Uploading images & documents

OPERA enables you to upload images of various types to your referrals, be they to HES or other OPERA providers.  This process occurs during the referral process once the red referral tab has been clicked.  

Once images are uploaded they are sent to our PACS platform that enables them to be viewed in hospital systems as well as shared widely across the various providers in England.

In this example we have included OCT images (see file types below) a PDF and various image formats.  In order to proceed, for each image you need to indicate when it was taken using the calendar function, and also which eye it represents - if any.

File Types

The system takes a wide variety file types:

  • JPEG or JPG
  • DCM or DICOM images (commonly exported from OCT machines)
  • MP4 - video files from slit lamps and similar
  • WMV - a video format that can be used to present OCT files
  • PDF - for visual fields, or letters or other documents
  • BMP - standard Windows image format
  • TIFF or TIF files - larger image types

If there is a file type that you use that is not included, please let us know.

Ensure correct images

It is very important that you ensure that the correct images are uploaded to the system for the patient that you are referring.  If you make a mistake and submit incorrect images for a patient, you should contact the OPERA HelpDesk for these to be deleted and the referral returned to you.

Once you have clicked a submit button the referral becomes locked and cannot be edited from your dashboard. If you have made a mistake and need to amend the information, you need to contact the OPERA HelpDesk to request for it to be rejected back to you. The OPERA team cannot edit the forms for you as they are locked medico-legal documents.

Adding the URN to images

Some hospitals require the URN (OPR) number to be added to images to improve traceability.  The URN should be placed in a non-diagnostic area.  If your area requires this your CGPL will let you know and for which images it is required,

Notes on Password Protected Documents

Please do not upload PDFs, Word documents etc with password protection enabled.  We are unable to merge these documents and hence there is a risk that they may not be included, or the receiving organisation cannot open them.  Referrals with password protected documents will be rejected.

Notes on Image Quality

Depending on the nature of the referral and the area you work in, your referral may require an image to be uploaded. Where clinical triage systems are in place, our triagers will normally reject images that are not appropriate and hence this will delay your patient’s referral.

Compression and cropping

It should not be necessary to compress any images before uploading.  Compression can impact on the diagnostic quality of images and hence your should upload the original image.  Images should also not be cropped as this may also remove diagnostically valuable information.  A full and true representation of the image should be provided.

No images

This is the most common reason for the rejection of a referral. Please ensure that you have read the referral guidance notes to see if an image is required and of what type. If you cannot provide an image please provide sufficient justification for this. An example of a service that requires certain types of image is the MREH rapid macula assessment service that requires a full OCT upload.

Non diagnostic quality

Another common reason to reject a referral is for non diagnostic value of the images supplied. Please ensure that the image is of the highest quality and has not been compressed, cropped or otherwise adjusted prior to upload.  Please also ensure that dates and laterality are correctly recorded.

Wrong image type

The most frequent reason for this rejection is the provision of single slice rather than multi slice OCT images.  Please consider uploading your multi-slice images whenever possible either in DCM or MP4 format.

Other materials

Other documents may be uploaded to the system – such as letters or reports – please ensure that these are scanned at high quality and are orientated correctly. PDF is the best format for these attachments as TIFF files tend to be very large and may exceed the maximum permitted 

In some cases a perfect image may not be obtainable - for example in PWLD services.  Please use the free text boxes to explain if this is the case.