Reviewed on : 9 Oct 2023

Reviewed by : Lucy Dyde, IFR Team Manager CW ICB

Expires : 9 Oct 2025

Interim Referral Advice from February until 1 April 2024

Ophthalmology referrals will not be triaged or processed by the Referral Support Service during February and March

Referrals should be made DIRECTLY to the provider during this period

Referral queries should be directed to Advice & Guidance

Referral Criteria for Cataract Surgery

Base the decision to refer a person for cataract surgery on a discussion with them (and their family or carers, as appropriate) that includes:

• How the cataract affects their vision and quality of life
• Whether one or both eyes are affected
• What surgery involves, including the risks and benefits (This is discussed in a patient information leaflet Understanding Cataracts produced jointly by the Royal College of Ophthalmologists and Royal National Institute of Blind People. Further information on shared decision making is also provided in the NHS England Decision support tool)
• How their quality of life may be affected if they choose not to have surgery
• Whether they want to have surgery

Do not restrict access to cataract surgery on the basis of visual acuity

Eligibility Criteria

Cataract surgery will be commissioned for patients who are experiencing difficulties with vision and or quality of life due to the presence of a cataract

Referrals for cataract surgery should not be based simply on the presence of a cataract.

Cataract surgery will not be commissioned solely for the purpose of correcting longstanding pre-existing myopia and hypermetropia

Cataract surgery will be supported where there is binocular disparity/imbalance (anisometropia).

Treatment will also be commissioned for the second eye where not treating would have a significant effect on the patient’s vision

Cataract surgery will also be funded in situations where it is indicated for screening or management of other ocular co-morbidities e.g., for control of glaucoma, or for adequate view of diabetic retinopathy

Visual acuity should be included in the referral as there is a higher risk of worse visual acuity after surgery where preoperatively it was very good e.g., 6/6 or better. It should only then be considered if the patient is experiencing significant symptoms attributable to the cataract