When to refer AMD
Structured for Australian optometry practice.
Clinical decision support only
OptoGuide™ supports professional judgement and does not diagnose or replace clinician responsibility.
Quick answer
- Referral urgency depends on whether the presentation suggests dry AMD monitoring or possible neovascular change.
- New distortion, reduced central vision, haemorrhage, or subretinal fluid should prompt urgent macular review.
- OCT, Amsler symptoms, and macular haemorrhage materially change referral timing.
- Stable drusen without exudative signs can often stay in optometric review with clear recall planning.
Common causes
- Early or intermediate dry AMD with drusen and pigment change.
- Geographic atrophy with progressive central impairment.
- Neovascular AMD with fluid, haemorrhage, or rapid symptom change.
Red flags (must not miss)
- New metamorphopsia or sudden central blur.
- Subretinal or intraretinal fluid on OCT.
- Macular haemorrhage or grey-green membrane suspicion.
- Rapid drop in visual acuity or new unilateral symptoms.
Use OptoGuide™ to guide this decision during consult.
What to check
- Baseline and current visual acuity, ideally monocular.
- Symptom change: distortion, central blur, reading difficulty.
- Macular OCT where available.
- Fundus signs: drusen load, pigment change, haemorrhage, fluid suspicion.
- Laterality and pace of change.
When to refer
- Urgent retinal referral for suspected neovascular AMD or rapid symptomatic change.
- Prompt referral when OCT or fundoscopy suggests fluid, haemorrhage, or active membrane.
- Monitor in optometric care when findings are dry and stable with appropriate recall.
Initial management
- Differentiate stable dry AMD from exudative change requiring escalation.
- Record baseline acuity and structural findings clearly for comparison.
- Give a defined review interval when referral is not required immediately.
Clinical basis
This guidance reflects standard optometric clinical reasoning based on:
- Australian optometry clinical practice patterns
- Australian medicines regulation and PBS prescribing context
- Common ophthalmology referral standards
- Evidence-based clinical training and practice
Use OptoGuide™ during consult for structured clinical guidance.