The College of Optometrists

Had a 15 year old girl in for a routine examination today. During opthalmoscopy I noticed a naevus on her left iris. On slit lamp examination this lesion appeared raised (3mmx3mm in size). Never seen her before so faxed an urgent letter to her gp to be seen at the HES in the next couple of days. Also handed a copy of the letter to mum to take to gp the same day. Fundus appeared healthy. Should I have done anything else?

was the mother with her on examiantion? did you quiz the mother? HAd she noticed it? if so had she noticed it more lately. Any good head photos of the girl at home - recent or old? these could give clues as to changes it size.

Think you've done the right thing by referring, however not sure that it requires such a degree of urgency. If wrote a letter to GP with a request for 'soon' - ie. within a month - referral, I'm sure this would have been sufficient. If it is a melanoma, it's not likely to do much in a month so I would have thought urgent referral's a bit OTT ??

Yes, did quiz the mother. Never noticed it before.. Probably at bit ott but I'm a pre-reg! Never seen anything like it before so I thought she'd need to be seen within 1-2 weeks.. I thought that's what the college referral criteria stated?

Id refer that speed too probably (Im NQ), especially with patients age. Asked HES about the same question a few months ago - they said see in <1 week. Especially with the big cancer word flashing in your mind.