Optometrist, GP or hospital eye clinic: who to see first

Three doors, and the one you knock on first

Something is wrong with your eye and it is 7 pm. Or your child's eye has turned in. Or your mother has woken with a grey curtain across half of what she sees. The question is not whether to get help but where, and in New Zealand there are three doors: an optometrist, a GP, and the public hospital eye service. The emergency department sits behind the third.

Picking the right door matters because the wrong one costs time. A practice like ours can look at the back of your eye within the hour; a GP can treat the shingles rash around it; only a hospital can repair a detached retina. This guide is built around one table, so if you are in a hurry, skip to it.

What an optometrist can do in New Zealand

Healthify NZ says you do not need a referral to see an optometrist for most eye concerns, and that is how NVISION works: you phone or book online for any appointment. Under the Optometrists and Dispensing Opticians Board's 2024 scope notice, an optometrist assesses, diagnoses, treats and manages conditions of the eye, and can prescribe restricted medicines unless a condition on their registration says otherwise.

In practice that covers a lot. Blurred vision and a new prescription. A red, gritty or watery eye, including the drops to treat an infection or inflammation where an optometrist is authorised to prescribe. Floaters and flashes, examined with dilating drops and retinal imaging the same day. Eye pressure, visual fields and OCT for glaucoma. Children who cannot read letters. Our conditions page lists what we treat.

There are limits, and they are the point of this guide. An optometrist does not operate, inject or laser, and does not admit you to hospital. When an exam finds a detached retina, a cataract ready for surgery, wet macular degeneration or an inflammation that needs an ophthalmologist, the optometrist's job is to refer you, quickly, and we do.

• Glaucoma. Only an optometrist with the Board's Glaucoma Prescribing endorsement may manage glaucoma independently; others share the care with an ophthalmologist. Dr Ryan Mahmoud holds that endorsement.
• Eye injuries. Healthify NZ says most eye injuries are covered by ACC, and ACC's optometry code list includes an initial eye examination and treatment such as foreign body removal and chemical burn irrigation. Ask when you book whether your visit can be lodged with ACC.
• Referrals. Healthify NZ describes the optometrist's path onward: to an ophthalmologist, a medical doctor who treats eye disease and performs surgery, when further investigation or treatment is needed.

When your GP is the right first call

Your GP is the right door when the eye is part of a bigger picture. A headache with fever, a stiff neck or weakness on one side is a GP or 111 matter, not an eye test. A painful rash on the forehead or around one eye, which may be shingles, needs a GP quickly because the treatment is a tablet, not a drop. New diabetes, blood pressure problems, thyroid trouble and medicines with eye side effects all start with the doctor who manages the whole of you.

Lumps, cysts and skin problems on the eyelids sit in the overlap. An optometrist can examine them; a GP can treat or refer for removal. Health New Zealand also notes that a pharmacist can help with minor problems such as eye infections without an appointment.

Your GP can refer you to the public hospital eye clinic, and so can an optometrist. If you already have a GP who knows your history, telling them what the optometrist found keeps your records in one place.

Hospital eye clinics, the emergency department and 111

Public hospital eye clinics are referral services. Greenlane Clinical Centre in Auckland, for example, states that you cannot self-refer to any service there; a GP or optometrist refers you. That is how the public system triages: the clinic sees people whose optometrist or GP has already found a reason.

The emergency department is different. Health New Zealand says to call 111 for an ambulance in any critical or life-threatening emergency, and that you can go straight to an emergency department. For an eye, Healthify NZ lists sudden loss of vision, a strong chemical such as oven cleaner or bleach in the eye, an object that has pierced the eye, and blurred or lost vision after an injury as reasons to call 111 or get care immediately.

Two more belong on that list. Healthify NZ describes a sudden red, painful eye with blurred vision, halos around lights and nausea as possible acute angle-closure glaucoma, which needs a doctor immediately. And it says a shadow or curtain in your side vision, or new flashes with a sudden increase in floaters, means contacting your healthcare provider, optometrist or an ophthalmologist right away, because a detached retina is a medical emergency. Our guide to floaters and flashes goes into that one.

Healthline, after hours and weekends

If you are unsure which door, Healthline on 0800 611 116 is free, answered 24 hours a day by nurses and paramedics, and Health New Zealand says it can tell you where the nearest after-hours GP, emergency department or pharmacy is. For a non-life-threatening problem that cannot wait for a booked appointment, Health New Zealand points to an after-hours or urgent medical centre, where you do not need an appointment but may have to wait.

NVISION Eyecare is open Monday to Friday, 9:00 am to 5:00 pm, and Saturday 8:30 am to 3:00 pm, and closed Sundays and public holidays. Within those hours, phone 09-475 5548 and describe the symptom; a same-day look at a red eye or new floaters is a different booking from a routine exam. Outside those hours, use the table above and Healthline rather than waiting for us to open.

When this practice is the wrong place

To be direct: do not book an optometry appointment, with us or anyone, for sudden loss of vision, a grey curtain or shadow across your sight, a chemical splash, something stuck in or through the eye, an eye injury with any loss of vision, or a red and painful eye with light sensitivity and nausea. Call 111 or go to the nearest emergency department. For a chemical splash, Healthify NZ says to flush the eye with clean, cool running water for at least 15 minutes first, then go.

For everything slower, an eye exam is the right first step, and the guide to what happens at your first appointment shows what that looks like. Our eye examinations page describes the exam, and the contact page has the address and a map.