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The patient may complain of a drop in visual acuity, reduction in colour contrast, or general blurring/haziness of their vision in one or both eyes.
When patient has significant symptoms as result of cataract/s and Cataract Assessment Questionnaire (CAQ) has been completed , complete direct referral to either GHFT service, Newmedica, Care UK Service or Tetbury Hospital.
If unsure of diagnosis direct patient to Community Optometrist for further assessment with a referral letter.
Cataract surgery is restricted as part of the CCG's policy in relation to Individual Funding Requests. Please see the full policy for further information.
Should examination reveal a condition other than cataract is responsible for the patients symptoms, they will be re-directed to the appropriate pathway by the community Optometrist.
When the patient is assessed by the ophthalmologist at the hospital following referral, in consultation with the patient, a decision may be taken with regard to the care pathway and in many cases whether surgery will be offered for one or both eyes. The following criteria will be used in reaching a decision: where operating on the first eye would create anisometropia of 2 dioptres or more, surgery will be offered for both eyes, but where patients are keen to have only one eye operated then one eye will be offered and the post-operative result matched to the unoperated eye.
It is recognised that the referring Optometrist/GP may have examined the patient on a number of occasions prior to referral. It will be possible for the Optometrist/GP, having discussed the options available with the patient, to express an opinion as to the preferred refractive outcome post operatively and to give reasons for this opinion. This will be taken into account when the patient is examined by the ophthalmologist in the hospital.
Post-operative follow up
Patients who have received cataract surgery on their First Eye or have complicated surgery or Significant co-morbidities, will have their follow up appointment at the Hospital.
Patients who have second eye cataract surgery, without complication or co-morbidities will receive their follow appointment at a registered community optometrist.
Community Optometrists will now conduct the post-operative examination and refraction for patients having had uncomplicated cataract surgery on their second eye with no significant co-morbidities. This will provide care closer to home for the patient- they will no longer be routinely reviewed at the hospital.
Patients eligible for this community service will have had uncomplicated surgery on the first and second eyes and be low risk.
During the discharge procedure the nurse practitioner arranges the post-op examination appointment at a community optical practice of the patient's choosing for 4 weeks post operatively.