Direct Referral

For 20 years, we have had direct referral for local optometrists to refer patients to the Eye Departments of St Helens and Warrington hospital. NHS England have commissioned an electronic Referral System (eRS) for optometry referrals and this is now active using the Opera online web-based software. Opera is now used by around 85% of local optical practices and is also used by the commissioned services, such as CUES, Cataract pre-op or Glaucoma Repeat Measures. Opera is fairly easy to use, provides standard referral letterscan and can also be integrated with most prcatice management systems.

If you are an optometrist or GOS contractor not currently using Opera for eRS GOS18 and are keen to start, please go to the following website:

The LOC advises all local optometrists and contractors to utilise the eRS GOS18 facility on Opera to refer all other patients to the Hospital Eye Service, GP, or fellow optometrists, providing the commissioned services for further assessment and treatment. If you have any difficulty 


There are Wet AMD services available locally at St Helens and Warrington eye departments. Local optometrists should refer rapidly to these services where they suspect the presence of wet AMD. This page includes versions of the AMD atlas document, which gives information on when to refer to HES.

The referral should now be done via the Opera software, either by eRS GOS18 or following a CUES appointment, where possible. The patient’s desired provider, such as AMD services at St Helens or Warrington should be chosen and it’s possible to upload and send images or OCT scan files.

The service will contact the patient and arrange an initial assessment within 2 weeks. NB The LOC does not advise referring AMD patients to the GP for onward referral.


If you have any comments to make or want more information, please contact the LOC chair Bob Wilkes [email protected] 0151 426 2214