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Purpose  Diseases involving the macula and posterior pole are leading causes of visual impairment and blindness worldwide and may require prompt ophthalmological care. However, access to eye‐care and timely patient management may be limited due to inefficient and inappropriate referrals between primary eye‐care providers and ophthalmology. Optometrists with a special interest in macular disease may be useful as a community aid to better stratify and recommend best‐practice management plans for suitable patients. This study assesses such a notion by appraising the optometric referral patterns of patients with suspected macular disease to an intermediate‐tier optometric imaging clinic.    Methods  We performed a retrospective review of patient records and referrals using patients examined at Centre for Eye Health ( CFEH ) for an initial or follow up macular assessment between the 1/7/2013 and 30/6/2014 ( n  = 291). The following data were analysed: patient demographic characteristics, primary reason for referral, diagnosed/suspected condition,  CFEH  diagnosis and recommended management plan.    Results  The number of referrals stipulating a diagnosis, confirmed after evaluation at  CFEH  was 121 of 291 (42%). After evaluation at  CFEH , the number of cases without a specific diagnosis was approximately halved (reduced from 47% to 23%), while the number of cases with no apparent defect or normal aging changes rose from 1% to 15%. Overall diagnostic congruency for specified macular conditions was high (58–94%); cases were seldom (30/291, 10%) found to have a completely different macular condition. 244 of 291 (84%) patients seen at  CFEH  were recommended ongoing optometric care: either with the referring optometrist or through recall to  CFEH . Referral to an ophthalmologist was recommended in 47 instances (16%).    Conclusions  More widespread adoption of intermediate‐tier optometric eye‐care referral pathways in macular disease (following opportunistic primary care screening) has the potential to reduce the number of cases with non‐specific diagnoses and to increase those with a diagnosis of normal aging changes or no apparent disease. The majority of cases seen under this intermediate‐tier model required ongoing optometric care only and did not require face‐to‐face consultation with an ophthalmologist.

Collaborative care of non‐urgent macular disease: a study of inter‐optometric referrals