The short answer
For a Medicare rebate, yes. You need a valid referral to an ophthalmologist, and it can come from your GP or from an optometrist. Without one, the ophthalmologist can only bill a lower Medicare item, so you'll usually pay more. You don't need a referral to see an optometrist, and for sudden vision loss or an eye injury you should go straight to an emergency department.
On this page
When should you go to emergency instead?
Sudden vision loss, a serious eye injury or other eye emergencies need care straight away. Go to your nearest hospital emergency department or call 000 for an ambulance [5]. Don't wait to get a referral or book a specialist.
Do you need a referral to see an ophthalmologist?
To get a Medicare rebate at the referred rate, yes. You can see a specialist without a referral, but the Medicare item they can bill is lower, so your out-of-pocket cost is likely to be higher [1]. Healthdirect advises getting a referral from your GP or optometrist before you see an ophthalmologist [5].
Ophthalmologists are medical doctors with additional training in diagnosing and treating eye conditions [5]. They look after problems such as [5]:
- glaucoma
- cataracts, including cataract surgery
- retinal detachment
- eye injuries, pain or inflammation
- a squint (strabismus)
- eye cancers
- eye problems linked to conditions like diabetes and high blood pressure
Optometrist or ophthalmologist: who do you need?
The two roles are different:
| Optometrist | Ophthalmologist | |
|---|---|---|
| Who they are | Eye health professional, not a doctor [5] | Medical doctor with specialist eye training [5] |
| What they do | Test vision, prescribe glasses and contact lenses, screen for serious eye conditions, treat minor problems [5] | Diagnose and treat eye disease, perform eye surgery, prescribe medicines [5] |
| Referral needed? | No, you can book directly [7] | Yes, for the Medicare rebate [1] |
Most eye testing can be provided under Medicare [7], and a standard optometry consultation doesn't need a referral. For example, item 10910 is a comprehensive initial consultation for people under 65 who haven't had a qualifying optometry consultation in the previous 36 months, with a schedule fee of $79.80 (checked November 2026) [6].
Can an optometrist refer you to an ophthalmologist?
Yes. Medicare's referral rules allow a registered optometrist to refer you to an ophthalmologist, and that referral is valid for the specialist rebate [1][2]. It only works for ophthalmologists. An optometrist's referral to any other specialist isn't valid for Medicare [2]. An optometrist's referral lasts 12 months from your first appointment unless a different period is stated [2].
If your problem is mainly about your eyes or vision, an optometrist is often a sensible first stop, since they can examine your eyes and refer on if needed [5][7]. Your GP is a good starting point if the eye problem is tied up with other health issues, such as diabetes, or if you also need other tests or referrals. Sudden vision loss or blurring in one or both eyes can also be a sign of stroke, which is a 000 emergency [10]. Our neurologist referral page covers the FAST signs.
Who else can refer you?
GPs are the main source of specialist referrals [1]. Other specialists can refer you too, for example an endocrinologist managing your diabetes, in consultation with or by notifying your GP [1]. Whoever writes it must have consulted with you and considered whether you need the referral [2].
What should the referral include?
A valid referral includes the reason for referral, relevant clinical information about your eyes, the date and the referring practitioner's signature [1][3]. It can be on paper or electronic [1]. If you've had an optometry exam, bring the report or results with you. See what goes in a referral letter.
Does it need to name a specific ophthalmologist?
No. In private rooms and other community settings, a referral doesn't have to name a specialist [1][3]. If it does, you can still take it to another ophthalmologist unless you've already started seeing the named one [1]. If you'll be a private patient in a public hospital outpatient clinic billed to Medicare, it must name a specialist [1].
How long does an ophthalmologist referral last?
| Who wrote it | How long it lasts |
|---|---|
| Your GP | 12 months, unless a shorter, longer or indefinite period is stated [1] |
| Your optometrist | 12 months, unless a different period is stated [2] |
| Another specialist | 3 months, or the length of a hospital admission [1][3] |
The period starts from your first appointment with the ophthalmologist, not the date the referral was written [1][3]. For ongoing care, such as glaucoma monitoring, your GP can write a referral for longer than 12 months or an indefinite one [3]. More detail is in how long a referral lasts.
What will Medicare cover, and what will you pay?
