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Clinical Guidelines

The aim of College Clinical Guidelines is to identify the best medical evidence, set standards of patient care and ensure patient safety, providing a benchmark for outcomes within which high quality Ophthalmology can be practiced in the UK health service.

Our guidelines are systematically generated to help clinicians make better decisions about appropriate healthcare for specific eye disorders, enhancing clinician and patient decision making by describing and appraising the scientific evidence and reasoning behind clinical recommendations.

They are developed to make recommendations for the majority of clinical situations; however they are intended as an aid to clinical judgment not to replace it. Guidelines do not provide the answers to every clinical question, nor guarantee a successful outcome in every case. The ultimate decision about a particular clinical procedure or treatment will always depend on each individual patient’s condition, circumstances and wishes, and the clinical judgment of the healthcare team.’

Guideline Title

Summary Information

Retinal Vein Occlusion (RVO) Guidelines July 2015

Executive Summary Eye advance online publication 28 August 2015; doi: 10.1038/eye.2015.164

These guidelines (July 2015) reflect changes in treatments, since the 2010 Interim RVO Guidelines. The guidelines provide evidence-based, clinical advice for the management of different aspects of RVO. The scope is limited to current diagnostic tools, management and service set-up and delivery to facilitate delivery of optimal care. They are aimed primarily at ophthalmologists but are relevant to other healthcare professionals, service providers, and commissioning organisations as well as patient groups. It is hoped that, if used appropriately, the guidelines will lead to a uniformly high standard of management of patients with RVO.
The guidelines are intended to set the standards for best practice in the NHS and in the private sector. They will be useful for education of ophthalmic trainees and those in other disciplines. The guidelines are also intended to give patients, carers and consumer organisations a resource with improved current information. The guidelines will act as a benchmark for service planning by providers, guide purchasers in the commissioning of services and set national standards for audit.AMD Electronic Referral Form

NICE is currently developing Guidelines on Macular Degeneration – anticipated publication date October 2017.

Standards for the Retrieval of Human Ocular Tissue used in Transplantation, Research and Training 2013 The purpose of these Standards for the Retrieval of Human Ocular Tissue used in Transplantation, Research and Training (“the Standards”) is to provide professional guidance for individuals and organizations involved in eye donation.
The guidance was developed by a guideline working party (GWP) from the Royal College of Ophthalmologists (RCO) and the Royal College of Paediatrics and Child Health (RCPCH). It brings together previous publications of the RCO and an update of the literature since these publications. The guidance is presented under a number of clinically relevant questions developed by the GWP. It is divided into four main chapters: 1. Aetiological factors and experimental models, 2. Clinical features and pathology. 3. Differential diagnosis and confounding conditions and 4.Guidance for the Ophthalmologist.The guidance includes a standardised proforma for documenting retinal findings in Appendix 3.The guidance has primarily been developed for ophthalmologists but is an evidence based resource for any physician or surgeon involved in child protection.
These guidelines will now cover the management of patients undergoing most routine ophthalmic procedures and are not limited to intraocular surgery. The purpose of these guidelines is to provide information for all members of the ophthalmic team in order to promote safe and effective local anaesthesia for ophthalmic patients. They are intended to apply to practice in the United Kingdom.
The aim of the guidelines is to provide evidence-based, clinical guidance for the best management of different aspects of diabetic eye disease. The foundations of the guidelines are based on evidence taken form the literature and published trials of therapies as well as consensus opinion of a representative expert panel convened by the Royal College of Ophthalmologists with an interest in this condition. The scope of the guidelines is limited to management of diabetic retinopathy with special focus on sight threatening retinopathy. It offers guidance regarding service set up to facilitate delivery of optimal clinical care for patients with retinopathy. The guidelines are prepared primarily for ophthalmologists, however they are relevant to other healthcare professionals, service providers and commissioning organisations as well as patient groups.
This guideline is designed for ophthalmologists managing children with strabismus (syn.squint), which is defined as a pathological misalignment of the visual axes. This is a broad subject and the reader is referred to comprehensive texts, for further information see bibliography.  The guidelines are intended to give general principles of management. It is assumed throughout this document that professionals dealing with common and uncommon cases of strabismus will have had adequate training and experience to manage children with these conditions.
The aim of these guidelines is to identify good clinical practice, set standards of patient care and safety and provide a benchmark for outcomes within which high quality cataract surgery can be practised. They represent the current understanding of the guideline development group but will not necessarily all remain applicable until the next review.

NICE is currently developing Guidelines on the management of cataracts in adults – anticipated publication date October 2017.

In 1997 Liverpool, London and Sheffield were designated as Centres of Excellence for adult ocular oncology in England by the National Commissioning Group (formerly the National Specialist Commissioning Advisory Group). The National Services Division in Scotland similarly designate a service for Scotland at North Glasgow University Hospital. These guidelines are not intended to be prescriptive but to act as an aid to considering referral of patients to the nationally designated ocular oncology centres. Referring ophthalmologists should continue to exercise discretion based on the individual clinical presentations of individual patients.
This evidence-based guideline for the screening and treatment of ROP was developed by a multidisciplinary guideline development group (GDG) of the Royal College of Paediatrics & Child Health (RCPCH) in collaboration with the Royal College of Ophthalmologists (RCOphth), British Association of Perinatal Medicine (BAPM) and the premature baby charity BLISS.It provides 25 evidence-based recommendations and 21 good practice points.This guideline has been produced specifically for use within the UK and supersedes the previous guideline. It will not be applicable in countries where more mature babies are at risk of sight threatening ROP.

Other documents

Intra-ocular injections by non-medical health care professionals 2013

Review of the Ocular side effects of Topiramate 2010

Ocular side effects of Topiramate: Frequently asked questions 2010

The Ocular Side-Effects of Vigabatrin (Sabril) Information and Guidance for Screening 2008