hour (allied health standard)

• Simple referral (15 mins): $80 (gap)

• Complex case (e.g., glaucoma): $100–$180 (gap)

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Service                                                                      Market Private Gap Fee                        Medicare

Routine vision test (no health check)                                  $60–70                                             ❌ No

Bulk-billed medical eye exam (Item 10910)                            $0                                                 ✅ Yes

Glaucoma referral (with tests)                                             $120–180                                          ❌ No

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Fees reflect time, skill, equipment use, and market rates which change with inflation.

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