Public eye care from GP referral to ophthalmologist (oftalmólogo)

Key rules

• Referral: You need a GP referral to see a public ophthalmologist, except in emergencies, which go straight to hospital urgencias.
• Glasses: Adults pay for glasses and contact lenses themselves.
• Waits: Waits vary widely by region, so check your own regional health service's waiting-list page.
• Opticians: An optician cannot refer you into the public system.

The route: GP first, then the ophthalmologist

In the public system you start with your GP (médico de familia) at your centro de salud. You book an appointment, explain the problem and ask for a referral to an ophthalmologist (oftalmólogo). The GP then sends you to a hospital or specialist centre. Emergencies are the exception: take them straight to hospital urgencias.

Opticians in shops cannot refer you into public ophthalmology. No national scheme lets an optometrist send you directly. Some regions run pilot or protocol-based programmes, such as diabetic retinopathy screening in primary care. Ask your GP whether your region has one for your problem.

Private care needs no referral. The page on choosing who to see first helps you decide between the routes.

What the public system covers

The public system covers diagnosis and treatment of eye disease by specialists. That includes:

• cataract surgery with a standard monofocal lens
• glaucoma
• retinal disease, including diabetic retinopathy screening and treatment
• retinal detachment
• strabismus and children's eye care
• corneal conditions, including transplants
• injections into the eye for conditions such as wet macular degeneration

Premium lenses, laser surgery for short-sightedness and purely cosmetic procedures are generally not covered. Some regions add services beyond this common list, so ask your regional health service.

Glasses and contact lenses

Adults pay in full for glasses and contact lenses. Some regions give limited help for children or for specific conditions, such as keratoconus, aphakia or high-grade refractive errors. Ask your regional health service what exists where you live.

How long you will wait

Waits depend heavily on your region and hospital. Ophthalmology is one of the longer specialties.

• First consultation: the national average has been roughly 2 to 3 months in recent years. Regions range from a few weeks to over six months.
• Cataract surgery: the national average has been roughly 3 to 4 months. Some regions are under 2 months and others well over 6.

These are averages. Urgent or suspected serious cases are seen faster. Some regions guarantee a maximum wait for cataract surgery, often 180 days, and may offer a private centre if it is exceeded. Ask the hospital or your GP whether your region does this.

Finding times for your region

Spain has 17 regional health services, each with its own website. Most have a waiting-list page showing times by hospital. The Ministry of Health (Sanidad) publishes national figures under listas de espera, updated about twice a year. Search for your region's name plus "listas de espera". For help with glasses, add "prestación ortoprotésica".

The timeline, checklist and questions below walk you through each step.

Optician, GP or ophthalmologist: who to see for which eye problem

Who should you see first for your eye problem?

• Hospital urgencias or 112: Go the same day for sudden loss of vision, sudden flashes of light, a shower of new floaters or a curtain across your vision. Also go for severe eye pain with redness, nausea or halos, chemical splashes (rinse with water at once), eye injuries, a foreign body you cannot remove, sudden double vision, a painful red eye with contact lenses, a newborn's red or swollen eye, or sudden eyelid swelling with fever or pain when you move the eye.

• Optician-optometrist: Choose this for blurred vision, a routine sight test or new glasses. The optician will send you to an ophthalmologist or GP if they see signs of eye disease, or of general health problems such as diabetes or high blood pressure.

• GP (médico de familia): Choose this for a mildly red or irritated eye, discharge or a stye, or for a disease or referral in the public system. A child's squint or suspected lazy eye goes to the paediatrician, who refers on. The GP's referral is how you reach a public ophthalmologist.

• Private ophthalmologist (oftalmólogo): Choose this if you have private cover and want to go straight to a specialist for an eye disease, or for a mild eye problem. Keep your scheduled reviews if you have diabetes or glaucoma.

If the problem is sudden or severe, go to urgencias today. If it is gradual or mild, start with the optician or your GP.

Timeline and deadlines

• Get a referral from your GP at the centro de salud: first step, before any public ophthalmology appointment

• Have cataract surgery if the ophthalmologist recommends it: roughly 3 to 4 months on average after being placed on the list; under 2 months to well over 6 months depending on the region

• Ask about a private centre if your region guarantees a maximum wait and it is exceeded: after the guaranteed time passes, often 180 days

Checklist

• Check your regional health service's waiting-list page for first-consultation times at your hospital.

• Ask the hospital or your GP what the guaranteed maximum wait is for cataract surgery in your region.

• Budget for glasses and contact lenses yourself, as the public system does not pay for them for adults.

• Ask your regional health service whether any aid exists for children or for conditions such as keratoconus.

Frequently asked questions

How long is the wait for a first ophthalmology appointment in the public system?

The national average wait for a first ophthalmology consultation is roughly 2 to 3 months, and some regions are well above 100 days. Differences between regions are large, from a few weeks to over six months.

How long is the wait for cataract surgery in the public system?

The national average wait for public cataract surgery is roughly 3 to 4 months, from under 2 months in some regions to well over 6 months in others.

Does the public system pay for adults' glasses or contact lenses?

No, adults pay in full for glasses and contact lenses, because they are not part of the public catalogue.