Cataract guidelines released

The NHS has been discouraged from restricting access to cataract surgery on the basis of visual acuity in new national guidelines

31 Oct 2017 by Selina Powell

New national guidance on the management of cataracts in adults has called for the NHS to stop restricting access to surgery on the basis of visual acuity.

The National Institute for Health and Care Excellence (NICE) recommends that referral decisions should be based on a discussion with the patient and their family about how the cataract affects the person’s vision and quality of life.

Other considerations for cataract surgery referral include whether one or both eyes are affected, the risks and benefits of surgery, whether the patient wants the operation and how the person’s quality of life may be affected if they choose not to have it.

Cataract surgery is the most common operation performed in the UK, with nearly 400,000 operations each year.

Clinical director at the Association of Optometrists, Dr Peter Hampson, told OT he welcomed the patient-centred approach to cataract surgery taken by NICE.

“As eye health professionals working in the community, optometrists know the first-hand experiences of many patients whose lives are negatively impacted by cataracts – limiting their ability to carry out everyday tasks such as driving or even going to the shops,” he highlighted.

“With people living and remaining active for longer, it’s so important that this group can maintain quality of life too,” Dr Hampson added.

He also supports not using visual acuity alone to determine if a patient should have cataract surgery.

“Cataracts can have a much wider impact on someone’s life than can be shown by a simple measure of visual acuity,” Dr Hampson shared.

Royal National Institute of Blind People’s deputy chief executive, Fazilet Hadi, highlighted to OT that many patients have been denied cataract surgery because of an arbitrary threshold imposed by Clinical Commissioning Groups (CCGs).

“This new guidance makes it clear this is not acceptable,” she emphasised.

“We urge CCGs to ensure the guidance is fully implemented and to prioritise eye health services so patients get timely access to treatment, rather than waiting months for sight-saving surgery,” Ms Hadi concluded. 

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