Ophthalmologists set their own fees, and it can be expensive to see one, so ask about costs and what Medicare will cover before your first visit [5]. As a guide, item 104, a specialist's initial attendance after referral, has a schedule fee of $103.95 and an 85% Medicare benefit of $88.40 (schedule fee updated 1 July 2026, checked November 2026) [4]. You pay any gap above the rebate.
If cost is a barrier, you can ask your GP about a referral to a public hospital eye clinic [5].
Does private health insurance help?
Not for consultations in the ophthalmologist's rooms. Health insurers can't contribute to out-of-hospital treatment for Medicare services [8]. Check your hospital cover separately if surgery is being discussed.
Can you get an ophthalmology referral by telehealth?
Yes. Referrals can be issued electronically [1], so a telehealth GP consultation can result in a referral sent to you or straight to the ophthalmologist. Medicare also has specialist telehealth items, including video for first appointments, but a valid referral is still needed [9]. Ask the ophthalmologist's practice whether your appointment can be by video or needs to be in person. For more, see can you get a referral online.
Getting a referral
Referral GP offers telehealth consultations, by phone or video, with AHPRA-registered Australian GPs. If it's clinically appropriate, your GP can refer you to an ophthalmologist and send the referral electronically.
A consultation doesn't guarantee a referral. Your GP decides what's clinically appropriate.
Bulk billed for eligible patients. If you're not eligible, a consultation fee may apply, and we'll confirm it with you before your consult.
Referral GP is not an emergency service. For sudden vision loss or an eye injury, go to an emergency department or call 000.
This page is general information, not medical advice.
Common questions
Can an optometrist refer me to an ophthalmologist?
What's the difference between an optometrist and an ophthalmologist?
Ophthalmologists are medical doctors with extra training in diagnosing and treating eye conditions, including eye surgery [5]. Optometrists test vision, prescribe glasses and contact lenses and screen for serious eye conditions, but they aren't doctors, and they refer people to an ophthalmologist for more serious problems [5].
How long does an ophthalmologist referral last?
Do I need a referral to see an optometrist?
What should I do if I suddenly lose vision?
Treat it as an emergency. Go to your nearest emergency department or call 000 for an ambulance [5]. Don't wait for a referral.
References
- MBS Online. Factsheet: Referrals for specialist services (July 2026). Accessed November 2026. mbsonline.gov.au/internet/mbsonline/publishing.nsf/650f3eec0dfb990fca2
- MBS Online. Explanatory note GN.6.16: Referral of patients to specialists or consultant physicians. Accessed November 2026. www9.health.gov.au/mbs/fullDisplay.cfm?type=note&q=GN.6.16&qt=noteID
- Services Australia. Referrals for specialist treatment (updated 15 August 2025). Accessed November 2026. servicesaustralia.gov.au/referrals-for-specialist-treatment
- MBS Online. Item 104: specialist initial attendance after referral (schedule fee updated 1 July 2026). Accessed November 2026. www9.health.gov.au/mbs/fullDisplay.cfm?type=item&q=104&qt=item
- healthdirect. Ophthalmologist (last reviewed November 2024). Accessed November 2026. healthdirect.gov.au/ophthalmologist
- MBS Online. Item 10910: optometrist comprehensive initial consultation (schedule fee updated 1 July 2026). Accessed November 2026. www9.health.gov.au/mbs/fullDisplay.cfm?type=item&q=10910&qt=item
- Better Health Channel (Victorian Government). Eye care: optometrists. Accessed November 2026. betterhealth.vic.gov.au/health/conditionsandtreatments/eye-care-optome
- Medical Costs Finder (Australian Government). A guide to out-of-pocket medical costs. Accessed November 2026. medicalcostsfinder.health.gov.au/resources/a-guide-to-out-of-pocket-me
- MBS Online. Explanatory note AN.40.1: Specialist and consultant physician MBS telehealth attendance items. Accessed November 2026. www9.health.gov.au/mbs/fullDisplay.cfm?type=note&q=AN.40.1&qt=noteID
- Stroke Foundation. Signs of stroke. Accessed November 2026. strokefoundation.org.au/about-stroke/learn/signs-of-stroke
Published by Referral GP. Last updated 6 November 2026. This page is general information only and isn’t a substitute for advice about your own situation. If you or someone else is in danger, call 000.