Cataracts and assessment for cataract surgery Referral Access Criteria

Referrers should use this page when referring patients to public adult ophthalmology outpatient services for cataracts, and assessment for cataract surgery.
Emergency referral
If any of the following are present or suspected, refer the patient to the emergency department or seek emergency medical advice if in a remote region.
  • Nil
Immediate referral
Orange exclamation mark in triangle: orange alertImmediately contact on-call registrar or service to arrange immediate ophthalmology assessment (seen within 7 days):
  • Nil
To contact the relevant service, see HealthPathways: Acute Ophthalmology Assessment (external site)
Presenting issues
If any of these issues are present, refer to outpatient services through the Central Referral Service (CRS).
  • 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 information
Referrals missing 'mandatory information' with no explanation provided may not be accepted by site. If 'mandatory information' is not included, the explanation must be provided in the body of the referral (e.g. patient unable to access test due to financial reasons or geographical location).

This information is required to inform accurate and timely triage. If unable to attach reports, please include relevant information/findings in the body of the referral and advise where (provider) investigation/imaging was completed.

History
  • Functional impact of symptoms on daily activities (e.g. vision limited activities, impact on work, study or carer role)
Examination
  • Nil
Investigations
  • Best corrected visual acuity (BCVA) - vision with most recent distance spectacles 
Highly desirable
History
  • Statement that the patient is willing to undergo surgery
  • State if patient has had previous cataract surgery
  • 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
Examination
  • Nil
Investigations
  • Most recent optometrist or private ophthalmologist report including:
    • Type of cataract
    • Refraction
    • Dilated retinal examination
Indicative triage category

Category 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) 

Category 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           

Category 3

Appointment within 365 days

  • Documented cataract with significant impact on quality of life +/- ADL and BCVA worse than 6/12 in either eye 
Exclusions
  • Nil
Useful information