Cataract Surgery

Referral Criteria

This policy applies to cataract surgery in adults.

Before a referral is made, the referrer must confirm that:

• The patient understands that the purpose of referral is for assessment for surgery
• The patient wishes to have surgery if it is offered
• The patient meets the criteria for cataract surgery

Cataract surgery will be routinely commissioned only in the following circumstances:

There is sufficient cataract in the eye proposed for surgery to account for the patient's visual symptoms and one or more of the following criteria apply:

• Best corrected visual acuity of 6/12 or worse in the affected eye AND the patient experiences one or more of the following due to subjective loss of visual performance:
  • Difficulty in accomplishing everyday tasks.
  • Reduced mobility, visual problems when driving or experiencing difficulty with steps or uneven ground.
  • Ability to work, act as a carer or live independently is affected.
• Patients who experience disabling problems with glare and a reduction in acuity in daylight or bright conditions or reduced contrast sensitivity.
• The patient has a best corrected visual acuity of better than 6/12 in the affected eye but they are working in an occupation in which visual acuity better than 6/12 is essential to their ability to continue to work.
• Where there is anisometropia following cataract surgery with a refractive difference between the two eyes of at least +/- 2.0 dioptres resulting in poor binocular vision or diplopia.
• Patients with rapidly progressive myopia.

Cataract surgery is also routinely commissioned under the following circumstances:

• Patients with glaucoma who require cataract surgery to control intra-ocular pressure.
• Patients with glaucoma who have undergone a trabeculectomy.
• Patients who have undergone a vitrectomy.
• Patients with diabetes in whom removal of the cataract is necessary to facilitate effective screening for diabetic retinopathy.

Referral Instructions

Where the circumstances of treatment for an individual patient do not meet the criteria described above exceptional funding can be sought. Individual cases will be reviewed by the appropriate panel of NHS Devon upon receipt of a completed application from the patient's GP, consultant or clinician. Applications cannot be considered from patients personally.

Applications for consideration for funding approval should be sent to:

Email:d-icb.ifr-newsdt@nhs.net

Patient Information

Individual Funding Request (IFR) Patient information leaflet

Date of publication: 19 October 2015

This policy has been adopted from Northern, Eastern and Western Devon CCG

and South Devon and Torbay CCG by NHS Devon CCG from 1 April 2019