What criteria should I use to decide when to refer a patient with dry eye syndrome to an ophthalmologist?

Guideline-aligned answer with reasoning, red flags and references. Clinically reviewed by Dr Kola Tytler MBBS CertHE MBA MRCGP.

Posted: 16 August 2025Updated: 16 August 2025 Guideline-Aligned (High Confidence) Clinically Reviewed
Dr Kola Tytler MBBS CertHE MBA MRCGPClinical Lead • iatroX

As an Admin in General Practice, you should consider referring a patient with dry eye syndrome to an ophthalmologist based on the following criteria:

  • Urgent Ophthalmology Same-Day Assessment:
    • If the patient has red flag symptoms or signs that may indicate a serious or sight-threatening cause for their symptoms .
    • If a serious complication is suspected .
  • Urgent Referral to Ophthalmology (within one week):
    • If a serious underlying cause is suspected, such as Stevens-Johnson syndrome or ocular cicatricial pemphigoid .
  • Referral to Ophthalmology or an Appropriate Specialist (urgency depending on clinical judgement):
    • If there is an uncertain diagnosis, especially if a child has unexplained symptoms or suspected corneal changes .
    • If a suspected underlying systemic condition is present, such as Sjögren’s syndrome .
    • If the patient has abnormal lid anatomy or function .
    • If persistent or severe symptoms do not respond to primary care management after 4–12 weeks, depending on clinical judgement .

Related Knowledge Topics

Educational content only. Always verify information and use clinical judgement.