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Ophthalmic Services Guidance

The Royal College of Ophthalmologists is the guardian of excellence in ophthalmology. It aims to set standards in all aspects of the delivery of ophthalmic care in the interests of patients and the public. Guidance is provided under various topics and is reviewed regularly. The guidance is intended to inform both ophthalmologists and those managing eye services. A summary of the information contained in the Ophthalmic Services Guidance Chapters that should be considered by commissioners and providers of ophthalmology services is also available Ophthalmic Service Guidance Chapters: Advice for Commissioners and Services Providers.

College 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.’

Quality Standards Development Tools

The College’s Quality Standards Group has produced a suite of simple self-assessment tools for the following clinical services:

Onward Referral Guidance

Guidance from the Academy of Medical Royal Colleges and endorsed by NHS England and NHS Improvement, BMA and RCN. The guidance clarifies the way in which hospital specialists can refer patients straight to other specialists for treatment, rather than send them back to their GP for onward referral.

The interface between primary and secondary care: Key messages for NHS clinicians and managers

NHS England briefing document on the interface between general practice and secondary care providers describing the key national requirements which clinicians and managers across the NHS need to be aware of.

New to follow up ratios in ophthalmology outpatient services

A set of documents suggesting realistic ratios for patient follow-up visits compared to new patient visits for cataract surgery, glaucoma, diabetic retinopathy, and AMD patients is currently under development. The purpose of this document is to help commissioners understand that this view is inadequate and to aid conversations between commissioners and ophthalmologists.

Joint Guidance from The Royal College of Ophthalmologists and The College of Optometrists

These guidance documents recommend how to improve services in four key areas: glaucoma, urgent eye care, age-related macular degeneration and low vision. It shows how commissioning community services delivering urgent eye care can reduce the number of people attending hospital casualty services at a time when they are struggling to meet demand.


Ocular Public Health Network – provides information and evidence for anyone who wants to make the case for eye health as part of the local public health planning process.
•    Sign up to NHS Networks at 
•    You can then access the Ophthalmic Public Health Network at

NICE Guidelines and Quality Standards

NICE Commissioning guides

NHS Right Care – The Right Care programme is focused on increasing value – value for patients and value for commissioners. The programme is targeted at clinicians, commissioners and patients. NHS Right Care Resources Centre

Public Health Outcomes Data Tool see section 4.12 1-1v on preventable sight loss

RNIB Sight Loss Data Tool (December 2018): The RNIB has published a Sight Loss Data Tool on its website. It gives information about sight loss, CVI and registration for each region & local authority in England.