Optometrists frequently encounter pathology that requires ophthalmological referral. Timely and appropriate referral to the hospital eye service improves patient care and enhances the relationship between all eye care heath professionals. This lecture reviews the common ophthalmic conditions seen by optometrists and how they should be managed or referred to an ophthalmologist in an appropriate time frame. The conditions covered include, eyelid lumps and bumps, cataract, glaucoma, red eye, vascular conditions and pigmented retinal lesions.