Purpose: To determine the type and frequency of consultations with the eye department of a major tertiary care teaching hospital. Methods: A retrospective review was undertaken of the medical records of inpatient consultations within the Ophthalmology Department of Royal Prince Alfred Hospital over the period from 1 July 1995 to 30 June 1997. The consults were divided into six types of consultation. A determination was made of the outcome and effect on patient management of each consultation. Results: There were 506 consultations over the 2-year period. For 389 patients a full ophthalmic assessment was requested and 175 of them (45%) had an ophthalmological diagnosis made or had change in management as a result of the consultation. Conclusion: Ophthalmological consultation is a valuable inpatient consultation service that makes a significant difference in the management of patients from other medical and surgical units within the hospital.