Cataracts and assessment for cataract surgery

Cataracts and assessment for cataract surgery – Adult

Emergency and immediate referrals

Referral to Emergency

Immediately contact on-call registrar to arrange an urgent (within 7 days) ophthalmology assessment for:

Presenting symptoms
Patient requests surgery for documented cataract with either: Significant symptoms that affect the person’s quality of life and / or activities of daily living (ADLs) (e.g. light or glare sensitivity, ability to drive, recognise faces, work or self-care and increased risk of falls) In the absence of significant symptoms, visual acuity 6/12 or worse in the affected eye

Presenting symptoms

Patient requests surgery for documented cataract with either:

Significant symptoms that affect the person’s quality of life and / or activities of daily living (ADLs) (e.g. light or glare sensitivity, ability to drive, recognise faces, work or self-care and increased risk of falls)
In the absence of significant symptoms, visual acuity 6/12 or worse in the affected eye

Mandatory referral information (referral will be returned if this information is not included)
Detailed patient information including: Vision limited activities Duration of symptoms Relevant examinations/investigations; Functional impact of symptoms on daily activities including impact on work, study or carer role State if patient has had previous cataract surgery Statement that the patient has indicated interest in having surgical treatment Most recent optometrist or private ophthalmologist report including: Best corrected visual acuity (BCVA) – vision with most recent distance spectacles Type of cataract Refraction Dilated retinal examination If unable to attach reports please include relevant information/results in the referral Referrer to state reason if not able to include in referral Note: This information is required to triage accurately, within a clinically suitable timeframe

Mandatory referral information (referral will be returned if this information is not included)

Detailed patient information including:
- Vision limited activities
- Duration of symptoms
- Relevant examinations/investigations;
Functional impact of symptoms on daily activities including impact on work, study or carer role
State if patient has had previous cataract surgery
Statement that the patient has indicated interest in having surgical treatment
Most recent optometrist or private ophthalmologist report including:
- Best corrected visual acuity (BCVA) – vision with most recent distance spectacles
- Type of cataract
- Refraction
- Dilated retinal examination
If unable to attach reports please include relevant information/results in the referral
Referrer to state reason if not able to include in referral

Note: This information is required to triage accurately, within a clinically suitable timeframe

Highly desirable referral information
If person is a carer, falls risk or commercial driver with specific visual acuity requirements for employment Assessment of vision-related activity limitations using a validated patient-reported outcome measure (PROM) such as Catquest-9SF

Indicative triage category

Indicative triage category
Cat 1 Appointment within 30 days	Documented cataract with significant impact on activities of daily living (ADL) and BCVA worse than 6/36 in each eye cataract inducing high intraocular pressure (phacomorphic/phacolytic)
Cat 2 Appointment within 90 days	Documented cataract with significant impact on ADL and: BCVA worse than 6/36 in one eye or BCVA worse than 6/12 in each eye
Cat 3 Appointment within 365 days	Documented cataract with significant impact on quality of life +/- ADL and BCVA worse than 6/12 in either eye

Excluded ophthalmology services

Referral to public ophthalmology outpatient services is not routinely accepted for the following conditions:

Condition	Details (where applicable)
Cataract	Patients who do not want surgery will not be accepted No visual acuity criteria Asymptomatic cataract where optical correction is possible

Useful Information for referring practitioners

Please refer to the following HealthPathways: Cataracts
For optometry requests, please refer to the following HealthPathways: Optometry Requests

More information